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Stem cell research & therapy2015; 6(1); 126; doi: 10.1186/s13287-015-0115-0

Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies.

Abstract: Autologous blood-derived biologicals, including autologous conditioned serum (ACS), are frequently used to treat tendinopathies in horses despite limited evidence for their efficacy. The purpose of this study was to describe the effect of a single intralesional injection of ACS in naturally occurring tendinopathies of the equine superficial digital flexor tendon (SDFT) on clinical, ultrasonographic, and histological parameters. Methods: Fifteen horses with 17 naturally occurring tendinopathies of forelimb SDFTs were examined clinically and ultrasonographically (day 0). Injured tendons were randomly assigned to the ACS-treated group (n = 10) receiving a single intralesional ACS injection or included as controls (n = 7) which were either untreated or injected with saline on day 1. All horses participated in a gradually increasing exercise programme and were re-examined nine times at regular intervals until day 190. Needle biopsies were taken from the SDFTs on days 0, 36 and 190 and examined histologically and for the expression of collagen types I and III by immunohistochemistry. Results: In ACS-treated limbs lameness decreased significantly until day 10 after treatment. Swelling (scores) of the SDFT region decreased within the ACS group between 50 and 78 days after treatment. Ultrasonographically, the percentage of the lesion in the tendon was significantly lower and the echogenicity of the lesion (total echo score) was significantly higher 78 and 106 days after intralesional ACS injection compared to controls. Histology revealed that, compared to controls, tenocyte nuclei were more spindle-shaped 36 days after ACS injection. Immunohistochemistry showed that collagen type I expression significantly increased between days 36 and 190 after ACS injection. Conclusions: Single intralesional ACS injection of equine SDFTs with clinical signs of acute tendinopathy contributes to an early significant reduction of lameness and leads to temporary improvement of ultrasonographic parameters of repair tissue. Intralesional ACS treatment might decrease proliferation of tenocytes 5 weeks after treatment and increase their differentiation as demonstrated by elevated collagen type I expression in the remodelling phase. Potential enhancement of these effects by repeated injections should be tested in future controlled clinical investigations.
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Publication Date: 2015-06-26 PubMed ID: 26113022PubMed Central: PMC4513386DOI: 10.1186/s13287-015-0115-0Google 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.

The research paper investigates the impact of single injection of Autologous Conditioned Serum (ACS) on horses’ tendinopathies. It reports that such injection led to reduced lameness and improved ultrasonographic parameters of the repair tissues in horses, suggesting the potential of ACS as a treatment for equine tendon injuries.

Research Objectives and Methodology

  • The study’s overall purpose was to determine the impact of a single intralesional injection of Autologous Conditioned Serum (ACS) on tendon healing in horses with naturally occurring tendinopathies.
  • The researchers studied fifteen horses inflicted with forelimb tendinopathies. The tendons were visually and ultrasonographically examined and then assigned to an ACS-treatment group, receiving a single ACS injection or a control group, receiving no treatment or a saline injection.
  • The horses in the study participated in an exercise program and were re-examined nine times until the end of the 190-day trial.
  • Biopsies were taken on days 0, 36, and 190 to examine histologically and to observe the expression of collagen types I and III.

Results

  • Results showed that a significant reduction of lameness in the ACS-treated horses till day 10 post-treatment was observed.
  • Swelling of the tendon region decreased in the ACS group between 50 and 78 days after treatment.
  • Ultrasonographically, the severity of the injuries in the tendons was significantly lower and the echogenicity (total echo score) was significantly higher 78 and 106 days following intralesional ACS injection compared with the controls.
  • Collagen type I expression increased significantly between days 36 and 190 after ACS injection, improving tendon repair.
  • Tenocyte nuclei were more spindle-shaped 36 days after ACS injection compared to controls, indicating that the treatment might decrease tenocyte proliferation and stimulate their differentiation.

Conclusions and Future Recommendations

  • The results suggested that a single intralesional ACS injection could significantly reduce lameness in horses with tendinopathy and improve the ultrasonographic parameters of the repair tissue.
  • The research also suggested that the ACS treatment might reduce the proliferation of tenocytes and increase their differentiation, helping in the process of tendon repair.
  • The potential for enhancing these effects through repeated injections was highlighted as a future area for controlled clinical investigations.

