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McCarrel TM. Equine Platelet-Rich Plasma. Vet Clin North Am Equine Pract 2023; 39:429-442. [PMID: 37550126 DOI: 10.1016/j.cveq.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Platelet-rich plasma (PRP) is an orthobiologic therapy composed of platelets, leukocytes, red blood cells, and plasma proteins. PRP has been used for 20 years, but progress determining efficacy has been slow. The definitions and classification of PRP are reviewed, and the use of PRP for tendon, ligament, and joint disease is discussed with a focus on findings of basic science and clinical studies, platelet activation, concurrent administration of nonsteroidal anti-inflammatory drugs, and treatment complications. Finally, the advantages of platelet lysates and freeze-dried platelets are discussed. The promising results of a PRP lysate optimized for antibiofilm and antimicrobial properties are introduced.
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Affiliation(s)
- Taralyn M McCarrel
- Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
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Troha K, Vozel D, Arko M, Bedina Zavec A, Dolinar D, Hočevar M, Jan Z, Kisovec M, Kocjančič B, Pađen L, Pajnič M, Penič S, Romolo A, Repar N, Spasovski V, Steiner N, Šuštar V, Iglič A, Drobne D, Kogej K, Battelino S, Kralj-Iglič V. Autologous Platelet and Extracellular Vesicle-Rich Plasma as Therapeutic Fluid: A Review. Int J Mol Sci 2023; 24:3420. [PMID: 36834843 PMCID: PMC9959846 DOI: 10.3390/ijms24043420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
The preparation of autologous platelet and extracellular vesicle-rich plasma (PVRP) has been explored in many medical fields with the aim to benefit from its healing potential. In parallel, efforts are being invested to understand the function and dynamics of PVRP that is complex in its composition and interactions. Some clinical evidence reveals beneficial effects of PVRP, while some report that there were no effects. To optimize the preparation methods, functions and mechanisms of PVRP, its constituents should be better understood. With the intention to promote further studies of autologous therapeutic PVRP, we performed a review on some topics regarding PVRP composition, harvesting, assessment and preservation, and also on clinical experience following PVRP application in humans and animals. Besides the acknowledged actions of platelets, leukocytes and different molecules, we focus on extracellular vesicles that were found abundant in PVRP.
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Affiliation(s)
- Kaja Troha
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Domen Vozel
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Matevž Arko
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Apolonija Bedina Zavec
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, SI-1000 Ljubjana, Slovenia
| | - Drago Dolinar
- Department of Orthopedic Surgery, University Medical Centre, Zaloška 9, SI-1000 Ljubljana, Slovenia
- MD-RI Institute for Materials Research in Medicine, Bohoričeva 5, SI-1000 Ljubljana, Slovenia
| | - Matej Hočevar
- Department of Physics and Chemistry of Materials, Institute of Metals and Technology, SI-1000 Ljubljana, Slovenia
| | - Zala Jan
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Matic Kisovec
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, SI-1000 Ljubjana, Slovenia
| | - Boštjan Kocjančič
- Department of Orthopedic Surgery, University Medical Centre, Zaloška 9, SI-1000 Ljubljana, Slovenia
| | - Ljubiša Pađen
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Manca Pajnič
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Samo Penič
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
| | - Anna Romolo
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
| | - Neža Repar
- University of Ljubljana, Research Group for Nanobiology and Nanotoxicology, Biotechnical Faculty, SI-1000 Ljubljana, Slovenia
| | - Vesna Spasovski
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia
| | - Nejc Steiner
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Vid Šuštar
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Aleš Iglič
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Damjana Drobne
- University of Ljubljana, Research Group for Nanobiology and Nanotoxicology, Biotechnical Faculty, SI-1000 Ljubljana, Slovenia
| | - Ksenija Kogej
- University of Ljubljana, Chair of Physical Chemistry, Faculty of Chemistry and Chemical Technology, SI-1000 Ljubljana, Slovenia
| | - Saba Battelino
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Veronika Kralj-Iglič
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
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Duddy HR, Schoonover MJ, Hague BA. Outcome following local injection of a liquid amnion allograft for treatment of equine tendonitis or desmitis – 100 cases. BMC Vet Res 2022; 18:391. [PMID: 36345002 PMCID: PMC9639279 DOI: 10.1186/s12917-022-03480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Tendon and ligament injuries are significant causes of loss of use and early retirement in performance horses. Amniotic fluid and tissue are excellent sources of growth factors and cytokines important in tendon and ligament healing. Thus, an equine-origin liquid amnion allograft (ELAA) may be beneficial in the treatment of equine tendonitis and desmitis. Objectives of this study were to report the outcome achieved (i.e. ability to return to work) for horses diagnosed with tendonitis or desmitis lesions treated with local injection of ELAA and to compare these outcomes to those reported for other regenerative medicine modalities. Methods A prospective, multi-center, non-blinded clinical trial was conducted. Equine veterinarians at 14 sites were selected to participate in the data collection for the trial. Criterion for inclusion was a horse presenting with lameness which was attributed to tendonitis or desmitis by diagnostic anesthesia and/or imaging. These horses were subsequently treated by local injection of the lesion with ELAA by the attending veterinarian. Standardized questionnaires describing each horse’s signalment, discipline, ability to return to work, and any adverse events were completed and submitted by the attending veterinarian following a minimum of six months of follow-up. The current literature was reviewed to identify clinical studies reporting outcomes of equine tendonitis/desmitis lesions treated with other regenerative therapies. Contingency table analyses were performed comparing outcomes. Results Questionnaires for 100 horses with 128 tendonitis and desmitis lesions met the inclusion criteria. Of these, 72 horses with 94 lesions returned to or exceeded their original level of work, 10 horses with 13 lesions returned to work but could not perform to previous standards, and 18 horses with 20 lesions did not return to work as a result of the injury. No differences were observed when outcome of horses treated with ELAA were compared to those of similar studies using other regenerative therapies. Conclusions Treatment of tendonitis and desmitis lesions by local injection of ELAA resulted in similar outcomes for horses returning to previous level of performance as other regenerative modalities such as mesenchymal stem cells, platelet-rich plasma, and autologous conditioned serum; however, blinded placebo-controlled studies are indicated. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-022-03480-5.
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Knott LE, Fonseca-Martinez BA, O'Connor AM, Goodrich LR, McIlwraith CW, Colbath AC. Current use of biologic therapies for musculoskeletal disease: A survey of board-certified equine specialists. Vet Surg 2022; 51:557-567. [PMID: 35383972 PMCID: PMC9322007 DOI: 10.1111/vsu.13805] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/05/2022] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
Objective To evaluate the use of mesenchymal stem cells (MSCs), autologous conditioned serum (ACS), platelet‐rich plasma (PRP), and autologous protein solution (APS) for the treatment of equine musculoskeletal disease by diplomates of the American College of Veterinary Surgery (ACVS), and American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR). Study design Cross‐sectional study. Sample population Diplomates (n = 423). Methods An email link was sent to ACVS and ACVMR diplomates. A survey contained 59 questions regarding demographics, as well as indications, frequency, adverse effects, and limitations of use. Responses were analyzed using Fisher's exact test. Results One hundred and fifty four surveys were analyzed. Years in practice and type of practice were not associated with biologic therapy use. PRP was the most used therapy (120/137; 87.5%). PRP and MSCs were most often administered intralesionally while ACS and APS were most often administered intra‐articularly. ACS (50/104; 48.1%) treatment was repeated commonly within 2 weeks of initial injection. MSCs (39/90; 43.3%) and PRP (38/100; 38%) were commonly repeated 1‐2 months after initial injection and APS was typically repeated >4 months after initial injection (21/53; 39.6%). Local inflammation and expense were the most common adverse effect and limitation of use. Conclusion Diplomates most commonly utilized PRP and MSC intralesionally for soft‐tissue injuries, and ACS and ACP intra‐articularly for joint injury. Protocols for repeated administration varied widely. Local inflammation was a clinical concern with the use of biologics. Clinical significance Biologic therapies are used commonly by ACVS and ACVSMR diplomates for soft tissue and joint disease.
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Affiliation(s)
- Lindsay E Knott
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - B Alexander Fonseca-Martinez
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Annette M O'Connor
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Laurie R Goodrich
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - C Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - Aimee C Colbath
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
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Fukuda K, Kuroda T, Tamura N, Mita H, Miyata H, Kasashima Y. Platelet lysate enhances equine skeletal muscle regeneration in a bupivacaine-induced muscle injury model. J Equine Vet Sci 2022; 112:103892. [DOI: 10.1016/j.jevs.2022.103892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
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Tomlinson F, Terschuur J, Henson F. Use of autologous products for the treatment of joint and soft tissue disease in horses: A systematic review. Vet Rec 2021; 188:e9. [PMID: 34651853 DOI: 10.1002/vetr.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/27/2020] [Accepted: 10/27/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Soft tissue injuries and joint disease are the predominate causes of lameness in the equine athlete and these pathologies carry a guarded prognosis for a return to previous performance. Recently the use of autologous products has become more widespread as a treatment in equine sports medicine. However, the efficacy of these products is yet to be fully established. OBJECTIVE To evaluate the current published evidence base regarding the efficacy of autologous products in soft tissue injuries and joint disease. METHODS A systematic review of English articles using MEDLINE, EMBASE and Web of Science databases from 1980 to 2017. The search strategy identified 1594 papers for review. RESULTS Fifty-eight papers were included in this review, 28 of which were randomised controlled trials. Significant benefit was reported under several parameters, most notably in the use of autologous chondrocytes in artificially induced cartilage defects on histology. One paper documented a significant clinical response under lameness examination. CONCLUSION The current literature shows that the treatment of soft tissue injury and cartilage disease with autologous products is safe and that the use of some products can give significant benefit on some outcome measures. True clinical significance is yet to be demonstrated with any product.
