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Topic:Muscle

The topic of muscle in horses encompasses the study of equine muscle structure, function, and physiology. Muscles in horses are responsible for movement, posture, and various metabolic processes. They are composed of muscle fibers that contract and relax to produce motion and generate force. Research in this area often focuses on muscle development, adaptation to exercise, and the impact of nutrition and training on muscle performance. Conditions such as muscle fatigue, injury, and disorders like equine exertional rhabdomyolysis are also explored. This page compiles peer-reviewed research studies and scholarly articles that investigate the anatomy, physiology, and clinical aspects of muscle in equine species.
Enhancing the Horse Grimace Scale (HGS): Proposed updates and anatomical descriptors for pain assessment.
Veterinary journal (London, England : 1997)    August 12, 2024   Volume 307 106223 doi: 10.1016/j.tvjl.2024.106223
Werner LC, de Oliveira GM, Daros RR, Costa ED, Michelotto PV.The use of grimace scales enables the clinical identification of changes in the facial expressions of animals caused by pain. The Horse Grimace Scale (HGS) is one such tool, comprising a pain coding system based on facial expressions and assessing six Facial Action Units (FAUs). Each FAU is accompanied by descriptions and anatomical details to assist the evaluator. However, the morphological descriptions for certain FAUs in the HGS are not sufficiently detailed, potentially hindering accurate interpretation. This study is an analytical investigation aimed at enhancing the morphoanatomical deta...
Effects of pacing strategy on metabolic responses to 2-min intense exercise in Thoroughbred horses.
Scientific reports    August 7, 2024   Volume 14, Issue 1 18352 doi: 10.1038/s41598-024-69339-x
Takahashi K, Mukai K, Ebisuda Y, Sugiyama F, Yoshida T, Hatta H, Kitaoka Y.Evidence suggests that positive pacing strategy improves exercise performance and fatigue tolerance in athletic events lasting 1-5 min. This study investigated muscle metabolic responses to positive and negative pacing strategies in Thoroughbred horses. Eight Thoroughbred horses performed 2 min treadmill running using positive (1 min at 110% maximal O uptake [V̇Omax], followed by 1 min at 90% V̇Omax) and negative (1 min at 90% V̇Omax, followed by 1 min at 110% V̇Omax) pacing strategies. The arterial-mixed venous O difference did not significantly differ between the two strategies. Pl...
Equine Sarcocystosis in the Northern Region of the Republic of Kazakhstan.
Animals : an open access journal from MDPI    August 7, 2024   Volume 14, Issue 16 2299 doi: 10.3390/ani14162299
Bermukhametov Z, Suleimanova K, Tomaruk O, Baimenov B, Shevchenko P, Batyrbekov A, Mikniene Z, Onur Girişgin A, Rychshanova R.A total of 396 samples were taken from the hearts, oesophagi, and diaphragms of 132 horses slaughtered at slaughterhouses in 2023 for subsequent examination. Methods: The histological method revealed pathomorphological changes in the muscle tissue. The molecular method identified the pathogen species. Results: Histological examination revealed thick-walled cysts with internal septa and numerous bradyzoites, and mononuclear inflammatory cells with pericyst infiltrates. Microcyst samples were amplified by polymerase chain reaction. Molecular genetic analysis allowed for the identification of 18 ...
Nerve entry points in the mimic musculature of the horse head.
Anatomia, histologia, embryologia    August 5, 2024   Volume 53, Issue 5 e13099 doi: 10.1111/ahe.13099
Wolschrijn CF, Smit IH, Schouten J, Moller Te NCR.Facial expressions are important in pain recognition in horses, but current observation-based pain scales remain subjective. A promising technique to quantitatively measure subtle changes in expression patterns, including changes invisible to the human eye, is surface electromyography (sEMG). To achieve high-quality and reliable sEMG signals, unilateral placement of bipolar electrodes is required in relation to the motor endplates (MEP). We aimed to localize the nerve entry points (NEPs; where the nerve branch first pierced the muscle belly) and the direction of the terminal nerve endings to e...
Return to sport activity following ultrasonographic diagnosis and conservative management of spontaneous injuries of the serratus cervicis ventralis and serratus thoracis ventralis muscles in 11 endurance horses.