Cite This Article

APA
Geburek F, Lietzau M, Beineke A, Rohn K, Stadler PM. (2015). Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies. Stem Cell Res Ther, 6(1), 126. https://doi.org/10.1186/s13287-015-0115-0

Publication

Stem cell research & therapy
ISSN: 1757-6512
NlmUniqueID: 101527581
Country: England
Language: English
Volume: 6
Issue: 1
Pages: 126
PII: 126

Researcher Affiliations

Geburek, Florian
  • Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany. florian.geburek@tiho-hannover.de.
Lietzau, Maren
  • Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany. m.lietzau@gmx.de.
Beineke, Andreas
  • Institute for Pathology, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany. andreas.beineke@tiho-hannover.de.
Rohn, Karl
  • Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 2, 30559, Hannover, Germany. karl.rohn@tiho-hannover.de.
Stadler, Peter M
  • Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany. peter.stadler@tiho-hannover.de.

MeSH Terms

  • Animals
  • Blood Transfusion, Autologous / veterinary
  • Collagen Type I / metabolism
  • Collagen Type III / metabolism
  • Forelimb
  • Horse Diseases / pathology
  • Horse Diseases / therapy
  • Horses
  • Immunohistochemistry
  • Male
  • Tendinopathy / pathology
  • Tendinopathy / therapy
  • Tendons / diagnostic imaging
  • Tendons / metabolism
  • Tendons / pathology
  • Ultrasonography
  • Wound Healing / physiology