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Affiliation(s)
| | - Janine Terschuur
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Frances Henson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Fantini P, Jiménez R, Vilés K, Iborra A, Palhares MS, Catalán J, Prades M, Miró J. Simple Tube Centrifugation Method for Platelet-Rich Plasma (PRP) Preparation in Catalonian Donkeys as a Treatment of Endometritis-Endometrosis. Animals (Basel) 2021; 11:ani11102918. [PMID: 34679937 PMCID: PMC8532663 DOI: 10.3390/ani11102918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/25/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Platelet-rich plasma (PRP) is used to improve the regenerative capacity of damaged tissues in different species. In equine medicine, PRP is commonly used to treat joint diseases, tendinitis, ligamentous lesions, and persistent endometritis. Jenny endometrium shows a high sensitivity to endometritis. There are important differences between donkey and horse blood characteristics. Several protocols to obtain horse PRP have been reported, but no protocols have yet been reported for obtaining donkey PRP. Our study shows that single-spin tube centrifugation at 133× g for 10 min is appropriate to obtain donkey PRP with therapeutic potential in jenny endometritis-endometriosis. Abstract The aim of this study was to standardize a simple, manual platelet-rich plasma (PRP) protocol in Catalonian donkeys using single-spin tube centrifugation as a treatment for jenny endometritis. The objective was to obtain a blood product with a moderate concentration of platelets (2 or 3 times baseline physiologic values) and a low WBC (White Blood Cells) concentration. Blood was drawn from six Catalonian donkeys using acid citrate dextrose (ACD) as an anticoagulant, and then processed by single centrifugation at 133× g for two different centrifugation times (10 and 15 min). The PRP samples were evaluated by flow cytometry, and TGF-β1 (Transforming Growth Factor-Beta1) concentrations were determined by enzyme-linked immunosorbent assay (ELISA). The 10 min centrifugation protocol resulted in a slightly greater release of TGF-β1 (6044.79 ng/mL), a 2.06-fold increase in platelet concentration, and a 15-fold reduction in leukocyte concentration when compared to the initial values. The 15 min centrifugation time resulted in a 2.44-fold increase in baseline platelet concentration, a reduction in WBC count by a factor of 20, and slightly lower TGF levels (5206 ng/mL). We conclude that both protocols are adequate for the obtention of PRP, and both may have an acceptable therapeutic potential for use in this species, although this needs to be further validated.
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Affiliation(s)
- Priscila Fantini
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
- Departmento de Clínica e Cirurgia Veterinárias, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
| | - Román Jiménez
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
| | - Karina Vilés
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
| | - Antoni Iborra
- SCAC Servei de Cultius Cellulars i Anticossos, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain;
| | - Maristela Silveira Palhares
- Departmento de Clínica e Cirurgia Veterinárias, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
| | - Jaime Catalán
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
| | - Marta Prades
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
| | - Jordi Miró
- Department de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (P.F.); (R.J.); (K.V.); (J.C.); (M.P.)
- Correspondence: ; Tel.: +34-93-5814293
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Maleas G, Mageed M. Effectiveness of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate as Treatments for Chronic Hindlimb Proximal Suspensory Desmopathy. Front Vet Sci 2021; 8:678453. [PMID: 34222402 PMCID: PMC8253571 DOI: 10.3389/fvets.2021.678453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were additionally registered at 12 months (T2) and 18 months (T3) after treatment. The BMAC cytology profiles from 22 horses were also analysed and compared to clinical outcomes. The results at T1 showed that 9% (2/22) of the horses in the control group were sound compared to 59% (25/46) and 84% (21/25) in the LR-PRP and BMAC groups, respectively. Additionally, ultrasound scores at T1 in the BMAC and LR-PRP groups were improved in comparison with the control group (p = 0.02). At T2, 68% of the horses in the BMAC group and 39% of the horses in the LR-PRP group had returned to the previous performance level. At T3, a significantly higher percentage of horses in the LR-PRP (43%) and BMAC (72%) group were sound when compared to the control (4.6%) group (p = 0.02). Similarly, at T3, significantly more horses of the BMAC (16/25) and of the LR-PRP (15/46) group had returned to the previous or a higher performance level compared to the control (1/22) group (p = 0.01). No correlation was found between long-term clinical outcome and cytology profiles in the BMAC group. In conclusion, long-term outcomes of treatment with LR-PRP or BMAC are significantly better than conventional treatment of the hindlimb chronic PSD in horses. Additionally, BMAC yielded better lameness scores than LR-PRP at short- and long-term follow-up.
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Camargo Garbin L, Lopez C, Carmona JU. A Critical Overview of the Use of Platelet-Rich Plasma in Equine Medicine Over the Last Decade. Front Vet Sci 2021; 8:641818. [PMID: 33869321 PMCID: PMC8044532 DOI: 10.3389/fvets.2021.641818] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/12/2021] [Indexed: 12/20/2022] Open
Abstract
In the 1990s, the role of platelets in inflammation and tissue healing was finally recognized. Since then, the clinical use of platelet-derived products (hemocomponents), such as, platelet-rich plasma (PRP), markedly increased. The promise of a more economical option of a disease-modifying treatment led to the intensive and continuous research of PRP products and to its widespread clinical use. A number of protocols and commercial kits have been developed with the intention of creating a more practical and reliable option for clinical use in equine patients. Still, the direct comparison between studies is particularly challenging due to the lack of standardization on the preparation methods and product composition. The incomplete reports on PRP cellular concentration and the poorly designed in vivo studies are additional matters that contest the clinical efficiency of this biomaterial. To overcome such challenges, several in vitro and in vivo studies have been proposed. Specifically, experiments have greatly focused in protocol optimization and its effect in different tissues. Additionally, in vivo studies have proposed different biological products envisioning the upgrade of the anti-inflammatory cytokines trusting to increase its anti-inflammatory effect. The individual variability and health status of the animal, type of tissue and condition treated, and protocol implemented are known to influence on the product's cell and cytokine composition. Such variability is a main clinical concern once it can potentially influence on PRP's therapeutic effects. Thus, lack of qualitative and quantitative evidence-based data supporting PRP's clinical use persists, despite of the numerous studies intended to accomplish this purpose. This narrative review aims to critically evaluate the main research published in the past decade and how it can potentially impact the clinical use of PRP.
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Affiliation(s)
- Livia Camargo Garbin
- Department of Veterinary Clinical Sciences, Faculty of Medical Sciences, School of Veterinary Medicine, The University of the West Indies at St. Augustine, St. Augustine, Trinidad and Tobago
| | - Catalina Lopez
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
| | - Jorge U Carmona
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
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The Use of Platelet-Rich Plasma for Treatment of Tenodesmic Lesions in Horses: A Systematic Review and Meta-Analysis of Clinical and Experimental Data. Animals (Basel) 2021; 11:ani11030793. [PMID: 33809227 PMCID: PMC7998797 DOI: 10.3390/ani11030793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Tenodesmic injuries are key problems for sport horses. Several therapies have been developed over the years, including platelet-rich plasma (PRP), an autologous product that should stimulate tissue regeneration with its high concentration of growth factors. Nowadays, there are conflicting reports concerning the effect of PRP in tenodesmic lesions. The aim of our systematic review was to determine the effect of PRP on tendons and ligaments healing through a meta-analysis, a process to determine consensus from across published studies. The meta-analysis is the quantitative component of a systematic review, a statistical synthesis of the published data about a topic. We selected studies that evaluate PRP therapy in vitro or in vivo, most of which had a high risk of bias. The results found there is no evidence that PRP enhances the healing of tendon and ligament injuries. In the future, further unbiased, blinded, and controlled studies are needed to clarify the efficacy of this platelet concentrate in the treatment of equine tendon and ligament injuries. Abstract The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors independently extracted data and assessed each study’s risk of bias. Treatment effects were evaluated using risk ratios for dichotomous data, together with 95% CI. Data were pooled using the random-effects model. The quality of the evidence for each outcome was assessed using GRADE criteria. Twenty-four trials met inclusion criteria for systematic review, while fifteen studies were included in the meta-analysis. Results showed no significant differences in the outcomes between PRP and control groups. Finally, there is no definitive evidence that PRP enhances tendons and ligaments healing. Therefore, there is a need for more controlled trials to draw a firmer conclusion about the efficacy of PRP as a treatment for tenodesmic lesions in the horse.
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Regenerative Medicine for Equine Musculoskeletal Diseases. Animals (Basel) 2021; 11:ani11010234. [PMID: 33477808 PMCID: PMC7832834 DOI: 10.3390/ani11010234] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Lameness due to musculoskeletal disease is the most common diagnosis in equine veterinary practice. Many of these orthopaedic disorders are chronic problems, for which no clinically satisfactory treatment exists. Thus, high hopes are pinned on regenerative medicine, which aims to replace or regenerate cells, tissues, or organs to restore or establish normal function. Some regenerative medicine therapies have already made their way into equine clinical practice mainly to treat tendon injures, tendinopathies, cartilage injuries and degenerative joint disorders with promising but diverse results. This review summarises the current knowledge of commonly used regenerative medicine treatments and critically discusses their use. Abstract Musculoskeletal injuries and chronic degenerative diseases commonly affect both athletic and sedentary horses and can entail the end of their athletic careers. The ensuing repair processes frequently do not yield fully functional regeneration of the injured tissues but biomechanically inferior scar or replacement tissue, causing high reinjury rates, degenerative disease progression and chronic morbidity. Regenerative medicine is an emerging, rapidly evolving branch of translational medicine that aims to replace or regenerate cells, tissues, or organs to restore or establish normal function. It includes tissue engineering but also cell-based and cell-free stimulation of endogenous self-repair mechanisms. Some regenerative medicine therapies have made their way into equine clinical practice mainly to treat tendon injures, tendinopathies, cartilage injuries and degenerative joint disorders with promising results. However, the qualitative and quantitative spatiotemporal requirements for specific bioactive factors to trigger tissue regeneration in the injury response are still unknown, and consequently, therapeutic approaches and treatment results are diverse. To exploit the full potential of this burgeoning field of medicine, further research will be required and is ongoing. This review summarises the current knowledge of commonly used regenerative medicine treatments in equine patients and critically discusses their use.
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Fukuda K, Kuwano A, Kuroda T, Tamura N, Mita H, Okada Y, Kasashima Y. Optimal double-spin method for maximizing the concentration of platelets in equine platelet-rich plasma. J Equine Sci 2020; 31:105-111. [PMID: 33376448 PMCID: PMC7750641 DOI: 10.1294/jes.31.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/05/2020] [Indexed: 11/01/2022] Open
Abstract
This study optimized the double-spin conditions for preparing equine platelet-rich plasma (PRP): leukocyte-rich PRP (L-PRP) and leukocyte-poor PRP (P-PRP). Whole blood samples were centrifuged at various double-spin conditions. Both L-PRP and P-PRP were prepared at each stage, and complete blood counts and growth factor concentrations were compared. Samples centrifuged at 160 × 900 g, 160 × 2,000 g, and 400 × 2,000 g exhibited the highest platelet counts. P-PRP had significantly lower leukocyte and erythrocyte contents than L-PRP, especially at 400 × 2,000 g. No significant differences were observed in growth factor concentrations. Our data suggest that optimum L-PRP preparation should include centrifugation under the aforementioned conditions, whereas centrifugation at 400 × 2,000 g is optimal for P-PRP.
