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Frontiers in veterinary science2022; 9; 843131; doi: 10.3389/fvets.2022.843131

Case Report: Repeated Intralesional Injections of Autologous Mesenchymal Stem Cells Combined With Platelet-Rich Plasma for Superficial Digital Flexor Tendon Healing in a Show Jumping Horse.

Abstract: In the present case report a show jumping 10-year-old Sella Italiano gelding, presented with severe lameness, swelling and pain at palpation of the mid-metacarpal region of the left forelimb. Clinical and ultrasound examination diagnosed a chronic tendonitis of the central region of the superficial digital flexor tendon (SDFT). The lesion was a reoccurrence since it developed from a previously healed injury. The horse had to stop competing and was unresponsive to gold-standard treatments as Non-steroidal anti-inflammatory drugs (NSAIDs) and conservative management after 6 months of therapy. The animal was subjected to repeated intralesional injections of autologous adipose-derived mesenchymal stem cells (AD-MSCs) combined with autologous platelet-rich plasma (PRP). The combined treatment was administered twice in a 1-month interval. The healing process was assessed through clinical examination, ultrasound imaging and quantification of oxidative stress products and inflammatory mediators in blood plasma. After 2 weeks from first injection, a reduction of concentration of oxidative-derived products was observed, together with an increase of anti-inflammatory cytokines and pro-mitotic growth factors. These results were reflected clinically as the horse showed a reduction of lameness along with swelling and pain after 4 weeks. At the 1-year follow-up, the horse showed no signs of lameness and swelling. The ultrasonographic examination highlighted a compact fiber alignment with a normal echogenic tendon as observed in the sound contralateral limb. Moreover, the horse went back to the previous level of competition. Our results suggest the positive effects of a repeated intralesional injection of AD-MSCs and PRP for the treatment of a chronic tendonitis with long-term effects and an improvement for both equine quality of life and athletic performance.
Copyright © 2022 Melotti, Carolo, Elshazly, Boesso, Da Dalt, Gabai, Perazzi, Iacopetti and Patruno.
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Publication Date: 2022-02-18 PubMed ID: 35252428PubMed Central: PMC8894652DOI: 10.3389/fvets.2022.843131Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study explores the use of repeated injections of autologous mesenchymal stem cells combined with platelet-rich plasma to treat chronic tendonitis in a horse, noting positive effects.

Study Overview

  • This research report revolves around a case involving a 10-year-old Sella Italiano gelding horse that was a showjumper. The horse had severe lameness along with swelling and pain in the mid-metacarpal region of its left forelimb.
  • Following clinical and ultrasound examination, it was diagnosed with chronic tendonitis in the central region of the superficial digital flexor tendon (SDFT). This was actually a recurrence, having developed from a previously healed injury, and the horse did not respond to standard treatments such as Non-steroidal anti-inflammatory drugs (NSAIDs).

The Treatment

  • After conventional treatments had failed, the gelding was treated with repeated intralesional injections of autologous adipose-derived mesenchymal stem cells (AD-MSCs), enhanced with autologous platelet-rich plasma (PRP). The combined treatment was carried out twice, with a gap of a month between the two applications.

Evaluating the Healing Process

  • Healing was continually assessed using clinical examination, ultrasound imaging, and measuring oxidative stress products and inflammatory mediators in the horse’s blood plasma.
  • After the first injection, a drop in the concentration of oxidative-derived products was observed in only two weeks, along with an uptick in anti-inflammatory cytokines and pro-mitotic growth factors.

Results

  • The horse showed clinical improvement, with a notable reduction in lameness, swelling, and pain within 4 weeks of treatment. After a year, the horse showed no signs of lameness or swelling.
  • Upon ultrasound examination, a normal echo was observed in the tendon, indicating a successful healing process. The echogenic tendon matched the unaffected contralateral limb, suggesting recovery.
  • Remarkably, the horse was able to return to the same level of competition as before the injury.

Study Significance

  • The findings strongly suggest that repeated injections of mesenchymal stem cells – sourced from the horse’s own fat tissue – and PRP can effectively treat chronic tendonitis in horses. The positive results were observed in the long-term and enhanced both the quality of life and athletic performance of horses.

Cite This Article

APA
Melotti L, Carolo A, Elshazly N, Boesso F, Da Dalt L, Gabai G, Perazzi A, Iacopetti I, Patruno M. (2022). Case Report: Repeated Intralesional Injections of Autologous Mesenchymal Stem Cells Combined With Platelet-Rich Plasma for Superficial Digital Flexor Tendon Healing in a Show Jumping Horse. Front Vet Sci, 9, 843131. https://doi.org/10.3389/fvets.2022.843131

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 9
Pages: 843131

Researcher Affiliations

Melotti, Luca
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.
Carolo, Anna
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.
Elshazly, Noha
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.
  • Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Boesso, Filippo
  • Veterinary Practicioner, Padua, Italy.
Da Dalt, Laura
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.
Gabai, Gianfranco
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.
Perazzi, Anna
  • Department of Animal Medicine, Production and Health, University of Padua-Agripolis Campus, Legnaro, Italy.
Iacopetti, Ilaria
  • Department of Animal Medicine, Production and Health, University of Padua-Agripolis Campus, Legnaro, Italy.
Patruno, Marco
  • Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Citations

This article has been cited 4 times.
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