References

This article includes 52 references
  1. Patterson-Kane JC, Firth EC. The pathobiology of exercise-induced superficial digital flexor tendon injury in Thoroughbred racehorses.. Vet J 2009 Aug;181(2):79-89.
    doi: 10.1016/j.tvjl.2008.02.009pubmed: 18406184google scholar: lookup
  2. Avella CS, Smith RKW. Diagnosis and management of tendon and ligament disorders.. In: Auer JA, Stick JA, editors. Equine Surgery. 4. St. Louis, Missouri, USA: Elsevier Saunders; 2011. pp. 1157–79..
  3. Geburek F, Stadler P. [Regenerative therapy for tendon and ligament disorders in horses. Terminology, production, biologic potential and in vitro effects].. Tierarztl Prax Ausg G Grosstiere Nutztiere 2011;39(6):373-83.
    pubmed: 22167082
  4. Lopez MJ, Jarazo J. State of the art: stem cells in equine regenerative medicine.. Equine Vet J 2015 Mar;47(2):145-54.
    doi: 10.1111/evj.12311pubmed: 24957845google scholar: lookup
  5. Smith RK, Werling NJ, Dakin SG, Alam R, Goodship AE, Dudhia J. Beneficial effects of autologous bone marrow-derived mesenchymal stem cells in naturally occurring tendinopathy.. PLoS One 2013;8(9):e75697.
    doi: 10.1371/journal.pone.0075697pmc: PMC3783421pubmed: 24086616google scholar: lookup
  6. Carvalho Ade M, Badial PR, Álvarez LE, Yamada AL, Borges AS, Deffune E, Hussni CA, Garcia Alves AL. Equine tendonitis therapy using mesenchymal stem cells and platelet concentrates: a randomized controlled trial.. Stem Cell Res Ther 2013 Jul 22;4(4):85.
    doi: 10.1186/scrt236pmc: PMC3854756pubmed: 23876512google scholar: lookup
  7. Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CH, Barneveld A, van Weeren PR. Effects of platelet-rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: A placebo-controlled experimental study.. J Orthop Res 2010 Feb;28(2):211-7.
    pubmed: 19714688doi: 10.1002/jor.20980google scholar: lookup
  8. Textor J. Autologous biologic treatment for equine musculoskeletal injuries: platelet-rich plasma and IL-1 receptor antagonist protein.. Vet Clin North Am Equine Pract 2011 Aug;27(2):275-98.
    doi: 10.1016/j.cveq.2011.05.001pubmed: 21872759google scholar: lookup
  9. Ionita JC, Brehm W. Autologe Blutprodukte in der Regenerativen Therapie: ACS, PRP, ACP, Knochenmark (Autologous blood products for regenerative therapies: ACS, PRP, ACP, bone marrow). In: Lauk HD, editor. Pferdeheilkunde Forum 2008 - Berliner Fortbildungstage. Berlin, Germany: Hippiatrika Verlag; 2008. pp. 588–91..
  10. Weinberger T. Regenerative Therapiemöglichkeiten beim Pferd - eine Übersicht (Regenerative treatment options in horses - an overview). Pferde Spiegel 2008;11:116–9.
    doi: 10.1055/s-0029-1225793google scholar: lookup
  11. Meijer H, Reinecke J, Becker C, Tholen G, Wehling P. The production of anti-inflammatory cytokines in whole blood by physico-chemical induction.. Inflamm Res 2003 Oct;52(10):404-7.
    doi: 10.1007/s00011-003-1197-1pubmed: 14520515google scholar: lookup
  12. Hraha TH, Doremus KM, McIlwraith CW, Frisbie DD. Autologous conditioned serum: the comparative cytokine profiles of two commercial methods (IRAP and IRAP II) using equine blood.. Equine Vet J 2011 Sep;43(5):516-21.
    doi: 10.1111/j.2042-3306.2010.00321.xpubmed: 21496084google scholar: lookup
  13. Frisbie DD, Kawcak CE, Werpy NM, Park RD, McIlwraith CW. Clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum in horses with experimentally induced osteoarthritis.. Am J Vet Res 2007 Mar;68(3):290-6.
    doi: 10.2460/ajvr.68.3.290pubmed: 17331019google scholar: lookup
  14. Dahlgren LA, van der Meulen MC, Bertram JE, Starrak GS, Nixon AJ. Insulin-like growth factor-I improves cellular and molecular aspects of healing in a collagenase-induced model of flexor tendinitis.. J Orthop Res 2002 Sep;20(5):910-9.
    doi: 10.1016/S0736-0266(02)00009-8pubmed: 12382953google scholar: lookup
  15. Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing.. Sports Med 2003;33(5):381-94.
    doi: 10.2165/00007256-200333050-00004pubmed: 12696985google scholar: lookup
  16. Heisterbach PE, Todorov A, Flückiger R, Evans CH, Majewski M. Effect of BMP-12, TGF-β1 and autologous conditioned serum on growth factor expression in Achilles tendon healing.. Knee Surg Sports Traumatol Arthrosc 2012 Oct;20(10):1907-14.
    doi: 10.1007/s00167-011-1772-xpubmed: 22124845google scholar: lookup
  17. Dahlgren LA, Harvey SC. Effect of autologous conditioned serum on the metabolism of normal tendon explants.. 54th Annual Meeting of the Orthopaedic Research Society; March 2–5. Rosemont, IL, USA: Orthopaedic Research Society; 2008..