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Affiliation(s)
- Kentaro Fukuda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Atsutoshi Kuwano
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Taisuke Kuroda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Norihisa Tamura
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Hiroshi Mita
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Yuji Okada
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Yoshinori Kasashima
- Research Planning and Coordination Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
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FUKUDA K, KURODA T, TAMURA N, MITA H, KASASHIMA Y. Optimal activation methods for maximizing the concentrations of platelet-derived growth factor-BB and transforming growth factor-β1 in equine platelet-rich plasma. J Vet Med Sci 2020; 82:1472-1479. [PMID: 32814750 PMCID: PMC7653321 DOI: 10.1292/jvms.20-0167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/06/2020] [Indexed: 11/22/2022] Open
Abstract
Platelet-rich plasma (PRP) therapy has been widely applied in various medical fields including humans and horses. This study aimed to establish an optimal activation method to stably and reproducibly maximize the concentrations of platelet-derived growth factor-BB (PDGF-BB) and transforming growth factor-β1 (TGF-β1) contained in equine PRP. Autologous PRP was prepared from 11 Thoroughbreds. For the activation test, PRP was activated by either a single freeze-thaw cycle (Fr) or adding calcium and autologous serum containing thrombin (Ca). PDGF-BB and TGF-β1 concentrations in Fr, Ca, nonactivated (No), and platelet-poor plasma (PPP) samples were determined using ELISA and compared. For repetitive freeze-thaw test, PRP was subjected to single (Fr1), double (Fr2), triple (Fr3), or quadruple (Fr4) freeze-thaw cycles and the concentrations of both growth factors in samples were compared similarly. The PDGF-BB concentration in Ca was significantly higher than that in other preparations. The TGF-β1 concentrations in Fr and Ca were significantly higher than those in PPP and No, with no significant differences between Fr and Ca. The concentrations of both factors were significantly increased in PRP treated with multiple cycles of freeze-thaw compared with that in PRP treated with a single cycle. No significant differences were noted among Fr2, Fr3, and Fr4. Our findings suggest that activation by adding calcium and autologous serum is optimal for instant use of PRP and that double freeze-thawing is an easier and optimal activation method for cryopreserved PRP.
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Affiliation(s)
- Kentaro FUKUDA
- Clinical Veterinary Medicine Division, Equine Research
Institute, Japan Racing Association, 1400-4 Shiba, Shimotsuke-shi, Tochigi 329-0412,
Japan
| | - Taisuke KURODA
- Clinical Veterinary Medicine Division, Equine Research
Institute, Japan Racing Association, 1400-4 Shiba, Shimotsuke-shi, Tochigi 329-0412,
Japan
| | - Norihisa TAMURA
- Clinical Veterinary Medicine Division, Equine Research
Institute, Japan Racing Association, 1400-4 Shiba, Shimotsuke-shi, Tochigi 329-0412,
Japan
| | - Hiroshi MITA
- Clinical Veterinary Medicine Division, Equine Research
Institute, Japan Racing Association, 1400-4 Shiba, Shimotsuke-shi, Tochigi 329-0412,
Japan
| | - Yoshinori KASASHIMA
- The Equine Research Institute, Japan Racing Association,
1400-4 Shiba, Shimotsuke-shi, Tochigi 329-0412, Japan
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14
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Kamm JL, Parlane NA, Riley CB, Gee EK, Dittmer KE, McIlwraith CW. Blood type and breed-associated differences in cell marker expression on equine bone marrow-derived mesenchymal stem cells including major histocompatibility complex class II antigen expression. PLoS One 2019; 14:e0225161. [PMID: 31747418 PMCID: PMC6867698 DOI: 10.1371/journal.pone.0225161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND As the search for an immune privileged allogeneic donor mesenchymal stem cell (MSC) line continues in equine medicine, the characterization of the cells between different sources becomes important. Our research seeks to more clearly define the MSC marker expression of different equine MSC donors. METHODS The bone marrow-derived MSCs from two equine breeds and different blood donor-types were compared over successive culture passages to determine the differential expression of important antigens. Eighteen Thoroughbreds and 18 Standardbreds, including 8 blood donor (erythrocyte Aa, Ca, and Qa antigen negative) horses, were evaluated. Bone marrow was taken from each horse for isolation and culture of MSCs. Samples from passages 2, 4, 6, and 8 were labelled and evaluated by flow cytometry. The cell surface expression of CD11a/18, CD44, CD90 and MHC class II antigens were assessed. Trilineage assays for differentiation into adipogenic, chondrogenic and osteogenic lines were performed to verify characterization of the cells as MSCs. FINDINGS There were significant differences in mesenchymal stem cell marker expression between breeds and blood antigen-type groups over time. Standardbred horses showed a significantly lower expression of MHC class II than did Thoroughbred horses at passages 2, 4 and 6. CD90 was significantly higher in universal blood donor Standardbreds as compared to non-blood donor Standardbreds over all time points. All MSC samples showed high expression of CD44 and low expression of CD11a/18. CONCLUSIONS Universal blood donor- type Standardbred MSCs from passages 2-4 show the most ideal antigen expression pattern of the horses and passages that we characterized for use as a single treatment of donor bone marrow-derived MSCs. Further work is needed to determine the significance of this differential expression along with the effect of the expression of MHC I on equine bone marrow-derived MSCs.
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Affiliation(s)
- J. Lacy Kamm
- Massey University, School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Veterinary Associates, Karaka, Auckland, New Zealand
- * E-mail:
| | - Natalie A. Parlane
- AgResearch, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Christopher B. Riley
- Massey University, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Erica K. Gee
- Massey University, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Keren E. Dittmer
- Massey University, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - C. Wayne McIlwraith
- Massey University, School of Veterinary Science, Massey University, Palmerston North, New Zealand
- Colorado State University, Orthopaedic Research Center, Fort Collins, Colorado, United States of America
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15
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Garbin LC, Olver CS. Platelet-Rich Products and Their Application to Osteoarthritis. J Equine Vet Sci 2019; 86:102820. [PMID: 32067662 DOI: 10.1016/j.jevs.2019.102820] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 08/04/2019] [Accepted: 10/22/2019] [Indexed: 12/15/2022]
Abstract
Autologous platelet-rich plasma (PRP) is a biological preparation made from the patient's own plasma that contains a platelet concentration above the whole blood baseline. Owing to the release of growth factors and other cytokines after degranulation, platelets have a central role in inflammation and in different stages of the healing process. For this reason, PRP-derived products have been used to enhance healing of musculoskeletal injuries and modulate progression of inflammatory processes, including osteoarthritis (OA). Osteoarthritis is one of the main causes of musculoskeletal disabilities in horses, and currently, there is no effective treatment for this disease. Treatments that focus on the modulation of inflammation and disease progression offer new hope for OA. Platelet-rich plasma provides a more practical and accessible option of therapy compared to other forms of biological treatment (i.e., stem cell therapies) and is believed to induce the production of functional matrix. However, several factors related to PRP production, including methods of preparation and application, and intraindividual variability, lead to an inconsistent product, precluding reliable conclusions about its efficacy for clinical use. The aim of this study was to review the benefits related to the clinical use of PRP in OA as well as factors that influence its use, the limitations of this treatment, and future directions of PRP research and therapy.
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Affiliation(s)
- Livia Camargo Garbin
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, University of West Indies, St. Augustine, Trinidad and Tobago, West Indies.
| | - Christine S Olver
- Veterinary Diagnostic Laboratory, Clinical Pathology Section, Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
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16
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Feigin K, Shope B. Use of Platelet-Rich Plasma and Platelet-Rich Fibrin in Dentistry and Oral Surgery: Introduction and Review of the Literature. J Vet Dent 2019; 36:109-123. [DOI: 10.1177/0898756419876057] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Platelet concentrates, mostly represented by platelet-rich plasma and platelet-rich fibrin, have gained significant interest in various medical and oral disciplines because of their potential to stimulate and boost regeneration of hard and soft tissues. Prepared from the patient’s own blood, they have been tested and used in various different surgical fields including oral and maxillofacial surgery. The effects of these biomaterials are described to be a result of the large concentration of platelets which contain a wide range of growth factors. The aim of this article is to introduce the principle and function of these platelet concentrates, to review their preparation, and to provide a comprehensive examination of the published oral and maxillofacial literature on this subject.
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17
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Giunta K, Donnell JR, Donnell AD, Frisbie DD. Prospective randomized comparison of platelet rich plasma to extracorporeal shockwave therapy for treatment of proximal suspensory pain in western performance horses. Res Vet Sci 2019; 126:38-44. [PMID: 31430578 DOI: 10.1016/j.rvsc.2019.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 07/17/2019] [Accepted: 07/31/2019] [Indexed: 01/11/2023]
Abstract
Proximal suspensory desmitis (PSD) is a frequent cause of lameness in the performance horse. Extracorporeal shockwave therapy (EST) and platelet rich plasma (PRP) have become common treatments for PSD yet clinical data on efficacy is limited. The main objective of this randomized, prospective clinical study was to compare long-term effectiveness of EST and PRP in Western performance horses. One hundred horses with lameness localized to the proximal suspensory ligament received treatment with either PRP or EST following baseline ultrasonographic evaluation. A veterinarian and agent evaluated the horses for lameness independently four days following the first treatment and long-term follow up was obtained from the agent at six and twelve months. Four days post treatment, horses treated with EST had significantly greater lameness improvement compared to PRP. At one-year horses with less severe baseline ultrasound changes (grades 0-1) appeared to respond better (degree of lameness) with EST treatment whereas horses with more severe ultrasound changes (grade 2) responded better to PRP. Horses with baseline lameness graded 1 or 2 were 5.1 times more likely to be back in work at 1 year compared to those presenting with grade 3 or 4. EST treatment was associated with going back to work 3.8 times more at one year compared to PRP independent of baseline ultrasound score. Both PRP and EST can be expected to yield favorable therapeutic responses in Western performance horses with lameness localized to the proximal suspensory region. Baseline ultrasound may guide treatment selection.