Journal of the American Veterinary Medical Association    August 2, 2024   1-6 doi: 10.2460/javma.24.03.0211
Puccetti M, Pilati N, Beccati F, Denoix JM.To describe the clinical diagnosis, ultrasound findings, and outcome of 11 endurance horses with injuries to the serratus ventralis thoracis (SVT) or serratus ventralis cervicis (SVC) muscle. Methods: 11 endurance horses competing in medium- to high-level competitions and presenting with lameness caused by injuries to the SVT or SVC muscle, as confirmed by ultrasonography. Methods: Physical examinations revealed swelling caudal to the shoulder region associated with dorsocranial displacement of the scapula and edema of the ventral thorax for horses with SVT injuries. Swelling cranial to the sc...
Culture and Immunomodulation of Equine Muscle-Derived Mesenchymal Stromal Cells: A Comparative Study of Innovative 2D versus 3D Models Using Equine Platelet Lysate.
Cells    July 31, 2024   Volume 13, Issue 15 1290 doi: 10.3390/cells13151290
Duysens J, Graide H, Niesten A, Mouithys-Mickalad A, Deby-Dupont G, Franck T, Ceusters J, Serteyn D.Muscle-derived mesenchymal stromal cells (mdMSCs) hold great promise in regenerative medicine due to their immunomodulatory properties, multipotent differentiation capacity and ease of collection. However, traditional in vitro expansion methods use fetal bovine serum (FBS) and have numerous limitations including ethical concerns, batch-to-batch variability, immunogenicity, xenogenic contamination and regulatory compliance issues. This study investigates the use of 10% equine platelet lysate (ePL) obtained by plasmapheresis as a substitute for FBS in the culture of mdMSCs in innovative 2D and 3...
Large-scale study of blood markers in equine atypical myopathy reveals subclinical poisoning and advances in diagnostic and prognostic criteria.
Environmental toxicology and pharmacology    July 18, 2024   Volume 110 104515 doi: 10.1016/j.etap.2024.104515
Renaud B, Kruse CJ, François AC, Cesarini C, van Loon G, Palmers K, Boemer F, Luis G, Gustin P, Votion DM.Equine atypical myopathy (AM) is a severe rhabdomyolysis syndrome primarily caused by hypoglycin A (HGA) and methylenecyclopropylglycine protoxins. This study aimed to refine diagnostic and prognostic criteria for AM while exploring apparently healthy cograzers. Blood samples from 263 horses, including AM cases (n= 95), cograzers (n= 73), colic horses (n= 19), and controls (n= 76), were analyzed for HGA, its toxic metabolite, and acylcarnitines profile. Diseased horses exhibited alterations in acylcarnitines that strongly distinguished them from controls and colic horses. Regression analyses i...
Changes of mRNA, miRNA and lncRNA expression contributing to skeletal muscle differences between fetus and adult Mongolian horses.
Comparative biochemistry and physiology. Part D, Genomics & proteomics    July 16, 2024   Volume 52 101294 doi: 10.1016/j.cbd.2024.101294
Ding W, Gong W, Liu H, Hu H, Shi L, Ren X, Cao Y, Zhang A, Shi X, Li Z, Bou T, Dugarjaviin M, Bai D.The growth and development of myofibers, as the fundamental units comprising muscle tissue, and their composition type are indeed among the most crucial factors influencing skeletal muscle types. Muscle fiber adaptation is closely associated with alterations in physiological conditions. Muscle fiber types undergo dynamic changes in fetus and adult horses. Our aim is to investigate the mechanisms influencing the differences in muscle fiber types between fetal and adult stages of Mongolian horses. The study investigated the distribution of muscle fiber types within longissimus dorsi muscle of fe...
Muscle-Driven Predictive Physics Simulations of Quadrupedal Locomotion in the Horse.
Integrative and comparative biology    July 14, 2024   Volume 64, Issue 3 694-714 doi: 10.1093/icb/icae095
van Bijlert PA, Geijtenbeek T, Smit IH, Schulp AS, Bates KT.Musculoskeletal simulations can provide insights into the underlying mechanisms that govern animal locomotion. In this study, we describe the development of a new musculoskeletal model of the horse, and to our knowledge present the first fully muscle-driven, predictive simulations of equine locomotion. Our goal was to simulate a model that captures only the gross musculoskeletal structure of a horse, without specialized morphological features. We mostly present simulations acquired using feedforward control, without state feedback ("top-down control"). Without using kinematics or motion captur...