  18. Wright-Carpenter T, Opolon P, Appell HJ, Meijer H, Wehling P, Mir LM. Treatment of muscle injuries by local administration of autologous conditioned serum: animal experiments using a muscle contusion model.. Int J Sports Med 2004 Nov;25(8):582-7.
    doi: 10.1055/s-2004-821303pubmed: 15532000google scholar: lookup
  19. Baltzer AW, Moser C, Jansen SA, Krauspe R. Autologous conditioned serum (Orthokine) is an effective treatment for knee osteoarthritis.. Osteoarthritis Cartilage 2009 Feb;17(2):152-60.
    doi: 10.1016/j.joca.2008.06.014pubmed: 18674932google scholar: lookup
  20. Sun HB, Li Y, Fung DT, Majeska RJ, Schaffler MB, Flatow EL. Coordinate regulation of IL-1beta and MMP-13 in rat tendons following subrupture fatigue damage.. Clin Orthop Relat Res 2008 Jul;466(7):1555-61.
    doi: 10.1007/s11999-008-0278-4pmc: PMC2505236pubmed: 18470577google scholar: lookup
  21. Dakin SG, Dudhia J, Smith RKW. Modulation of prostaglandin E2 production in equine tendon cells.. In: 49th British Equine Veterinary Association Congress; September 8–11. Newmarket, England: Equine Veterinary Journal, Ltd; 2010. p. 96..
  22. Majewski M, Ochsner PE, Liu F, Flückiger R, Evans CH. Accelerated healing of the rat Achilles tendon in response to autologous conditioned serum.. Am J Sports Med 2009 Nov;37(11):2117-25.
    doi: 10.1177/0363546509348047pubmed: 19875360google scholar: lookup
  23. Jann H, Stashak TS. Tendon and Paratendon Lacerations.. In: Stashak TS, Theoret CL, editors. Equine Wound Management. Ames, Iowa, USA: Wiley-Blackwell; 2008. pp. 489–508..
  24. Edinger J. Orthopädische Untersuchung der Gliedmaβen und der Wirbelsäule (Orthopaedic examination of the limbs and the vertebral column). In: Wissdorf H, Gerhards H, Huskamp B, Deegen E, editors. Praxisorientierte Anatomie und Propädeutik des Pferdes (Practical anatomy and propaedeutics of the horse) Hannover: M. u. H. Schaper; 2010. pp. 890–926..
  25. Schmidt H. Die Behandlung akuter und chronischer Sehnenerkrankungen beim Pferd mit hochmolekularer Hyaluronsäure (The treatment of acute and chronic tendon injuries in the horse with high molecular weight hyaluronic acid).. Dr. med. vet. thesis. Tierärztliche Hochschule Hannover: Hannover, Germany; 1989..
  26. Genovese RL, Rantanen NW, Hauser ML, Simpson BS. Diagnostic ultrasonography of equine limbs.. Vet Clin North Am Equine Pract 1986 Apr;2(1):145-226.
    pubmed: 3516322doi: 10.1016/s0749-0739(17)30738-1google scholar: lookup
  27. Rantanen NW, Jorgensen JS, Genovese RL. Ultrasonographic evaluation of the equine limb: technique.. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse. 1. St. Louis: Elsevier; 2003. pp. 166–88..
  28. Reef VB, Genovese RL, Davis WM. Initial long-term results of horses with superficial flexor tendinitis treated with intralesional beta-aminoproprionitrile fumarate. 43rd Annual Convention of the AAEP; December 7–10. Lexington, KY, USA: American Association of Equine Practitioners; 1997. pp. 301–5..
  29. Wagels R, Ruhmann K, Stadler P, Drommer W. Percutaneous core biopsy of the flexor tendons in the horse.. Tierarztl Prax G N 2001;29:199–205.
  30. Aström M, Rausing A. Chronic Achilles tendinopathy. A survey of surgical and histopathologic findings.. Clin Orthop Relat Res 1995 Jul;(316):151-64.
    pubmed: 7634699
  31. Alldinger S, Wünschmann A, Baumgärtner W, Voss C, Kremmer E. Up-regulation of major histocompatibility complex class II antigen expression in the central nervous system of dogs with spontaneous canine distemper virus encephalitis.. Acta Neuropathol 1996 Sep;92(3):273-80.
    doi: 10.1007/s004010050518pubmed: 8870829google scholar: lookup
  32. Kummerfeld M, Seehusen F, Klein S, Ulrich R, Kreutzer R, Gerhauser I, Herder V, Baumgärtner W, Beineke A. Periventricular demyelination and axonal pathology is associated with subependymal virus spread in a murine model for multiple sclerosis.. Intervirology 2012;55(6):401-16.
    doi: 10.1159/000336563pubmed: 22538300google scholar: lookup
  33. Ulrich R, Baumgärtner W, Gerhauser I, Seeliger F, Haist V, Deschl U, Alldinger S. MMP-12, MMP-3, and TIMP-1 are markedly upregulated in chronic demyelinating theiler murine encephalomyelitis.. J Neuropathol Exp Neurol 2006 Aug;65(8):783-93.
    doi: 10.1097/01.jnen.0000229990.32795.0dpubmed: 16896312google scholar: lookup
  34. Dahlgren LA, Mohammed HO, Nixon AJ. Temporal expression of growth factors and matrix molecules in healing tendon lesions.. J Orthop Res 2005 Jan;23(1):84-92.
    doi: 10.1016/j.orthres.2004.05.007pubmed: 15607879google scholar: lookup