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Affiliation(s)
- Kelly Giunta
- Blue Ridge Equine Clinic, 4510 Mockernut Lane, Earlysville, VA 22936, USA.
| | - Josh R Donnell
- La Mesa Equine Lameness Center, 8386 FM 455E, Pilot Point, TX 76258, USA.
| | - Alan D Donnell
- La Mesa Equine Lameness Center, 8386 FM 455E, Pilot Point, TX 76258, USA.
| | - David D Frisbie
- Colorado State University, Equine Orthopaedic Research Center, 300 W Drake Road, Fort Collins, CO 80523, USA.
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18
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Jiménez-Aristazábal RF, Carmona JU, Prades M. Changes on the Structural Architecture and Growth Factor Release, and Degradation in Equine Platelet-Rich Fibrin Clots Cultured Over Time. J Equine Vet Sci 2019; 82:102789. [PMID: 31732113 DOI: 10.1016/j.jevs.2019.102789] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/09/2019] [Accepted: 07/19/2019] [Indexed: 12/11/2022]
Abstract
The aims of the present study were (1) to describe the microscopic and ultrastructural appearance of equine platelet-rich fibrin (PRF) clots and (2) to determine the release and degradation of transforming growth factor beta 1 (TGF-β1) and insulin-like growth factor type I (IGF-I) from PRF clots incubated over 14 days. Whole blood from six horses was collected into plain tubes and centrifuged at 240 g for 8 minutes. Clots were evaluated by histology and by both transmission and scanning electronic microscopy (TEM and SEM). Growth factor concentrations were measured by ELISA at 48-hour intervals over 14 days and analyzed by one-way repeated-measures ANOVA. Histology showed a clot composed by a fibrin layer and a cellular layer with platelets and leukocytes. Scanning electron microscopy showed the cells trapped by an incipient fibrin network at 1 hour. At day 8, these cells were embedded by an incipient fibrin network. At day 14, the leukocytes and platelet aggregates from the clot were imbibed in an organized web of fibrin fibrils. TEM exhibited platelets with preserved cytoplasm and alpha granules randomly scattered at day 8, and damaged platelets with interrupted cytoplasm and organelle emigration to the periphery at day 14. TGF-β1 and IGF-I concentrations showed a progressive increase until day 14. TGF-β1 was released from PRF clots in a gradual and controlled manner, and increasing its concentration for two weeks, which supports TEM findings indicating that platelets began disintegrating by day 14. Furthermore, IGF-I production and release from PRF clots is sustained over time.
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Affiliation(s)
- Román F Jiménez-Aristazábal
- Departament de Medicina i Cirurgía Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
| | - Jorge U Carmona
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
| | - Marta Prades
- Departament de Medicina i Cirurgía Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
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19
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Carrozzo U, Toniato M, Harrison A. Assessment of Noninvasive Low-Frequency Ultrasound as a Means of Treating Injuries to Suspensory Ligaments in Horses: A Research Paper. J Equine Vet Sci 2019; 80:80-89. [PMID: 31443840 DOI: 10.1016/j.jevs.2019.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/12/2019] [Indexed: 01/09/2023]
Abstract
Therapeutic ultrasound is a noninvasive technique, which is well tolerated by horses, does not need sedation, and can easily be performed in a routine clinical setting. Twenty-three client-owned sport horses were recruited at Clinica Equina San Biagio and included in this case study. Treatment of the injured suspensory ligament apparatus was administered using an EQ Pro, low-frequency therapeutic unit (38 kHz). The noninvasive treatment consisted of massaging the injured area in combination with a traditional ultrasound gel while maintaining the head of the device in direct contact with the injured area. The results indicate that 20 of the 23 horses in this study benefitted from EQ Pro treatment and, following a routine rehabilitation program, returned to competition status: a success rate of 87%. Furthermore, treatment duration was 3.3 ± 0.4 weeks on average, with a healthy outcome as assessed by ultrasound at 6.8 ± 1.9 weeks. Among the 23 horses in this study, 65% of them benefitted from EQ Pro treatment of a duration of just ≤3.3 weeks. It is concluded that EQ Pro therapy is a promising and effective form of treatment for horses with suspensory ligament injury. It is furthermore rapid and easy to use in the Equine Veterinary Clinic setting and does not require sedation. Future studies should now focus on the mechanisms by which this new treatment activates the healing process of the suspensory ligaments of injured horses.
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Affiliation(s)
- Ugo Carrozzo
- Clinica Equina San Biagio, San Biagio di Argenta, FE, Italy.
| | - Matteo Toniato
- Clinica Equina San Biagio, San Biagio di Argenta, FE, Italy
| | - Adrian Harrison
- Department of Pathobiological Sciences, Faculty of Health & Medical Science, Copenhagen University, Frederiksberg C, Copenhagen, Denmark
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20
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Sills ES, Wood SH. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response. Biosci Rep 2019; 39:BSR20190805. [PMID: 31092698 PMCID: PMC6549090 DOI: 10.1042/bsr20190805] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 01/19/2023] Open
Abstract
In clinical infertility practice, one intractable problem is low (or absent) ovarian reserve which in turn reflects the natural oocyte depletion associated with advancing maternal age. The number of available eggs has been generally thought to be finite and strictly limited, an entrenched and largely unchallenged tenet dating back more than 50 years. In the past decade, it has been suggested that renewable ovarian germline stem cells (GSCs) exist in adults, and that such cells may be utilized as an oocyte source for women seeking to extend fertility. Currently, the issue of whether mammalian females possess such a population of renewable GSCs remains unsettled. The topic is complex and even agreement on a definitive approach to verify the process of 'ovarian rescue' or 're-potentiation' has been elusive. Similarities have been noted between wound healing and ovarian tissue repair following capsule rupture at ovulation. In addition, molecular signaling events which might be necessary to reverse the effects of reproductive ageing seem congruent with changes occurring in tissue injury responses elsewhere. Recently, clinical experience with such a technique based on autologous activated platelet-rich plasma (PRP) treatment of the adult human ovary has been reported. This review summarizes the present state of understanding of the interaction of platelet-derived growth factors with adult ovarian tissue, and the outcome of human reproductive potential following PRP treatment.
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Affiliation(s)
- E Scott Sills
- Gen 5 Fertility Center, Office for Reproductive Research, Center for Advanced Genetics; San Diego, CA, U.S.A.
- Applied Biotechnology Research Group, University of Westminster; London W1B 2HW, U.K
| | - Samuel H Wood
- Gen 5 Fertility Center, Office for Reproductive Research, Center for Advanced Genetics; San Diego, CA, U.S.A
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21
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Kirkpatrick CJ, Ernst NS, Trumble TN. Palmar/plantar approach for radiographic-guided injection of the equine distal interphalangeal joint collateral ligament insertion. Vet Rec 2019; 184:527. [PMID: 30842259 DOI: 10.1136/vr.105027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 11/03/2022]
Abstract
There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collateral fossa. Radiographs verified ideal needle location on the proximal border of the distal phalanx at the collateral fossa. Dye was injected. Hoof walls were partially removed and collateral ligaments were dissected with needles in place to determine needle and dye location. Accuracy of needle placement into the insertion of the DIPJ collateral ligament was 41/48 (85 per cent), with lower accuracy of dye within the ligament (34/48; 71 per cent). Dye entered the DIPJ in 2/48 injections, but dye entered periligamentous structures in 22/48 (46 per cent) injections. A palmar/plantar radiographic-guided injection of the insertion of the DIPJ collateral ligament had high accuracy rate with low injection rate of the DIPJ in cadavers.
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Affiliation(s)
- C Jordan Kirkpatrick
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Nicolas S Ernst
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Troy N Trumble
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
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22
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Piuzzi NS, Dominici M, Long M, Pascual-Garrido C, Rodeo S, Huard J, Guicheux J, McFarland R, Goodrich LR, Maddens S, Robey PG, Bauer TW, Barrett J, Barry F, Karli D, Chu CR, Weiss DJ, Martin I, Jorgensen C, Muschler GF. Proceedings of the signature series symposium "cellular therapies for orthopaedics and musculoskeletal disease proven and unproven therapies-promise, facts and fantasy," international society for cellular therapies, montreal, canada, may 2, 2018. Cytotherapy 2018; 20:1381-1400. [PMID: 30316562 PMCID: PMC8487641 DOI: 10.1016/j.jcyt.2018.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 12/17/2022]
Abstract
The Signature Series Symposium "Cellular Therapies for Orthopaedics and Musculoskeletal Disease Proven and Unproven Therapies-Promise, Facts and Fantasy" was held as a pre-meeting of the 26th International Society for Cellular Therapy (ISCT) annual congress in Montreal, Canada, May 2, 2018. This was the first ISCT program that was entirely dedicated to the advancement of cell-based therapies for musculoskeletal diseases. Cellular therapies in musculoskeletal medicine are a source of great promise and opportunity. They are also the source of public controversy, confusion and misinformation. Patients, clinicians, scientists, industry and government share a commitment to clear communication and responsible development of the field. Therefore, this symposium convened thought leaders from around the world in a forum designed to catalyze communication and collaboration to bring the greatest possible innovation and value to patients with musculoskeletal conditions.
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Affiliation(s)
- Nicolas S Piuzzi
- Department of Orthopedic Surgery and Biomedical Engineering Cleveland Clinic, Cleveland, Ohio, USA; Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Massimo Dominici
- Laboratory of Cellular Therapy, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Marc Long
- MTF Biologics, Edison, New Jersey, USA
| | - Cecilia Pascual-Garrido
- Adult Reconstruction-Adolescent and Young Adult Hip Service, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Scott Rodeo
- Orthopaedic Soft Tissue Research Program, Hospital for Special Surgery, New York, New York, USA
| | - Johnny Huard
- Department of Orthopaedic Surgery, UTHealth Medical School, Houston, Texas, USA; Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Jérome Guicheux
- INSERM, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Nantes University School of Dental Medicine, ONIRIS, Nantes, France; CHU Nantes, PHU4 OTONN, Nantes, France
| | - Richard McFarland
- Advanced Regenerative Manufacturing Institute, Manchester, New Hampshire, USA, and Standards Coordinating Body, Gaithersburg, Maryland, USA
| | - Laurie R Goodrich
- Orthopaedic Research Center and Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | | | - Pamela G Robey
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Thomas W Bauer
- Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, New York, USA
| | - John Barrett
- Stem Cell Allogeneic Transplant Section, National Institutes of Health, Bethesda, Maryland, USA
| | - Frank Barry
- Regenerative Medicine Institute, National University of Ireland, Galway, Ireland
| | - David Karli
- Steadman Philippon Research Institute, Vail, Colorado, USA; Greyledge Technologies, LLC, Vail, Colorado, USA
| | - Constance R Chu
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Daniel J Weiss
- University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Ivan Martin
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Christian Jorgensen
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Hôpital Lapeyronie, Montpellier, France
| | - George F Muschler
- Department of Orthopedic Surgery and Biomedical Engineering Cleveland Clinic, Cleveland, Ohio, USA.