Characterisation of phenotypic patterns in equine exercise-associated myopathies.
Equine veterinary journal    July 5, 2024   doi: 10.1111/evj.14128
Lindsay-McGee V, Massey C, Li YT, Clark EL, Psifidi A, Piercy RJ.Equine exercise-associated myopathies are prevalent, clinically heterogeneous, generally idiopathic disorders characterised by episodes of myofibre damage that occur in association with exercise. Episodes are intermittent and vary within and between affected horses and across breeds. The aetiopathogenesis is often unclear; there might be multiple causes. Poor phenotypic characterisation hinders genetic and other disease analyses. Objective: The aim of this study was to characterise phenotypic patterns across exercise-associated myopathies in horses. Methods: Historical cross-sectional study, w...
Timing of feeding a protein supplement on nitrogen balance and plasma amino acids during exercise recovery in horses.
Journal of animal physiology and animal nutrition    July 2, 2024   doi: 10.1111/jpn.14012
Graham-Thiers P, Bowen K.Eight geldings weighing 544 ± 16 kg were used to evaluate feeding a postexercise protein meal on plasma amino acids during recovery. Horses were fed sweet feed, corn, grass hay and equal amounts of a protein pellet (32% CP) with meals (MP group) or postexercise (EP group). Horses exercised 1-2 h/day, 5 days/week, for 12 weeks. A pre and poststudy 4 days total urine and feces collection was conducted. Urine and fecal samples were analyzed for nitrogen (N) to calculate N balance. Blood samples were drawn immediately after and at 1 and 3 h postexercise at the start and end of the stud...
Physiological comparison of conditioned and non-conditioned university horses following semester break.
Journal of equine veterinary science    June 28, 2024   105143 doi: 10.1016/j.jevs.2024.105143
Stellmack JM, Logan AA, Higgins AH, Hoffman RM.Periods of limited activity during semester break may reduce performance during return to ridden work. This study evaluated fitness and muscling of horses when returning to work, following a 12-week period during which horses either continued (conditioned) or discontinued (non-conditioned) ridden work. It was hypothesized that non-conditioned horses would have a lower level of fitness, resulting in higher resting and peak heart rates and lower levels of muscling. Twelve mature, stock type horses aged 16 ± 5 years were assigned to either a conditioned group that maintained light-to-moderate ri...
Influence of surgical intervention at the level of the dorsal spinous processes on the biomechanics of the equine thoracolumbar spine.
Equine veterinary journal    June 27, 2024   doi: 10.1111/evj.14123
Baudisch N, Singer E, Jensen KC, Eichler F, Meyer HJ, Lischer C, Ehrle A.Surgical treatment options for horses with overriding dorsal spinous processes include interspinous ligament desmotomy and partial spinous process ostectomy. The impact of spinal surgery on the three-dimensional biomechanics of the equine thoracolumbar spine and the epaxial musculature is unclear. Objective: To investigate the influence of interspinous ligament desmotomy and cranial wedge ostectomy on the biomechanics of the equine thoracolumbar spine and the paraspinal Musculi multifidi. Methods: Ex-vivo experiments. Methods: Twelve equine thoracolumbar spine specimens were mounted in a custo...
Comparative transcriptome analysis of slow-twitch and fast-twitch muscles in Kazakh horses.
Meat science    June 26, 2024   Volume 216 109582 doi: 10.1016/j.meatsci.2024.109582
Wang J, Ren W, Sun Z, Han Z, Zeng Y, Meng J, Yao X.This study conducted a thorough analysis of the myofiber type composition in the extensor digitorum longus muscle (EDL) and soleus muscle (SOL) of Kazakh horses, across different genders (male and female). The results showed significant differences in myofiber type composition between EDL and SOL, with a higher proportion of Type I fibers in SOL muscles and a greater prevalence of Type II fibers in EDL muscles. Additionally, the myofiber diameter in Kazakh horses was relatively small, potentially related to the tenderness and edible quality of their muscles. Using high-throughput sequencing te...
Adiposity in mares induces insulin dysregulation and mitochondrial dysfunction which can be mitigated by nutritional intervention.