  35. Chuen FS, Chuk CY, Ping WY, Nar WW, Kim HL, Ming CK. Immunohistochemical characterization of cells in adult human patellar tendons.. J Histochem Cytochem 2004 Sep;52(9):1151-7.
    doi: 10.1369/jhc.3A6232.2004pubmed: 15314082google scholar: lookup
  36. Birch HL, Bailey AJ, Goodship AE. Macroscopic 'degeneration' of equine superficial digital flexor tendon is accompanied by a change in extracellular matrix composition.. Equine Vet J 1998 Nov;30(6):534-9.
    doi: 10.1111/j.2042-3306.1998.tb04530.xpubmed: 9844973google scholar: lookup
  37. van Schie HT, Bakker EM, Cherdchutham W, Jonker AM, van de Lest CH, van Weeren PR. Monitoring of the repair process of surgically created lesions in equine superficial digital flexor tendons by use of computerized ultrasonography.. Am J Vet Res 2009 Jan;70(1):37-48.
    doi: 10.2460/ajvr.70.1.37pubmed: 19119947google scholar: lookup
  38. van Schie HT, Bakker EM, Jonker AM, van Weeren PR. Computerized ultrasonographic tissue characterization of equine superficial digital flexor tendons by means of stability quantification of echo patterns in contiguous transverse ultrasonographic images.. Am J Vet Res 2003 Mar;64(3):366-75.
    doi: 10.2460/ajvr.2003.64.366pubmed: 12661879google scholar: lookup
  39. Kasashima Y, Takahashi T, Smith RK, Goodship AE, Kuwano A, Ueno T, Hirano S. Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999.. Equine Vet J 2004 May;36(4):346-50.
    doi: 10.2746/0425164044890580pubmed: 15163043google scholar: lookup
  40. van Schie JT, Bakker EM, van Weeren PR. Ultrasonographic evaluation of equine tendons: a quantitative in vitro study of the effects of amplifier gain level, transducer-tilt, and transducer-displacement.. Vet Radiol Ultrasound 1999 Mar-Apr;40(2):151-60.
    doi: 10.1111/j.1740-8261.1999.tb01901.xpubmed: 10225527google scholar: lookup
  41. Movin T, Guntner P, Gad A, Rolf C. Ultrasonography-guided percutaneous core biopsy in Achilles tendon disorder.. Scand J Med Sci Sports 1997 Aug;7(4):244-8.
    doi: 10.1111/j.1600-0838.1997.tb00147.xpubmed: 9241031google scholar: lookup
  42. Movin T. Tendon tissue sampling.. Scand J Med Sci Sports 2000 Dec;10(6):368-71.
    doi: 10.1034/j.1600-0838.2000.010006368.xpubmed: 11085566google scholar: lookup
  43. Buck C, Drommer W, Wagels R, Stadler P. Scanning electron microscopy examination of tendon biopsies in healthy horses and patients with different stages of tendon healing.. Pferdeheilkunde 2002;18:521–8.
  44. Södersten F, Hultenby K, Heinegård D, Johnston C, Ekman S. Immunolocalization of collagens (I and III) and cartilage oligomeric matrix protein in the normal and injured equine superficial digital flexor tendon.. Connect Tissue Res 2013;54(1):62-9.
    doi: 10.3109/03008207.2012.734879pmc: PMC3545546pubmed: 23020676google scholar: lookup
  45. Henninger RW, Bramlage RW, Bailey M, Bertone AL, Weisbrode SE. Effects of tendon splitting on experimentally-induced acute equine tendinitis.. Vet Comp Orthop Traumatol 1992;1:5–13.
  46. Meershoek LS, Lanovaz JL, Schamhardt HC, Clayton HM. Calculated forelimb flexor tendon forces in horses with experimentally induced superficial digital flexor tendinitis and the effects of application of heel wedges.. Am J Vet Res 2002 Mar;63(3):432-7.
    doi: 10.2460/ajvr.2002.63.432pubmed: 11911580google scholar: lookup
  47. Ross MW. Movement.. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse. 2. St. Louis: Elsevier Saunders; 2011. pp. 64–80..
  48. Turner TA. Thermography as an aid to the clinical lameness evaluation.. Vet Clin North Am Equine Pract 1991 Aug;7(2):311-38.
    pubmed: 1933566doi: 10.1016/s0749-0739(17)30502-3google scholar: lookup
  49. Boehart S, Arndt G, Carstanjen B. Ultrasonographic morphometric measurements of digital flexor tendons and ligaments of the palmar metacarpal region in Haflinger horses.. Anat Histol Embryol 2010 Aug;39(4):366-75.
    doi: 10.1111/j.1439-0264.2010.01003.xpubmed: 20545636google scholar: lookup
  50. Gillis CL. Rehabilitation of Tendon and Ligament Injuries. 43rd Annual Convention of the AAEP; December 7–10. Lexington, KY, USA: American Association of Equine Practitioners; 1997. pp. 306–9..
  51. Silver IA, Brown PN, Goodship AE, Lanyon LE, McCullagh KG, Perry GC, Williams IF. A clinical and experimental study of tendon injury, healing and treatment in the horse.. Equine Vet J Suppl 1983 Jul;(1):1-43.
    pubmed: 9079042
  52. Nixon AJ, Saxer RA, Brower-Toland BD. Exogenous insulin-like growth factor-I stimulates an autoinductive IGF-I autocrine/paracrine response in chondrocytes.. J Orthop Res 2001 Jan;19(1):26-32.
    doi: 10.1016/S0736-0266(00)00013-9pubmed: 11332617google scholar: lookup