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23
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Ortved KF. Regenerative Medicine and Rehabilitation for Tendinous and Ligamentous Injuries in Sport Horses. Vet Clin North Am Equine Pract 2018; 34:359-373. [DOI: 10.1016/j.cveq.2018.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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24
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Pluim M, Martens A, Vanderperren K, Sarrazin S, Koene M, Luciani A, van Weeren PR, Delesalle C. Short- and long term follow-up of 150 sports horses diagnosed with tendinopathy or desmopathy by ultrasonographic examination and treated with high-power laser therapy. Res Vet Sci 2018; 119:232-238. [PMID: 30005398 DOI: 10.1016/j.rvsc.2018.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/24/2018] [Accepted: 06/10/2018] [Indexed: 12/17/2022]
Affiliation(s)
- M Pluim
- Department of Virology, Parasitology & Immunology, Research Group Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; Tierklinik Luesche, Essernerstrase 39a, 49456 Bakum, Germany.
| | - A Martens
- Department of Surgery and Anaesthesiology of domestic animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - K Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - S Sarrazin
- Department of obstetrics, Reproduction and herd health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - M Koene
- Tierklinik Luesche, Essernerstrase 39a, 49456 Bakum, Germany
| | - A Luciani
- Tierklinik Luesche, Essernerstrase 39a, 49456 Bakum, Germany
| | - P R van Weeren
- Department of Equine Sciences, Utrecht University, Yalelaan 1, 3584, CL, Utrecht, the Netherlands
| | - C Delesalle
- Department of Virology, Parasitology & Immunology, Research Group Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Jacquet-Guibon S, Dupays AG, Coudry V, Crevier-Denoix N, Leroy S, Siñeriz F, Chiappini F, Barritault D, Denoix JM. Randomized controlled trial demonstrates the benefit of RGTA® based matrix therapy to treat tendinopathies in racing horses. PLoS One 2018. [PMID: 29522564 PMCID: PMC5844532 DOI: 10.1371/journal.pone.0191796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A randomized controlled trial was performed on racing horses, to evaluate the efficacy of a new class of therapeutic agents in regenerative medicine—ReGeneraTing Agents® (RGTA®), to treat tendinopathies. Preliminary uncontrolled studies on tendon healing in racing horses with RGTA® (OTR4131)—Equitend® showed encouraging results, justifying performing a randomized, controlled, multicenter study with a two-year racing performance follow up. The objective of this study was to evaluate the effect of Equitend® versus placebo on acute superficial digital flexor tendonitis in racing French Standardbred Trotters (ST). Twenty-two ST were randomly and blindly assigned to receive with a ratio of 2 to 1, a single Equitend® (n = 14) or placebo (n = 8) intralesional injection under ultrasonographic guidance. Horses were evaluated over 4 months, by clinical and ultrasonographic evaluations (day 0, months 1, 2, 4), and their racing performances followed up over the 2 years after treatment. During the first month of treatment, a significant decrease in the cross-sectional area (CSA) was found in the Equitend® group (p = 0.04). After 4 months, the number of Equitend® treated horses with an improved CSA was significantly higher than the placebo-treated horses (p = 0.03571). The Equitend® group returned to their pre-injury performance level, racing in, and winning, significantly more races than the placebo group (p = 0.01399 and 0.0421, respectively). Furthermore, recurrence was significantly higher in the placebo group than in the Equitend® group (71.4% vs 16.6%, p = 0.02442). In conclusion, we measured a significant, short-term, reduction effect on CSA and demonstrated a long-term beneficial effect of intralesional injection of Equitend® for the treatment of superficial digital flexor tendonitis on racing ST, racing 2. 3 times more often than placebo, with 3.3 times fewer recurrences maintaining pre-injury performance level. This study may open the way for the development of a human treatment of tendonitis.
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Affiliation(s)
- Sandrine Jacquet-Guibon
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
- Unité Sous Contrat 957, Biomécanique et Pathologie Locomotrice du Cheval, Institut National de la Recherche Agronomique, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
- * E-mail:
| | | | - Virginie Coudry
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
- Unité Sous Contrat 957, Biomécanique et Pathologie Locomotrice du Cheval, Institut National de la Recherche Agronomique, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
| | - Nathalie Crevier-Denoix
- Unité Sous Contrat 957, Biomécanique et Pathologie Locomotrice du Cheval, Institut National de la Recherche Agronomique, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
| | | | - Fernando Siñeriz
- Organ, Tissue, Regeneration, Repair and Replacement Société Actions Simplifiés, Paris, France
| | - Franck Chiappini
- Organ, Tissue, Regeneration, Repair and Replacement Société Actions Simplifiés, Paris, France
| | - Denis Barritault
- Organ, Tissue, Regeneration, Repair and Replacement Société Actions Simplifiés, Paris, France
- Laboratoire de recherche sur la Croissance Cellulaire, Réparation, et Régénération Tissulaire, Faculté des Sciences, Université Paris-Est Créteil, Créteil, France
| | - Jean-Marie Denoix
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
- Unité Sous Contrat 957, Biomécanique et Pathologie Locomotrice du Cheval, Institut National de la Recherche Agronomique, Ecole Nationale vétérinaire d’Alfort, Maisons-Alfort, France
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Carmona JU, Gómez WA, López C. Could Platelet-Rich Plasma Be a Clinical Treatment for Horses With Laminitis? J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2017.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Influence of calcium salts and bovine thrombin on growth factor release from equine platelet-rich gel supernatants. Vet Comp Orthop Traumatol 2017; 30:1-7. [DOI: 10.3415/vcot-16-02-0026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023]
Abstract
SummaryObjective: To compare five activation methods in equine platelet-rich plasma (PRP) by determination of platelet-derived growth factor BB (PDGF-BB) and transforming growth factor beta 1 (TGF-β1) concentrations in platelet-rich gel (PRG) supernatants.Methods: Platelet-rich plasma from 20 horses was activated by calcium chloride (CC), calcium gluconate (CG), bovine thrombin (BT), and their combinations, BTCC and BTCG. Both growth factor concentrations in PRG supernatants were measured by ELISA and compared with plasma and platelet ly-sates (PL) over time.Results: Growth factor concentrations were significantly lower in plasma and higher for all PRG supernatants. Platelet lysates contained a significantly lower concentration of PDGF-BB than PRG supernatants and a significantly higher concentration of TGF-β1 than PRG supernatants. Clots from PRP activated with sodium salts were more stable over time and had significant growth factor release, whereas CC produced gross salt deposition. Significant correlations were noticed for platelet with leukocyte concentrations in PRP (rs: 0.76), platelet counts in PRP with TGF-β1 concentrations in PRG supernatants (rs: 0.86), platelet counts in PRP with PDGF-BB concentrations in PRG super-natants (rs: 0.78), leukocyte counts in PRP with TGF-β1 concentrations in PRG supernatants (rs: 0.76), and PDGF-BB concentrations with activating substances (rs: 0.72).Clinical significance: Calcium gluconate was the better substance to induce PRP activation. It induced growth factor release free from calcium precipitates in the clots. Use of BT alone or combined with calcium salts was not advantageous for growth factor release.
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Evaluation of a filter-prepared platelet concentrate for the treatment of suspensory branch injuries in horses. Vet Comp Orthop Traumatol 2017; 24:363-9. [DOI: 10.3415/vcot-11-01-0001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 05/09/2011] [Indexed: 02/06/2023]
Abstract
SummaryObjectives: Platelet preparations have become a treatment for soft tissue injuries in horses. This study evaluated a novel filter-based system to concentrate platelets and assesses its value in the treatment of suspensory ligament branch desmitis.Methods: Filtered platelet concentrate was prepared from 55 ml of venous blood obtained from 21 normal horses. Platelets and white blood cells in whole blood and filtered platelet concentrate were measured, as was platelet activating factor (PAF)–induced platelet-derived growth factor-BB (PDGF-BB) release. Eleven horses with 18 focal acute suspensory ligament branch injuries were treated intra-lesionally with autologous filtered platelet concentrate and evaluated clinically and ultrasonographically for one to three years.Results: The increase in concentration of platelets in the filtered concentrate in comparison with whole blood (6.9 ± 1.9-fold) was significantly greater than the increase in white blood cells (3.8 ± 0.8-fold) (p <0.0001). There was no effect of sex or breed on platelet concentration. Platelets were responsive to PAF with >100-fold higher levels of PDGF release over basal levels. All hypoechoic lesions re-evaluated within three months had resolved. Five of the 11 horses returned to their previous level of work, one was exercising at a lower level, three were retired, one died for unrelated reasons, and one was still convalescing.Clinical significance: Filtered platelet concentrate was easily and reliably prepared and injected into suspensory ligament branch injuries without short-term complications. This treatment was associated with rapid resolution of ultrasonographic lesions and lameness. Filtered platelet concentrate represents a convenient alternative for the treatment of suspensory ligament branch injuries.