Scientific reports    June 18, 2024   Volume 14, Issue 1 13992 doi: 10.1038/s41598-024-64628-x
Fresa K, Catandi GD, Whitcomb L, Gonzalez-Castro RA, Chicco AJ, Carnevale EM.Obesity is a complex disease associated with augmented risk of metabolic disorder development and cellular dysfunction in various species. The goal of the present study was to investigate the impacts of obesity on the metabolic health of old mares as well as test the ability of diet supplementation with either a complex blend of nutrients designed to improve equine metabolism and gastrointestinal health or L-carnitine alone to mitigate negative effects of obesity. Mares (n = 19, 17.9 ± 3.7 years) were placed into one of three group: normal-weight (NW, n = 6), obese (OB, n = 7...
Changes in muscle activation with graded surfaces during canter in Thoroughbred horses on a treadmill.
PloS one    June 14, 2024   Volume 19, Issue 6 e0305622 doi: 10.1371/journal.pone.0305622
Takahashi Y, Takahashi T, Mukai K, Ebisuda Y, Ohmura H.Understanding how muscle activity changes with different surface grades during canter is essential for developing training protocols in Thoroughbreds because canter is their primary gait in training and races. We measured the spatiotemporal parameters and the activation of 12 surface muscles in the leading limb side of 7 Thoroughbreds. Horses were equipped with hoof strain gauges and cantered at 10 m/s on a treadmill set to grades of -4%, 0%, 4%, and 8%, randomly, for 30 seconds each without a lead change. Integrated electromyography (iEMG) values during stance and swing phases were calculated...
Inflammatory and Immune-Mediated Myopathies, What Do We Know?
The Veterinary clinics of North America. Equine practice    June 7, 2024   S0749-0739(24)00036-1 doi: 10.1016/j.cveq.2024.05.003
Aleman M.Inflammatory myopathies or myositis encompass diseases characterized by the presence of inflammatory cellular infiltrates, mainly polymorphonuclear cells and/or lymphocytes, in muscle. This is in contrast to most forms of muscle disease characterized by myodegeneration that results in macrophage infiltration. Inflammatory myopathies could have infectious or noninfectious causes. Noninfectious causes consist of primary (genetic, autoimmune) or acquired immune-mediated disease. Focal, multifocal or diffuse, acute or recurrent forms of disease can occur. This article will mainly review immune-med...
Primary phenotypic features associated with caudal neck pathology in warmblood horses.
Journal of veterinary internal medicine    June 3, 2024   doi: 10.1111/jvim.17125
Dyson S, Zheng S, Aleman M.Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available. Objective: Describe the clinical features associated with neck pain or stiffness, neck-related thoracic limb lameness, proprioceptive ataxia consistent with a cervicothoracic spinal cord or nerve lesion, and their frequency of occurrence compared with control horses. Methods: A total of 223 Warmblood horses. Methods: Case-control study. Controls and cases were recruited prospectively. All horses underwent predetermined lameness and neurologic examinations. Th...
Effects of conditioning on the left ventricular function of young purebred Arabian horses.
PloS one    June 3, 2024   Volume 19, Issue 6 e0304724 doi: 10.1371/journal.pone.0304724
Ramos GV, Santos MM, Gava FN, de Lacerda-Neto JC.The effects of conditioning on cardiac function in young horses is still unknown. For this reason, this study evaluated the left ventricular (LV) function of young horses by echocardiography after six weeks of conditioning. Fourteen untrained young purebred Arabian horses were evaluated at rest and after a stress test (ST) before and after a six-week conditioning program. There was an increase in V4 (p < 0.001) after conditioning, as well as a reduction in both heart rate (HR) at rest and peak HR during the ST (p < 0.001). There was also a reduction in internal diameter, along with an in...
Heat acclimation improves exercise performance in hot conditions and increases heat shock protein 70 and 90 of skeletal muscles in Thoroughbred horses.
Physiological reports    May 25, 2024   Volume 12, Issue 10 e16083 doi: 10.14814/phy2.16083
Ebisuda Y, Mukai K, Takahashi Y, Yoshida T, Matsuhashi T, Kawano A, Miyata H, Kuwahara M, Ohmura H.This study aimed to determine whether heat acclimation could induce adaptations in exercise performance, thermoregulation, and the expression of proteins associated with heat stress in the skeletal muscles of Thoroughbreds. Thirteen trained Thoroughbreds performed 3 weeks of training protocols, consisting of cantering at 90% maximal oxygen consumption (VO2max) for 2 min 2 days/week and cantering at 7 m/s for 3 min 1 day/week, followed by a 20-min walk in either a control group (CON; Wet Bulb Globe Temperature [WBGT] 12-13°C; n = 6) or a heat acclimation group (HA; WBGT 29-30°...
