Comparison of autologous bone marrow and adipose tissue derived mesenchymal stem cells, and platelet rich plasma, for treating surgically induced lesions of the equine superficial digital flexor tendon.
Authors: Romero A, Barrachina L, Ranera B, Remacha A R, Moreno B, de Blas I, Sanz A, Vázquez F J, Vitoria A, Junquera C, Zaragoza P, Rodellar C
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Stem Cell and PRP Treatments for Equine Tendon Injuries Satisfactory long-term outcomes in equine tendinopathy remain elusive despite decades of investigation, prompting ongoing research into the mechanisms underpinning regenerative therapies. Researchers surgically induced lesions in the superficial digital flexor tendons of 12 horses and compared three interventions—bone marrow-derived mesenchymal stem cells (BM-MSCs), adipose tissue-derived mesenchymal stem cells (AT-MSCs), and platelet-rich plasma (PRP)—against a control saline group, using serial ultrasound imaging, histopathological analysis, and gene expression profiling over 45 weeks. All three treatments demonstrated superior healing compared to controls, with BM-MSCs showing the earliest sonographic improvement at week 6 and evidence of enhanced tissue quality through upregulation of collagen type I, decorin, tenascin, and matrix metalloproteinase III. Whilst the clinical differences between treatments remained modest, BM-MSCs consistently outperformed both PRP and AT-MSCs across multiple assessment parameters, suggesting stem cell source matters more than the choice between cells and growth factors alone. These findings support a regenerative rather than merely anti-inflammatory approach to tendon injury, though practitioners should recognise that all three modalities substantially improved healing relative to untreated lesions—a consideration when balancing efficacy against the practical and financial demands of bone marrow harvesting versus more accessible alternatives.
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Practical Takeaways
- •Bone marrow-derived stem cell therapy appears more effective than adipose tissue-derived MSCs or PRP alone for treating SDFT lesions, though all three treatments outperformed untreated controls.
- •Treatment effects become apparent by 6-10 weeks post-injection, with improvements sustained to at least 45 weeks, supporting clinical use in rehabilitation protocols.
- •Consider offering autologous BM-MSC therapy as a primary regenerative option for SDFT injuries when available, though any regenerative treatment is preferable to conservative management alone.
Key Findings
- •Bone marrow-derived MSCs showed earlier ultrasound improvement at week 6 compared to other treatments.
- •All three treatments (BM-MSCs, AT-MSCs, PRP) were superior to control by week 10 and maintained advantage through 45 weeks.
- •BM-MSCs demonstrated superior gene expression profiles with increased collagen type I, decorin, tenascin and MMP III mRNA compared to AT-MSCs and PRP.
- •Histological collagen orientation scores favored all treated tendons over control, with BM-MSCs showing the best overall outcome.