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Seabaugh KA, Thoresen M, Giguère S. Extracorporeal Shockwave Therapy Increases Growth Factor Release from Equine Platelet-Rich Plasma In Vitro. Front Vet Sci 2017; 4:205. [PMID: 29270410 PMCID: PMC5726030 DOI: 10.3389/fvets.2017.00205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/20/2017] [Indexed: 01/03/2023] Open
Abstract
Introduction Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) are common treatments for soft tissue injuries in horses. Shockwave triggers cell specific responses to promote healing. Growth factors released from PRP also promote healing. It has been hypothesized that greater growth factor release would amplify the healing process. The combination of ESWT and PRP could promote healing in injured tendons and ligaments in the horse. The objective of this study was to determine if application of shockwaves to PRP samples increases the concentration of transforming growth factor-β1 (TGF-β1) and platelet-derived growth factor ββ (PDGF-ββ) released from the platelets in vitro. Materials and methods PRP was produced from blood drawn from six horses. The PRP from each horse was exposed to the following treatments: (1) positive control (freeze-thaw cycle), (2) untreated negative control, or shockwaves with either (3) a "standard probe" (ESWT-S) with a 2 cm focal width and medium energy density or (4) a "power probe" (ESWT-P) with a 1 cm focal width and high energy density. After each treatment, the samples were centrifuged, and the supernatant was harvested. The supernatant was then used for growth factor quantification via commercially available ELISA kits for TGF-β1 and PDGF-ββ. Results Concentrations of TGF-β1 and PDGF-ββ in PRP that underwent a freeze-thaw cycle were significantly increased compared with all other treatments. Both ESWT-S and ESWT-P resulted in significantly increased TGF-β1 concentrations, 46 and 33%, respectively, when compared with the negative control. Both ESWT-S and ESWT-P resulted in significantly increased PDGF-ββ concentrations, 219 and 190%, respectively, when compared with the negative control. Discussion These data indicate that the application of ESWT to PRP increases the expression of growth factors in vitro. This suggests that the combination therapy of local PRP injection followed by ESWT may stimulate release of growth factors from platelets after they have been injected into the area of injury. Conclusion The combination of PRP and ESWT might result in synergism of two modalities previously utilized individually for tendon and ligament injuries in horses.
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Affiliation(s)
- Kathryn A Seabaugh
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,Department of Large Animal Medicine, University of Georgia, Athens, GA, United States
| | - Merrilee Thoresen
- Department of Large Animal Medicine, University of Georgia, Athens, GA, United States.,Department of Pathobiology & Population Medicine, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Steeve Giguère
- Department of Large Animal Medicine, University of Georgia, Athens, GA, United States
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Abouelnasr K, Hamed M, Lashen S, El-Adl M, Eltaysh R, Tagawa M. Enhancement of abdominal wall defect repair using allogenic platelet-rich plasma with commercial polyester/cotton fabric (Damour) in a canine model. J Vet Med Sci 2017; 79:1301-1309. [PMID: 28603214 PMCID: PMC5559380 DOI: 10.1292/jvms.17-0139] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Platelet-rich plasma (PRP) has an important role in musculoskeletal surgery; however, it has been underutilized for accelerating the healing of abdominal wall defects in veterinary practice. Therefore, the aim of this study was
to evaluate the use of commercial polyester/cotton fabric (Damour) as a new composite mesh for the repair of experimentally induced abdominal wall defects in canine models, and to investigate the possible role of PRP for improving
such repair and reducing allied complications. For this purpose, abdominal wall defects were created in 24 healthy mongrel dogs and then repaired with mesh alone (control group) or mesh and allogenic PRP (PRP group). Dogs were
euthanized after 2 or 4 months for gross examination of implantation site, detection of adhesion score and hernia recurrence. Moreover, tissue samples were collected for histological and gene expression analyses for
neovascularization, collagen formation and tissue incorporation. Hernia recurrence was not recorded in PRP-treated dogs that also displayed significantly more neovascularization and less severe adhesion to the underlings (1.08 ±
0.51) in comparison to control group (2.08 ± 0.99). Histological and molecular evaluation confirmed the gross findings that collagen deposition, new vessel formation, and overexpression of angiogenic and myofibroplastic genes
(COL1α1, COL3α1, VEGF and TGFβ1) were observed more frequently in the PRP group, at both time points. In conclusion, we found that addition of allogenic PRP to
Damour mesh enhanced neovessel formation, and increased tissue deposition and incorporation, with subsequent reduction of peritoneal adhesion and recurrence rate.
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Affiliation(s)
- Khaled Abouelnasr
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Hamed
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Aswan University, Aswan 81528, Egypt
| | - Samah Lashen
- Department of Cytology and Histology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed El-Adl
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Rasha Eltaysh
- Department of Pharmacology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Michihito Tagawa
- Veterinary Medical Center, Department of Clinical Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
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Fukuda K, Miyata H, Kuwano A, Kuroda T, Tamura N, Kotoyori Y, Kasashima Y. Does the injection of platelet-rich plasma induce changes in the gene expression and morphology of intact Thoroughbred skeletal muscle? J Equine Sci 2017; 28:31-39. [PMID: 28721121 PMCID: PMC5506447 DOI: 10.1294/jes.28.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/27/2017] [Indexed: 01/19/2023] Open
Abstract
Platelet-rich plasma (PRP) therapy is promising for treating skeletal muscle injuries in human athletes by promoting muscle regeneration. It might also be useful for treating muscle injuries in equine athletes. In the present
study, muscle regeneration induced by injection of PRP into intact muscle of Thoroughbred was investigated. Autologous PRP and saline were injected twice into intact left and right gluteus medius muscles of seven clinically
healthy Thoroughbreds. Muscle samples were collected from the injection sites by needle biopsy at 2 and 7 days after PRP injection. Immunohistochemical staining to identify the types of myosin heavy chains (MHCs) and satellite
cells was performed to compare morphological changes among intact (pre-injection), saline-, and PRP-injected muscles. The expression of marker genes related to muscle regeneration (MHC-I, MHC-II, and embryonic MHC [MHC-e]),
satellite cell activity (CK, Pax7, MyoD, and myogenin), and proinflammatory and promyogenic cytokines (IL-6, IGF-1, and HGF) was analyzed and compared between saline- and PRP-injected muscles. There were no obvious morphological
differences among the three treatments. There were no significant differences in gene expression associated with satellite cell activity between saline and PRP injection at 7 days after injection. MHC genes showed significantly
higher expression levels with PRP than with saline, including MHC-e at 2 days and MHC-I at 7 days after injection. It is suggested that injection of PRP into intact skeletal muscle does not induce specific morphological changes,
but upregulate the expression of genes related to muscle regeneration.
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Affiliation(s)
- Kentaro Fukuda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Hirofumi Miyata
- Department of Biological Chemistry, Faculty of Agriculture, Yamaguchi University, Yamaguchi 753-8515, Japan
| | | | - Taisuke Kuroda
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Norihisa Tamura
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Yasumitsu Kotoyori
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Yoshinori Kasashima
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
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Cancedda R, Bollini S, Descalzi F, Mastrogiacomo M, Tasso R. Learning from Mother Nature: Innovative Tools to Boost Endogenous Repair of Critical or Difficult-to-Heal Large Tissue Defects. Front Bioeng Biotechnol 2017; 5:28. [PMID: 28503549 PMCID: PMC5408079 DOI: 10.3389/fbioe.2017.00028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/10/2017] [Indexed: 12/16/2022] Open
Abstract
For repair of chronic or difficult-to-heal tissue lesions and defects, major constraints exist to a broad application of cell therapy and tissue engineering approaches, i.e., transplantation of “ex vivo” expanded autologous stem/progenitor cells, alone or associated with carrier biomaterials. To enable a large number of patients to benefit, new strategies should be considered. One of the main goals of contemporary regenerative medicine is to develop new regenerative therapies, inspired from Mother Nature. In all injured tissues, when platelets are activated by tissue contact, their released factors promote innate immune cell migration to the wound site. Platelet-derived factors and factors secreted by migrating immune cells create an inflammatory microenvironment, in turn, causing the activation of angiogenesis and vasculogenesis processes. Eventually, repair or regeneration of the injured tissue occurs via paracrine signals activating, mobilizing or recruiting to the wound site cells with healing potential, such as stem cells, progenitors, or undifferentiated cells derived from the reprogramming of tissue differentiated cells. This review, largely based on our studies, discusses the identification of new tools, inspired by cellular and molecular mechanisms overseeing physiological tissue healing, that could reactivate dormant endogenous regeneration mechanisms lost during evolution and ontogenesis.
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Affiliation(s)
- Ranieri Cancedda
- Biorigen Srl, Genova, Italy.,Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Sveva Bollini
- Department of Experimental Medicine, University of Genova, Genova, Italy
| | | | | | - Roberta Tasso
- IRCCS AOU San Martino-IST National Institute of Cancer Research, Genova, Italy
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Best TM, Caplan A, Coleman M, Goodrich L, Hurd J, Kaplan LD, Noonan B, Schoettle P, Scott C, Stiene H, Huard J. Not Missing the Future. Curr Sports Med Rep 2017; 16:202-210. [DOI: 10.1249/jsr.0000000000000357] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Geburek F, Gaus M, van Schie HTM, Rohn K, Stadler PM. Effect of intralesional platelet-rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies - a randomized prospective controlled clinical trial. BMC Vet Res 2016; 12:191. [PMID: 27604193 PMCID: PMC5015224 DOI: 10.1186/s12917-016-0826-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/01/2016] [Indexed: 12/13/2022] Open
Abstract
Background Regenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Twenty horses with naturally occurring tendinopathies of forelimb SDFTs were randomly assigned to the PRP-treated group (n = 10) or control group (n = 10) after clinical and ultrasonographic examination. The SDFTs received an intralesional treatment with autologous PRP or were injected with saline, respectively (day 0). All horses participated in a standardized exercise programme and were re-examined clinically, with B-mode ultrasonography (5 times at regular intervals) and ultrasound tissue characterization (week 12 and 24 after treatment) until week 24. Long-term performance was estimated via telephone inquiry. Results Compared to day 0, lameness decreased significantly by week 8 after treatment with PRP and by week 12 in the control group. Ultrasonographically there was no difference in the summarized cross sectional area between the groups at any time point. Ultrasound tissue characterization showed that echo types representing disorganized matrix decreased significantly throughout the observation period in the PRP-treated group. Echo type II, representing discontinuous fascicles, not yet aligned into lines of stress was significantly higher 24 weeks after PRP treatment. Eighty percent of the PRP treated horses reached their previous or a higher level of performance after 12 months compared to 50 % in the CG. After 24 months these proportions were 60 % and 50 %, respectively. Conclusions A single intralesional treatment with PRP up to 8 weeks after onset of clinical signs of tendinopathy contributes to an earlier reduction of lameness compared to saline treatment and to an advanced organization of repair tissue as the fibrillar matrix is getting organized into fascicles while remodelling continues. Long term, PRP treatment has the potential to increase the number of horses reaching their previous level of performance. Earlier treatment of tendinopathy with PRP should be considered to enhance these effects.
