Abstract: This paper provides a bird's-eye perspective of the general principles of stem-cell therapy and tissue engineering; it relates comparative knowledge in this area to the current and future status of equine regenerative medicine.The understanding of equine stem cell biology, biofactors, and scaffolds, and their potential therapeutic use in horses are rudimentary at present. Mesenchymal stem cell isolation has been proclaimed from several equine tissues in the past few years. Based on the criteria of the International Society for Cellular Therapy, most of these cells are more correctly referred to as multipotent mesenchymal stromal cells, unless there is proof that they exhibit the fundamental in vivo characteristics of pluripotency and the ability to self-renew. That said, these cells from various tissues hold great promise for therapeutic use in horses. The 3 components of tissue engineering - cells, biological factors, and biomaterials - are increasingly being applied in equine medicine, fuelled by better scaffolds and increased understanding of individual biofactors and cell sources.The effectiveness of stem cell-based therapies and most tissue engineering concepts has not been demonstrated sufficiently in controlled clinical trials in equine patients to be regarded as evidence-based medicine. In the meantime, the medical mantra "do no harm" should prevail, and the application of stem cell-based therapies in the horse should be done critically and cautiously, and treatment outcomes (good and bad) should be recorded and reported.Stem cell and tissue engineering research in the horse has exciting comparative and equine specific perspectives that most likely will benefit the health of horses and humans. Controlled, well-designed studies are needed to move this new equine research field forward. Médecine régénérative actuelle et future — Principes, concepts et usage thérapeutique de la thérapie des cellules souches et de l’ingénierie tissulaire en médecine équine. Cet article fournit un survol des principes généraux de la thérapie des cellules souches et de l’ingénierie tissulaire; il établit un lien entre les connaissances comparées dans ce domaine et la situation actuelle et future de la médecine régénérative équine. La compréhension de la biologie des cellules souches équines, des biofacteurs et des échafauds ainsi que de leur usage thérapeutique potentiel chez les chevaux sont rudimentaires à l’heure actuelle. L’isolement de la cellule souche mysenchymateuse a été proclamée pour plusieurs tissus équins au cours des dernières années. En se fondant sur les critères de l’International Society for Cellular Therapy, la plupart de ces cellules sont correctement appelées des cellules stromales mesenchymateuses à moins qu’il n’y ait preuve qu’elles présentent les caractéristiques fondamentales in vivo de la pluripotence et la capacité de s’autorenouveler. Cela dit, ces cellules provenant de divers tissus s’annoncent très prometteuses pour l’usage thérapeutique chez les chevaux. L’application des 3 composantes de l’ingénierie tissulaire — les cellules, les facteurs biologiques et les biomatériaux — est de plus en plus utilisée en médecine équine, alimentée par de meilleurs échafauds et une meilleure compréhension des biofacteurs individuels et des sources des cellules. L’efficacité des thérapies basées sur les cellules souches et de la plupart des concepts d’ingénierie tissulaire n’a pas été démontrée suffisamement dans le cadre d’essais cliniques contrôlés chez des patients équins pour être considérée comme de la médecine factuelle. Entretemps, le mantra médical de «s’abstenir de tout mal» et l’application des thérapies à base de cellules souches chez le cheval devraient être utilisés avec discernement et prudence et les résultats des traitements (bons et mauvais) devraient être consignés et rapportés. La recherche sur les cellules souches et l’ingénierie tissulaire chez le cheval possède des perspectives comparées et équines spécifiques qui profiteront le plus probablement à la santé des chevaux et des humains. Des études contrôlées et bien conçues sont requises pour faire progresser ce nouveau domaine de la recherche équine. (Traduit par Isabelle Vallières)
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This research paper primarily focuses on the theoretical and practical aspects of stem cell therapy and tissue engineering in equine medicine, discussing the challenges and potential therapeutic use of these innovative therapies, although their effectiveness is yet to be proven through controlled clinical trials.
Understanding Stem Cell Therapy and Tissue Engineering in Equine Medicine
The paper provides an overview of the principles of stem cell therapy and tissue engineering, key areas of focus within regenerative medicine that use the body’s cells and biofactors to treat diseases or repair damaged tissues.
The authors note that our understanding of equine stem cell biology, biofactors, and scaffolds (structures used to support the growth of new tissues) is still in the early stages. Knowledge in these areas, plus their potential therapeutic use in horses, is limited but growing.
Research into mesenchymal stem cells, multipotent stromal cells that can differentiate into a variety of cell types, has shown promise. These cells, isolated from various equine tissues, could offer substantial therapeutic benefits in horses. However, the authors clarify that these cells should more accurately be termed “multipotent mesenchymal stromal cells,” as proof of their true pluripotency – the ability to differentiate into all cell types – and capacity for self-renewal in vivo is lacking.
Tissue Engineering and its Relevance in Equine Medicine
The study discusses tissue engineering, a rapidly evolving field in regenerative medicine. It highlights how the three key components of tissue engineering – cells, biological factors, and biomaterials – are progressively being integrated into equine medicinal practices. This trend is fueled by advancements in scaffold technologies and the in-depth comprehension of biofactors associated with different cell types.
Future developments in this area hold tremendous promise for horses and humans alike, given the similar biological and physiological characteristics shared between the two species. As such, research outcomes obtained from equines can often be extrapolated to human medical scenarios and vice versa.
The Need for Caution and Further Research
The researchers mention that practical applications of stem cell therapies and tissue engineering must be carried out meticulously and with caution. Clinical trials demonstrating the effectiveness of these tactics on a broad scale are currently insufficient; thus, application of these therapies is not yet a part of evidence-based medicine.
In this context, the authors appeal to the medical standard of primum non nocere – “first, do no harm.” Especially given the potential risks associated with these pioneering approaches, the authors underscore the importance of thorough documentation and reporting of all treatment outcomes, both positive and negative.
The paper concludes by arguing for the need for controlled, well-designed studies to advance this field of equine research. Findings from this research will not only enhance equine health, but also potentially contribute to the health of human patients.
Cite This Article
APA
Koch TG, Berg LC, Betts DH.
(2009).
Current and future regenerative medicine – principles, concepts, and therapeutic use of stem cell therapy and tissue engineering in equine medicine.
Can Vet J, 50(2), 155-165.
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