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  1. Mayet A, Zablotski Y, Roth SP, Brehm W, Troillet A. Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis. Front Vet Sci 2023;10:1125695.
    doi: 10.3389/fvets.2023.1125695pubmed: 36908512google scholar: lookup
  2. Smith EJ, Beaumont RE, McClellan A, Sze C, Palomino Lago E, Hazelgrove L, Dudhia J, Smith RKW, Guest DJ. Tumour necrosis factor alpha, interleukin 1 beta and interferon gamma have detrimental effects on equine tenocytes that cannot be rescued by IL-1RA or mesenchymal stromal cell-derived factors. Cell Tissue Res 2023 Mar;391(3):523-544.
    doi: 10.1007/s00441-022-03726-6pubmed: 36543895google scholar: lookup
  3. 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 Nov 7;18(1):391.
    doi: 10.1186/s12917-022-03480-5pubmed: 36345002google scholar: lookup
  4. Kerscher M, Wagner-Schiffler S, Noah EM, Fischer T, Greiner-Krüger D, Sattler S, Kaptan T, Drabik A, Hamed G, Reinecke J, Wehling J. Cell-Free Blood Cell Secretome (BCS) Counteracts Skin Aging: Multi-Center Prospective Regenerative Aesthetic Medicine Study Using Exokine®. Clin Cosmet Investig Dermatol 2022;15:1157-1173.
    doi: 10.2147/CCID.S357810pubmed: 35784268google scholar: lookup
  5. 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 May;51(4):557-567.
    doi: 10.1111/vsu.13805pubmed: 35383972google scholar: lookup
  6. Gaesser AM, Underwood C, Linardi RL, Even KM, Reef VB, Shetye SS, Mauck RL, King WJ, Engiles JB, Ortved KF. Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model. Front Vet Sci 2021;8:697551.
    doi: 10.3389/fvets.2021.697551pubmed: 34291103google scholar: lookup
  7. Ribitsch I, Oreff GL, Jenner F. Regenerative Medicine for Equine Musculoskeletal Diseases. Animals (Basel) 2021 Jan 19;11(1).
    doi: 10.3390/ani11010234pubmed: 33477808google scholar: lookup
  8. Ribitsch I, Baptista PM, Lange-Consiglio A, Melotti L, Patruno M, Jenner F, Schnabl-Feichter E, Dutton LC, Connolly DJ, van Steenbeek FG, Dudhia J, Penning LC. Large Animal Models in Regenerative Medicine and Tissue Engineering: To Do or Not to Do. Front Bioeng Biotechnol 2020;8:972.
    doi: 10.3389/fbioe.2020.00972pubmed: 32903631google scholar: lookup
  9. Buchheit T, Huh Y, Maixner W, Cheng J, Ji RR. Neuroimmune modulation of pain and regenerative pain medicine. J Clin Invest 2020 May 1;130(5):2164-2176.
    doi: 10.1172/JCI134439pubmed: 32250346google scholar: lookup
  10. Shojaee A, Parham A. Strategies of tenogenic differentiation of equine stem cells for tendon repair: current status and challenges. Stem Cell Res Ther 2019 Jun 18;10(1):181.
    doi: 10.1186/s13287-019-1291-0pubmed: 31215490google scholar: lookup
  11. McClellan A, Evans R, Sze C, Kan S, Paterson Y, Guest D. A novel mechanism for the protection of embryonic stem cell derived tenocytes from inflammatory cytokine interleukin 1 beta. Sci Rep 2019 Feb 26;9(1):2755.
    doi: 10.1038/s41598-019-39370-4pubmed: 30808942google scholar: lookup
  12. Ahrberg AB, Horstmeier C, Berner D, Brehm W, Gittel C, Hillmann A, Josten C, Rossi G, Schubert S, Winter K, Burk J. Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model. BMC Musculoskelet Disord 2018 Jul 18;19(1):230.
    doi: 10.1186/s12891-018-2163-ypubmed: 30021608google scholar: lookup
  13. Wilson JM, McKenzie E, Duesterdieck-Zellmer K. International Survey Regarding the Use of Rehabilitation Modalities in Horses. Front Vet Sci 2018;5:120.