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Affiliation(s)
- Florian Geburek
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
| | - Moritz Gaus
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - Hans T M van Schie
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, 3584 CM, Utrecht, Netherlands
| | - Karl Rohn
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 2, 30559, Hannover, Germany
| | - Peter M Stadler
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
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White NA, Barrett JG. Magnetic Resonance Imaging-Guided Treatment of Equine Distal Interphalangeal Joint Collateral Ligaments: 2009-2014. Front Vet Sci 2016; 3:73. [PMID: 27656645 PMCID: PMC5011138 DOI: 10.3389/fvets.2016.00073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/23/2016] [Indexed: 12/22/2022] Open
Abstract
Objectives To determine the outcome of treating distal interphalangeal joint collateral ligament (DIJCL) desmopathy using magnetic resonance imaging (MRI)-guided ligament injection. Methods Medical records of 13 adult horses diagnosed with DIJCL desmopathy using low-field MRI and treated by MRI-guided ligament injection of mesenchymal stem cells and/or platelet-rich plasma (PRP) were reviewed. Information collected included signalment, MRI diagnosis, treatment type, time to resolution of lameness, and level of exercise after treatment. Results Collateral ligament inflammation was diagnosed as a cause of lameness in 13 horses. MRI was used to guide the injection of the injured DIJCL. All lameness attributed to DIJCL desmopathy resolved with the resulting level of performance at expected (10) or less than expected (3). Conclusion and clinical relevance Injection of the DIJCL can be safely completed in horses standing in a low-field magnet guided by MRI as previously demonstrated in cadaver specimens. The positive response in all horses suggests that administration of stem cells or PRP along with rest and appropriate shoeing may be a safe and useful treatment for DIJCL desmopathy.
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Affiliation(s)
- Nathaniel A White
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech , Leesburg, VA , USA
| | - Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech , Leesburg, VA , USA
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Witte S, Dedman C, Harriss F, Kelly G, Chang YM, Witte TH. Comparison of treatment outcomes for superficial digital flexor tendonitis in National Hunt racehorses. Vet J 2016; 216:157-63. [PMID: 27687944 DOI: 10.1016/j.tvjl.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/28/2022]
Abstract
Superficial digital flexor (SDF) tendonitis is a common injury in Thoroughbred racehorses. Injuries require prolonged rehabilitation, with unpredictable outcomes and a high incidence of re-injury. This observational case-control study aimed to compare race outcomes after commonly advocated treatments for tendon healing. Clinical and racing records were evaluated for 127 National Hunt racehorses treated between 2007 and 2011 for an SDF tendon injury. Two age- and sex-matched control horses were selected for each case horse to analyse the effect on post-injury racing outcomes of pre-injury data, lesion severity and treatment group [controlled exercise alone, bar firing, intralesional platelet-rich plasma (PRP), tendon splitting, tendon splitting combined with bar firing]. Control horses raced more often than case horses, with higher maximum racing post rating (RPRmax) and longer racing distances. Pre-injury racing performance was not associated with treatment group. Rate of return to racing was not associated with lesion severity or treatment group. Number of races, total distance raced post-injury and RPRmax were not associated with lesion severity or treatment group. Controlled exercise alone offered similar post-injury racing outcomes in National Hunt racehorses with SDF tendonitis to the other treatment options examined. Bar firing, either alone or in conjunction with tendon splitting, provided no additional benefit in rate of return to racing and race performance.
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Affiliation(s)
| | - C Dedman
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - F Harriss
- Fethard Equine Hospital, Fethard, Kilnockin, Tipperary, Ireland
| | - G Kelly
- Fethard Equine Hospital, Fethard, Kilnockin, Tipperary, Ireland
| | - Y-M Chang
- Research Support Office, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - T H Witte
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom.
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Ionita CR, Troillet AR, Vahlenkamp TW, Winter K, Brehm W, Ionita JC. Comparison of humoral insulin-like growth factor-1, platelet-derived growth factor-BB, transforming growth factor-β1, and interleukin-1 receptor antagonist concentrations among equine autologous blood-derived preparations. Am J Vet Res 2016; 77:898-905. [DOI: 10.2460/ajvr.77.8.898] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zeng YC, Tang HR, Zeng LP, Chen Y, Wang GP, Wu RF. Assessment of the effect of different vitrification solutions on human ovarian tissue after short-term xenotransplantation onto the chick embryo chorioallantoic membrane. Mol Reprod Dev 2016; 83:359-69. [PMID: 26924442 DOI: 10.1002/mrd.22631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/20/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Yu-Cui Zeng
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
| | - Hui-Ru Tang
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Li-Ping Zeng
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Yun Chen
- Department of Ultrasound; Peking University Shenzhen Hospital; Shenzhen China
| | - Guo-Ping Wang
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Rui-Fang Wu
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Key Laboratory of Gynecological Diagnostic Technology Research; Shenzhen China
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Lewis D, Scott M, Fischer CD, Bond SL, Léguillette R. FEASIBILITY FOR ULTRASOUND-GUIDED INJECTION OF THE COLLATERAL LIGAMENTS OF THE DISTAL INTERPHALANGEAL JOINT IN HORSES. Vet Radiol Ultrasound 2016; 57:299-305. [DOI: 10.1111/vru.12341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/21/2015] [Accepted: 11/02/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Danyse Lewis
- Moore Equine Veterinary Centre, 260048A Writing Creek Cres; Rocky View County; AB T4A 0M9 Canada
| | - Mike Scott
- Moore Equine Veterinary Centre, 260048A Writing Creek Cres; Rocky View County; AB T4A 0M9 Canada
| | - Carrie D. Fischer
- Department of Veterinary Clinical and Diagnostic Services, Faculty of Veterinary Medicine; University of Calgary; Calgary AB T2N 4N1 Canada
| | - Stephanie L. Bond
- Department of Veterinary Clinical and Diagnostic Services, Faculty of Veterinary Medicine; University of Calgary; Calgary AB T2N 4N1 Canada
| | - Renaud Léguillette
- Department of Veterinary Clinical and Diagnostic Services, Faculty of Veterinary Medicine; University of Calgary; Calgary AB T2N 4N1 Canada
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Barrett MF, Frisbie DD, King MR, Werpy NM, Kawcak CE. A review of how magnetic resonance imaging can aid in case management of common pathological conditions of the equine foot. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12542] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M. F. Barrett
- Department of Environmental and Radiological Health Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - D. D. Frisbie
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - M. R. King
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - N. M. Werpy
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville USA
| | - C. E. Kawcak
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
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Jalowiec JM, D'Este M, Bara JJ, Denom J, Menzel U, Alini M, Verrier S, Herrmann M. An In Vitro Investigation of Platelet-Rich Plasma-Gel as a Cell and Growth Factor Delivery Vehicle for Tissue Engineering. Tissue Eng Part C Methods 2015; 22:49-58. [PMID: 26467221 DOI: 10.1089/ten.tec.2015.0223] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Platelet-rich plasma (PRP) has been used for different applications in human and veterinary medicine. Many studies have shown promising therapeutic effects of PRP; however, there are still many controversies regarding its composition, properties, and clinical efficacy. The aim of this study was to evaluate the influence of different platelet concentrations on the rheological properties and growth factor (GF) release profile of PRP-gels. In addition, the viability of incorporated bone marrow-derived human mesenchymal stem cells (MSCs) was investigated. PRP (containing 1000 × 10(3), 2000 × 10(3), and 10,000 × 10(3) platelets/μL) was prepared from human platelet concentrates. Platelet activation and gelification were achieved by addition of human thrombin. Viscoelastic properties of PRP-gels were evaluated by rheological studies. The release of GFs and inflammatory proteins was measured using a membrane-based protein array and enzyme-linked immunosorbent assay. MSC viability and proliferation in PRP-gels were assessed over 7 days by cell viability staining. Cell proliferation was examined using DNA quantification. Regardless of the platelet content, all tested PRP-gels showed effective cross-linking. A positive correlation between protein release and the platelet concentration was observed at all time points. Among the detected proteins, the chemokine CCL5 was the most abundant. The greatest release appeared within the first 4 h after gelification. MSCs could be successfully cultured in PRP-gels over 7 days, with the highest cell viability and DNA content found in PRP-gels with 1000 × 10(3) platelets/μL. The results of this study suggest that PRP-gels represent a suitable carrier for both cell and GF delivery for tissue engineering. Notably, a platelet concentration of 1000 × 10(3) platelets/μL appeared to provide the most favorable environment for MSCs. Thus, the platelet concentration is an important consideration for the clinical application of PRP-gels.
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Affiliation(s)
| | | | | | - Jessica Denom
- 2 Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université Paris Diderot Paris 7 , Paris, France
| | | | - Mauro Alini
- 1 AO Research Institute Davos , Davos, Switzerland
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42
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Ghassab S, Dulin J, Bertone AL. Thromboelastographic Clot Characteristics of Autologous Equine Blood Products After Activation by Autologous Thrombin, Bovine Thrombin, or Calcium Chloride. Vet Surg 2015; 44:970-5. [DOI: 10.1111/vsu.12404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jennifer Dulin
- Department of Veterinary Medicine; The Ohio State University; Columbus Ohio
| | - Alicia L. Bertone
- Department of Veterinary Medicine; The Ohio State University; Columbus Ohio
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43
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Smith RK, Garvican ER, Fortier LA. The current 'state of play' of regenerative medicine in horses: what the horse can tell the human. Regen Med 2015; 9:673-85. [PMID: 25372081 DOI: 10.2217/rme.14.42] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The horse is an attractive model for many human age-related degenerative diseases of the musculoskeletal system because it is a large animal species that both ages and exercises, and develops naturally occurring injuries with many similarities to the human counterpart. It therefore represents an ideal species to use as a 'proving ground' for new therapies, most notably regenerative medicine. Regenerative techniques using cell-based therapies for the treatment of equine musculoskeletal disease have been in use for over a decade. This review article provides a summary overview of the sources, current challenges and problems surrounding the use of stem cell and non-cell-based therapy in regenerative medicine in horses and is based on presentations from a recent Havemeyer symposium on equine regenerative medicine where speakers are selected from leading authorities in both equine and human regenerative medicine fields from 10 different countries.