The application of a single session of capacitive resistive electric transfer 24 h before exercise modifies the accelerometric pattern in standardbred racing trotters.
BMC veterinary research    May 22, 2024   Volume 20, Issue 1 217 doi: 10.1186/s12917-024-04039-2
Argüelles D, Saitua A, Miraz R, Calle-González N, Requena F, Nocera I, Vitale V, Sgorbini M, Muñoz A.It has been reported that capacitive resistive electric transfer (CRET) increases blood circulation, hemoglobin oxygenation and temperature in muscles. The attributed benefits of these changes have been linked to improved athletic performance, enhanced muscle flexibility and fastening recovery from exercise-induced fatigue. For all of this, the present research aims to investigate whether the application of CRET 24 h before exercise affects the accelerometric pattern in horses during exercise. Six sound Standardbred trotters were subjected to a CRET session of 40 min of duration, applied on ...
Ultrasonographic measurement of diaphragm muscle activity for assessment of respiratory function in horses.
Journal of equine veterinary science    May 17, 2024   105100 doi: 10.1016/j.jevs.2024.105100
Oliveira BE, Canola PA.Ultrasonographic imaging of the diaphragm is a non-invasive alternative for respiratory function evaluation in horses. This study aimed to measure diaphragm thickness, thickening (change in thickness with contraction) and thickening fraction in healthy adult horses during tidal breathing and forced vital capacity. Correlation between body weight (≤400 kg and >400 kg) and diaphragm thickness was investigated. To that purpose, 20 adult horses, weight 409±50 kg, height 1.47±0.05 m, and age 16±6 years were included in the study. Diaphragm thickness was measured at end-inspiration and end-e...
Equine Musculoskeletal Pathologies: Clinical Approaches and Therapeutical Perspectives-A Review.
Veterinary sciences    April 26, 2024   Volume 11, Issue 5 doi: 10.3390/vetsci11050190
Reis IL, Lopes B, Sousa P, Sousa AC, Caseiro AR, Mendonça CM, Santos JM, Atayde LM, Alvites RD, Maurício AC.Musculoskeletal injuries such as equine osteoarthritis, osteoarticular defects, tendonitis/desmitis, and muscular disorders are prevalent among sport horses, with a fair prognosis for returning to exercise or previous performance levels. The field of equine medicine has witnessed rapid and fruitful development, resulting in a diverse range of therapeutic options for musculoskeletal problems. Staying abreast of these advancements can be challenging, prompting the need for a comprehensive review of commonly used and recent treatments. The aim is to compile current therapeutic options for managin...
Investigating age-related differences in muscles of Kazakh horse through transcriptome analysis.
Gene    April 24, 2024   Volume 919 148483 doi: 10.1016/j.gene.2024.148483
Ren W, Wang J, Zeng Y, Wang T, Sun Z, Meng J, Yao X.This study conducted transcriptome sequencing on the skeletal muscles of three different anatomical locations across various growth stages to investigate the impact of ages on crucial candidate genes and molecular mechanisms associated with muscle development in Kazakh horses. Sixteen Kazakh horses were selected, and they were divided into four age groups, each with four biological replicates. Tissue samples from the longest dorsal muscle, abdominal muscle, and diaphragm muscle were collected for analysis. The results revealed differential mRNA expression in the longest dorsal muscle between t...
Local and systemic responses to repeated gluteal muscle microbiopsies in mature sedentary horses.
Journal of equine veterinary science    April 18, 2024   105070 doi: 10.1016/j.jevs.2024.105070
Artman JL, Wesolowski LT, Semanchik PL, Isles JK, Norton SA, White-Springer SH.We aimed to test the hypothesis that repeated muscle collections would impact mitochondrial function, antioxidant status, and markers of inflammation and muscle damage. Twenty-six horses (8 geldings, 18 mares; mean±SD 9.5±3.5 y) had gluteus medius muscle biopsy samples collected at: 0 and 24h (n=7); 0 and 6h (n=6); 0, 6, and 12h (n=7); or 0, 6, 12, and 24h (n=6). Blood was collected from all horses every 6h for 72h, starting 24h prior to the 0h muscle collection. Data were analyzed using mixed linear models. Muscle integrative (per mg tissue) electron transfer capacity of complex II decrease...