    doi: 10.3389/fvets.2018.00120pubmed: 29942811google scholar: lookup
  14. Genç E, Beytemur O, Yuksel S, Eren Y, Çağlar A, Küçükyıldırım BO, Güleç MA. Investigation of the biomechanical and histopathological effects of autologous conditioned serum on healing of Achilles tendon. Acta Orthop Traumatol Turc 2018 May;52(3):226-231.
    doi: 10.1016/j.aott.2018.01.005pubmed: 29454565google scholar: lookup
  15. Geburek F, Roggel F, van Schie HTM, Beineke A, Estrada R, Weber K, Hellige M, Rohn K, Jagodzinski M, Welke B, Hurschler C, Conrad S, Skutella T, van de Lest C, van Weeren R, Stadler PM. Effect of single intralesional treatment of surgically induced equine superficial digital flexor tendon core lesions with adipose-derived mesenchymal stromal cells: a controlled experimental trial. Stem Cell Res Ther 2017 Jun 5;8(1):129.
    doi: 10.1186/s13287-017-0564-8pubmed: 28583184google scholar: lookup
  16. Geburek F, Gaus M, van Schie HT, 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 Sep 7;12(1):191.
    doi: 10.1186/s12917-016-0826-1pubmed: 27604193google scholar: lookup
  17. Najeb M, Samy A, Rizk A, Mosbah E, Karrouf G. Regenerative biologics modulating inflammation and promoting tenogenesis in equine superficial digital flexor tendonitis: from molecular pathways to clinical translation. Ir Vet J 2025 Sep 17;78(1):21.
    doi: 10.1186/s13620-025-00309-zpubmed: 40963139google scholar: lookup
  18. Roth SP, Liso G, Brehm W, Wagner B, Schnabel CL, Troillet A. Selected cytokine and chemokine concentrations in equine autologous conditioned serum are similar under defined and practically relevant storage conditions. Front Vet Sci 2025;12:1588240.
    doi: 10.3389/fvets.2025.1588240pubmed: 40496923google scholar: lookup
  19. Najeb M, Samy A, Rizk A, Mosbah E, Karrouf G. Clinical benefits of early-stage autologous conditioned serum and injectable platelet-rich fibrin on healing superficial digital flexor tendonitis in donkeys. Ir Vet J 2025 Jun 7;78(1):13.
    doi: 10.1186/s13620-025-00299-ypubmed: 40483508google scholar: lookup
  20. Reis IL, Lopes B, Sousa P, Sousa AC, Caseiro AR, Mendonça CM, Santos JM, Atayde LM, Alvites RD, Maurício AC. Equine Musculoskeletal Pathologies: Clinical Approaches and Therapeutical Perspectives-A Review. Vet Sci 2024 Apr 26;11(5).
    doi: 10.3390/vetsci11050190pubmed: 38787162google scholar: lookup
  21. Li H. Effect of Application of Autologous Conditioned Serum on Wound Healing in Diabetic Mice Through Inhibition of STING Pathway Activation. Biochem Genet 2025 Feb;63(1):623-633.
    doi: 10.1007/s10528-024-10734-4pubmed: 38478149google scholar: lookup
  22. Pérez Fraile A, González-Cubero E, Martínez-Flórez S, Olivera ER, Villar-Suárez V. Regenerative Medicine Applied to Musculoskeletal Diseases in Equines: A Systematic Review. Vet Sci 2023 Nov 23;10(12).
    doi: 10.3390/vetsci10120666pubmed: 38133217google scholar: lookup
  23. Burk J, Wittenberg-Voges L, Schubert S, Horstmeier C, Brehm W, Geburek F. Treatment of Naturally Occurring Tendon Disease with Allogeneic Multipotent Mesenchymal Stromal Cells: A Randomized, Controlled, Triple-Blinded Pilot Study in Horses. Cells 2023 Oct 24;12(21).
    doi: 10.3390/cells12212513pubmed: 37947591google scholar: lookup
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