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Affiliation(s)
- Roger Kw Smith
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK
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44
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Brossi PM, Moreira JJ, Machado TSL, Baccarin RYA. Platelet-rich plasma in orthopedic therapy: a comparative systematic review of clinical and experimental data in equine and human musculoskeletal lesions. BMC Vet Res 2015; 11:98. [PMID: 25896610 PMCID: PMC4449579 DOI: 10.1186/s12917-015-0403-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/20/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This systematic review aimed to present and critically appraise the available information on the efficacy of platelet rich plasma (PRP) in equine and human orthopedic therapeutics and to verify the influence of study design and methodology on the assumption of PRP's efficacy. We searched Medline, PubMed, Embase, Bireme and Google Scholar without restrictions until July 2013. Randomized trials, human cohort clinical studies or case series with a control group on the use of PRP in tendons, ligaments or articular lesions were included. Equine clinical studies on the same topics were included independently of their design. Experimental studies relevant to the clarification of PRP's effects and mechanisms of action in tissues of interest, conducted in any animal species, were selected. RESULTS This review included 123 studies. PRP's beneficial effects were observed in 46.7% of the clinical studies, while the absence of positive effects was observed in 43.3%. Among experimental studies, 73% yielded positive results, and 7.9% yielded negative results. The most frequent flaws in the clinical trials' designs were the lack of a true placebo group, poor product characterization, insufficient blinding, small sampling, short follow-up periods, and adoption of poor outcome measures. The methods employed for PRP preparation and administration and the selected outcome measures varied greatly. Poor study design was a common feature of equine clinical trials. From studies in which PRP had beneficial effects, 67.8% had an overall high risk of bias. From the studies in which PRP failed to exhibit beneficial effects, 67.8% had an overall low risk of bias. CONCLUSIONS Most experimental studies revealed positive effects of PRP. Although the majority of equine clinical studies yielded positive results, the human clinical trials' results failed to corroborate these findings. In both species, beneficial results were more frequently observed in studies with a high risk of bias. The use of PRP in musculoskeletal lesions, although safe and promising, has still not shown strong evidence in clinical scenarios.
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Affiliation(s)
- Patrícia M Brossi
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Juliana J Moreira
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Thaís S L Machado
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Raquel Y A Baccarin
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
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45
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Lomas A, Ryan C, Sorushanova A, Shologu N, Sideri A, Tsioli V, Fthenakis G, Tzora A, Skoufos I, Quinlan L, O'Laighin G, Mullen A, Kelly J, Kearns S, Biggs M, Pandit A, Zeugolis D. The past, present and future in scaffold-based tendon treatments. Adv Drug Deliv Rev 2015; 84:257-77. [PMID: 25499820 DOI: 10.1016/j.addr.2014.11.022] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 11/08/2014] [Accepted: 11/12/2014] [Indexed: 02/07/2023]
Abstract
Tendon injuries represent a significant clinical burden on healthcare systems worldwide. As the human population ages and the life expectancy increases, tendon injuries will become more prevalent, especially among young individuals with long life ahead of them. Advancements in engineering, chemistry and biology have made available an array of three-dimensional scaffold-based intervention strategies, natural or synthetic in origin. Further, functionalisation strategies, based on biophysical, biochemical and biological cues, offer control over cellular functions; localisation and sustained release of therapeutics/biologics; and the ability to positively interact with the host to promote repair and regeneration. Herein, we critically discuss current therapies and emerging technologies that aim to transform tendon treatments in the years to come.
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Romagnoli N, Rinnovati R, Ricciardi G, Lambertini C, Spinella G, Spadari A. Clinical Evaluation of Intralesional Injection of Platelet-Rich Plasma for the Treatment of Proximal Suspensory Ligament Desmitis in Horses. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2014.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Souza MVD, Pinto JDO, Costa MMD, Santos ECD, Garcia SL, Oliveira LLD. Quantificação de fatores de crescimento na pele de equinos tratada com plasma rico em plaquetas. PESQUISA VETERINÁRIA BRASILEIRA 2014. [DOI: 10.1590/s0100-736x2014000600016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
O plasma rico em plaquetas (PRP) é um produto derivado da centrifugação do sangue total, sendo rico em fatores bioativos, como os de crescimento. Apesar da ampla utilização em processos cicatriciais, há controvérsia sobre a eficácia da terapia na cicatrização cutânea. O objetivo desse estudo foi quantificar e comparar a concentração dos fatores TGF-β1 e PDGF-BB no PRP, plasma sanguíneo e pele, durante diferentes fases do processo de cicatrização da pele tratada ou não com PRP. Foram utilizados sete equinos machos castrados, mestiços, hígidos, com idade entre 16 e 17 (16,14±0,63) anos. Três lesões em formato quadrangular (6,25cm²) foram produzidas cirurgicamente nas regiões glúteas direita e esquerda de todos os animais. Doze horas após indução das feridas, 0,5mL do PRP foi administrado em cada uma das quatro extremidades das feridas de uma das regiões glúteas (Grupo tratado = GT), escolhida aleatoriamente. A região contralateral foi utilizada como controle (GC). As feridas foram submetidas à limpeza diária com água Milli Q, e amostras foram obtidas mediante biópsias realizadas com Punch de 6mm. Foram obtidas seis biópsias de pele, sendo a primeira realizada logo após a produção da ferida (T0), e as demais com 1 (T1) 2 (T2) 7 (T3) e 14 (T4) dias após a indução da lesão. A sexta biópsia (T5) foi obtida após completo fechamento da pele, que ocorreu aproximadamente aos 37 dias (36,85±7,45, GC; 38,85±6,46, GT). Também foram obtidas amostras de sangue com EDTA em todos os tempos mencionados. A quantificação dos fatores de crescimento TGF-β1 e PDGF-BB na pele, PRP e plasma sanguíneo foi realizada pela técnica ELISA. Os dados foram analisados estatisticamente pelo teste t, correlação de Pearson e regressão, utilizando nível de significância de 5%. Não houve diferença entre os grupos, nos valores dos dois fatores de crescimento mensurados na pele, nos diferentes tempos. Também não houve correlação entre a quantidade dos fatores de crescimento presentes na pele e no plasma. Por outro lado, correlação positiva foi observada entre PRP e pele no grupo tratado, para os fatores de crescimento TGF-β1 (r=0,31) e PDGF-BB (r=0,38), bem como entre ambos os fatores de crescimento presentes no PRP (r=0,81). Considerando as concentrações dos fatores de crescimento no T0, os maiores valores cutâneos (p<0,05) do TGF-β1, em ambos os grupos, ocorreram nos tempos T3 e T5. Valores mais elevados (p<0,05) do PDGF-BB ocorreram no T4 (GT) e T5 (GC). No plasma não houve alteração nas concentrações desses fatores em relação ao T0, o que sugere que o PRP não acarreta efeito sistêmico, quando os procedimentos adotados na presente pesquisa são utilizados. A administração local de PRP no volume estudado, 12 h após indução cirúrgica de ferida cutânea na região glútea de equinos não ocasiona maiores concentrações dos fatores de crescimento TGF-β1 e PDGF-BB no plasma sanguíneo e pele, durante o processo de cicatrização.
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48
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Elder S, Thomason J. Effect of platelet-rich plasma on chondrogenic differentiation in three-dimensional culture. Open Orthop J 2014; 8:78-84. [PMID: 24843389 PMCID: PMC4023405 DOI: 10.2174/1874325001408010078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/16/2014] [Accepted: 04/20/2014] [Indexed: 02/01/2023] Open
Abstract
Platelet-rich plasma (PRP) may have the potential to enhance articular cartilage regeneration through release of
growth factors including transforming growth factor isoforms. The purpose of this study was to investigate the potential
for PRP to stimulate chondrogenic differentiation in three-dimensional PRP hydrogel constructs. Allogenic PRP was
prepared using a double centrifugation protocol which resulted in a platelet concentration approximately 250% above
baseline. Canine marrow stromal cells were encapsulated at 6.8×106 cells/ml in either 2% sodium alginate or in a 3:1
mixture of freshly prepared PRP and 2% alginate. PRP and alginate beads were cultured in chemically defined
chondrogenic medium with and without 10 ng/ml TGF-β3. PRP cultures were additionally supplemented with frozen-thawed
PRP. In the absence of TGF-β3, PRP had a mild stimulatory effect on cell proliferation. PRP did not stimulate cell
proliferation in the presence of TGF-β3. Cells exposed to TGF-β3 accumulated significantly more GAG/DNA than those
which were not, but there was not a statistically significant difference between alginate and PRP. Total collagen content
was greater in PRP than in alginate, regardless of TGF-β3. Chondrogenesis in PRP was qualitatively and spatially
different than that which occurred in conventional alginate beads and was characterized by isolated centers of intense
chondrogenesis. Overall the results demonstrate that PRP alone weakly promotes chondroinduction of marrow stromal
cells, and the effect is greatly augmented by TGF-β3.
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Affiliation(s)
- Steven Elder
- Department of Agricultural & Biological Engineering, Bagley College of Engineering, Mississippi State University, Starkville, MS, USA
| | - John Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, USA
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Bertone AL, Ishihara A, Zekas LJ, Wellman ML, Lewis KB, Schwarze RA, Barnaba AR, Schmall ML, Kanter PM, Genovese RL. Evaluation of a single intra-articular injection of autologous protein solution for treatment of osteoarthritis in horses. Am J Vet Res 2014; 75:141-51. [PMID: 24471750 DOI: 10.2460/ajvr.75.2.141] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate intra-articular autologous protein solution (APS) for the treatment of osteoarthritis in horses. Animals-40 client-owned horses with naturally occuring osteoarthritis. PROCEDURES APS was generated from a dual-device system that concentrated plasma and WBC proteins and enriched platelet growth factors. Horses were randomly assigned to receive an intra-articular injection of 5 mL of saline (0.9% NaCl) solution (n = 20) or APS (20), exercised on a treadmill, and evaluated on the basis of lameness grades, kinetic gait analysis, joint circumference, and range of motion for 14 days. Horses that received saline solution were administered APS at termination of the study, and clients scored horses for lameness and discomfort before, 12 weeks after, and 52 weeks after the APS injection. RESULTS The APS group had significant improvements in lameness grade, asymmetry indices of vertical peak force, and range of joint motion by 14 days, compared with baseline or control group values. No adverse effects associated with APS treatment were evident. Clients assessed lameness and comfort as improved at 12 and 52 weeks. The APS had greater likelihood (OR, 4.3 to 30.0) of a therapeutic response in horses with a lameness score < 4, < 10% vertical force asymmetry, or absence of marked osteophyte formation, subchondral sclerosis, or joint space narrowing. Concentration of interleukin-1 receptor antagonist in APS was 5.8 times that in blood. CONCLUSIONS AND CLINICAL RELEVANCE Intra-articular administration of APS can be considered an effective treatment option for equine osteoarthritis, with the potential for disease-modifying effects.
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Affiliation(s)
- Alicia L Bertone
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210
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Rich FR. Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/scd.2014.42005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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