Lameness, muscle atrophy, and a discharging tract overlying the right shoulder region in a 3-year-old gelding.
Journal of the American Veterinary Medical Association    April 10, 2024   1-3 doi: 10.2460/javma.24.02.0085
Fletcher O, Brennan M, Pereira M, Bianco C, Dixon J.No abstract available
Identification of mulberry leaf flavonoids and evaluating their protective effects on H2O2-induced oxidative damage in equine skeletal muscle satellite cells.
Frontiers in molecular biosciences    April 8, 2024   Volume 11 1353387 doi: 10.3389/fmolb.2024.1353387
Zhang X, Geng A, Cao D, Dugarjaviin M. Horses are susceptible to oxidative stress during strenuous endurance exercise, leading to muscle fatigue and damage. Mulberry leaf flavonoids (MLFs) possess significant antioxidant properties. However, the antioxidant efficacy of MLFs can be influenced by the extraction process, and their impact on HO-induced oxidative stress in equine skeletal muscle satellite cells (ESMCs) remains unexplored. Our study employed three extraction methods to obtain MLFs: ultrasound-assisted extraction (CEP), purification with AB-8 macroporous resin (RP), and n-butanol extraction (NB-EP). We assessed the prot...
Gross, organoleptic and histologic assessment of cadaveric equine heads preserved using chemical methods for veterinary surgical teaching.
Journal of veterinary science    April 3, 2024   Volume 25, Issue 2 e29 doi: 10.4142/jvs.23176
Romero Corrêa R, Peres Mendes R, Darley Velasquez Piñeros D, De Lima AE, do Valle De Zoppa AL, Lopes Correia da Silva LC, de Francisco Strefezzi R....Preservation of biological tissues has been used since ancient times. Regardless of the method employed, tissue preservation is thought to be a vital step in veterinary surgery teaching and learning. Objective: This study was designed to determine the usability of chemically preserved cadaveric equine heads for surgical teaching in veterinary medicine. Methods: Six cadaveric equine heads were collected immediately after death or euthanasia and frozen until fixation. Fixation was achieved by using a hypertonic solution consisting of sodium chloride, sodium nitrite and sodium nitrate, and an alc...
Classification performance of sEMG and kinematic parameters for distinguishing between non-lame and induced lameness conditions in horses.
Frontiers in veterinary science    April 2, 2024   Volume 11 1358986 doi: 10.3389/fvets.2024.1358986
St George LB, Spoormakers TJP, Hobbs SJ, Clayton HM, Roy SH, Richards J, Serra Bragança FM.Despite its proven research applications, it remains unknown whether surface electromyography (sEMG) can be used clinically to discriminate non-lame from lame conditions in horses. This study compared the classification performance of sEMG absolute value (sEMGabs) and asymmetry (sEMGasym) parameters, alongside validated kinematic upper-body asymmetry parameters, for distinguishing non-lame from induced fore- (iFL) and hindlimb (iHL) lameness. Bilateral sEMG and 3D-kinematic data were collected from clinically non-lame horses ( = 8) during in-hand trot. iFL and iHL (2-3/5 AAEP) were induced...
Optimization of the Amplification of Equine Muscle-Derived Mesenchymal Stromal Cells in a Hollow-Fiber Bioreactor.
Methods and protocols    April 2, 2024   Volume 7, Issue 2 32 doi: 10.3390/mps7020032
Duysens J, Graide H, Niesten A, Mouithys-Mickalad A, Ceusters J, Serteyn D.The main causes of mortality in horses are the gastrointestinal pathologies associated with septic shock. Stem cells have shown, through systemic injection, a capacity to decrease inflammation and to regenerate injured tissue faster. Nevertheless, to achieve this rapid and total regeneration, systemic injections of 1 to 2 million cells per kilogram of body weight must be considered. Here, we demonstrate for the first time the feasibility and expansion capacity of equine muscle-derived mesenchymal stromal cells (mdMSCs) in a functionally closed, automated, perfusion-based, hollow-fiber bioreact...