Researchers at the College of Veterinary Medicine at Cornell University in Ithaca, New York have reported the effective treatment with an autolgous adult stem cell therapy of tendonitis in horses.
Led by Dr. Alan J. Nixon, the study was not so much a "clinical trial" in the ordinary sense of the term, but was perhaps more correctly an "experimental study", since the researchers sacrificed the horses at the end of the evaluation period in order to conduct thorough histological and mechanical analysis of the tendons.
In the study, the researchers artificially induced tendonitis in the superficial digital flexor tendons (SDFT) of both forelimbs of an undisclosed number of horses. Six days later, autologous mesenchymal stem cells (MSCs) were then derived from the bone marrow of each horse, expanded and injected into one of the SDFT lesions, while the other untreated, "control" limb received an injection of 1 milliliter of saline. The MSCs were also gene-enhanced with IGF-1 (insulin-like growth factor 1), which has been demonstrated to stimulate cellular proliferation and tendon fiber deposition in the core lesion of tendonitis. Ultrasound examination of the tendons was performed at the start of the trial as well as at 2, 4, 6 and 8 weeks after administration of the therapy. According to an online abstract, "the horses were euthanized at 8 weeks and SDFTs were mechanically tested to failure and evaluated for biochemical composition and histologic characteristics."
As Dr. Nixon explains, "The biochemical composition of the treated and untreated tendons were similar 8 weeks after treatment. However, tendons injected with the stem cells had significantly improved histology scores, indicating a more normal microscopic appearance in treated tendons than untreated tendons. Nonetheless, more research is needed regarding the optimal dose of stem cells and the use of gene enhancement techniques to augment the observed benefit before making this technology clinically available."
The researchers conclude, "These findings indicate a benefit to the use of MSCs and AdIGF-MSCs for the treatment of tendonitis."
The results of the trial will be published in an upcoming edition of the Journal of Orthopedic Research in an article entitled, "Mesenchymal stem cells and insulin-like growth factor-1 gene-enhanced mesenchymal stem cells improve structural aspects of healing in equine flexor digitorum superficialis tendons."
Tendon injuries are often catastrophic and fatal in horses, while even minor tendon injuries can end the career of a race horse. According to Dr. Nixon, "At present, few successful treatment options exist for horses with tendon injuries. While stem cell therapy has become a hot topic in equine medicine, there are few controlled studies clearly documenting the safety or efficacy of this treatment modality for tendonitis in horses."
If killing the horse is a requirement for conducting a "controlled" study, then most people would probably conclude it’s a good thing that there aren’t many controlled studies that have been conducted.
In fact, a number of companies throughout the world are already treating horses, as well as other animals, with autolgous adult stem cell therapies, and not only do the animals improve as a result of the therapy but the animals are also allowed to continue living and enjoy the remainder of their lives. Perhaps the most renowned of these companies is the U.S.-based Vet-Stem, which has treated over 3,000 horses and 2,000 dogs with autologous adult stem cell therapy for a variety of joint injuries and degenerative conditions that include tendonitis as well as ligament injuries and age-related osteoarthritis. None of the animals treated by Vet-Stem’s autolgous adult stem cell therapy ever had to be euthanized, but instead were allowed to live out their natural lives.
Additrionally, in September of 2007 Vet-Stem licensed their proprietary adult stem cell technology to the Central Veterinary Research Laboratory (CVRL) of Dubai in the United Arab Emirates, thereby allowing the CVRL to offer the same adipose-derived adult stem cell animal therapies throughout the Middle East. Sheik Mohammed bin Rashid al-Maktoum, the ruler of Dubai and the Prime Minister of the UAE, is an avid thoroughbred owner and a sponsor of the Dubai World Cup, the world’s most highly-prized horse race. As Vet-Stem founding CEO Dr. Harman described in 2007, "The Central Veterinary Research Laboratory will be an excellent partner in bringing this technology from the U.S. to the Middle East as they are already the most respected reference lab in the region." CVRL now provides stem cell services for the treatment of injuries not only in thoroughbred race horses and Arabian endurance horses, but also in racing camels, among other species, throughout the Middle East.
It is actually incorrect, therefore, to claim that "there are few controlled studies clearly documenting the safety or efficacy of this treatment modality for tendonitis in horses", since more than 3,000 case studies have been documented by Vet-Stem alone, not counting the other case studies conducted around the world by other companies that are performing similar therapies in other countries. It is also incorrect to claim that "more research is needed regarding the optimal dose of stem cells and the use of gene enhancement techniques to augment the observed benefit before making this technology clinically available", since, actually, such technology is, in fact, already clinicallly available.
Given the consistent success of such therapies as those used by Vet-Stem, one might seriously question the wisdom and necessity of conducting "controlled studies" in which the horses must be killed at the end of the study in order to determine the efficacy of the medical therapy. Horses are not generally bred and maintained in the same manner as laboratory mice, although in this Cornell study, one might easily get the impression that the two animals are interchangeable.
Ordinarily, veterinarians, like all physicians, measure the efficacy of a therapy by the ability of the patient to recover – not by killing the patient in order to examine the mechanical, biochemical and histological properties of the tissue that was treated. Such an approach to medical therapy would be considered entirely unacceptable in humans, and even in horses the concept seems to lack basic horse sense.
