Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model.
Abstract: Mesenchymal stromal cells (MSC) have shown promising results in the treatment of tendinopathy in equine medicine, making this therapeutic approach seem favorable for translation to human medicine. Having demonstrated that MSC engraft within the tendon lesions after local injection in an equine model, we hypothesized that they would improve tendon healing superior to serum injection alone. Methods: Quadrilateral tendon lesions were induced in six horses by mechanical tissue disruption combined with collagenase application 3 weeks before treatment. Adipose-derived MSC suspended in serum or serum alone were then injected intralesionally. Clinical examinations, ultrasound and magnetic resonance imaging were performed over 24 weeks. Tendon biopsies for histological assessment were taken from the hindlimbs 3 weeks after treatment. Horses were sacrificed after 24 weeks and forelimb tendons were subjected to macroscopic and histological examination as well as analysis of musculoskeletal marker expression. Results: Tendons injected with MSC showed a transient increase in inflammation and lesion size, as indicated by clinical and imaging parameters between week 3 and 6 (p < 0.05). Thereafter, symptoms decreased in both groups and, except that in MSC-treated tendons, mean lesion signal intensity as seen in T2w magnetic resonance imaging and cellularity as seen in the histology (p < 0.05) were lower, no major differences could be found at week 24. Conclusions: These data suggest that MSC have influenced the inflammatory reaction in a way not described in tendinopathy studies before. However, at the endpoint of the current study, 24 weeks after treatment, no distinct improvement was observed in MSC-treated tendons compared to the serum-injected controls. Future studies are necessary to elucidate whether and under which conditions MSC are beneficial for tendon healing before translation into human medicine.
Publication Date: 2018-07-18 PubMed ID: 30021608PubMed Central: PMC6052633DOI: 10.1186/s12891-018-2163-yGoogle Scholar: Lookup
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- Comparative Study
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Summary
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The research article focuses on comparing the effects of mesenchymal stromal cells (MSC) and the effects of serum alone on the healing process of tendon injuries in horses. Findings suggest that although MSC treatment initially resulted in an increased inflammation response, no significant improvement was observed in comparison to serum-only treatments after a 24 week period.
Research Methodology
- In order to carry out the experiment, tendon lesions were induced on six horses three weeks prior to the treatment.
- These injuries were created using a combination of mechanical disruptions and collagenase application.
- The treatment involved injecting the affected areas with MSC suspended in serum or just serum alone.
- Research data was continually gathered over a 24 week period through clinical examinations, ultrasound, and magnetic resonance imaging.
- To gather more detailed data on the effects of the treatments, tendon biopsies were collected three weeks post-treatment from the hind limbs of the horses.
Findings and Analysis
- Interestingly, tendon lesions that were treated with MSC showed an initial increase in inflammation and lesion size between week 3 and 6 after the treatment.
- This was determined through assessing multiple parameters in clinical and imaging data.
- Subsequently, symptoms began to decrease in both the group of tendons treated with MSC and in the control group (treated with serum alone).
- Although the inflammation and cellularity levels in the tendons treated with MSC were found to be lower at the end of the 24th week, no significant differences were observed in the overall health of the tendons between the two groups.
Conclusions and Implications
- The research concluded that while MSC did influence the inflammation process in tendon healing, there was no significant improvement in the tendon healing process when compared to the control group after a period of 24 weeks.
- Therefore, while MSC have previously shown promising results in equine tendon healing, this study highlights the need for further research to confirm their complete effectiveness and applicability in human medicine.
- Additional studies are necessary to determine the exact conditions under which MSC can be beneficial for tendon healing in both equine and human subjects.
Cite This Article
APA
Ahrberg AB, Horstmeier C, Berner D, Brehm W, Gittel C, Hillmann A, Josten C, Rossi G, Schubert S, Winter K, Burk J.
(2018).
Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model.
BMC Musculoskelet Disord, 19(1), 230.
https://doi.org/10.1186/s12891-018-2163-y Publication
Researcher Affiliations
- Department of Orthopedics, Traumatology and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. annette.ahrberg@medizin.uni-leipzig.de.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany. annette.ahrberg@medizin.uni-leipzig.de.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
- Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.
- University Equine Hospital, University of Leipzig, Leipzig, Germany.
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
- Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.
- University Equine Hospital, University of Leipzig, Leipzig, Germany.
- University Equine Hospital, University of Leipzig, Leipzig, Germany.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
- Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.
- Department of Orthopedics, Traumatology and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
- Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.
- Institute of Veterinary Physiology, University of Leipzig, Leipzig, Germany.
- University Equine Hospital, University of Leipzig, Leipzig, Germany.
- Institute of Anatomy, Medical Faculty, University of Leipzig, Leipzig, Germany.
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
- Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.
- Institute of Veterinary Physiology, University of Leipzig, Leipzig, Germany.
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria.
MeSH Terms
- Animals
- Cells, Cultured
- Disease Models, Animal
- Female
- Follow-Up Studies
- Horses
- Male
- Mesenchymal Stem Cell Transplantation / methods
- Mesenchymal Stem Cell Transplantation / trends
- Serum
- Tendinopathy / diagnostic imaging
- Tendinopathy / therapy
Grant Funding
- BMBF 1315883 / German Federal Ministry of Education and Research
- not applicable / Saxon Ministry of Science and the Fine Arts
Conflict of Interest Statement
ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Approval of the local ethics committee (Landesdirektion Leipzig, TVV 34/13) had been given beforehand. No human participants have been involved. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
This article includes 53 references
- de Jonge S, van den Berg C, de Vos RJ, van der Heide HJ, Weir A, Verhaar JA, Bierma-Zeinstra SM, Tol JL. Incidence of midportion Achilles tendinopathy in the general population.. Br J Sports Med 2011 Oct;45(13):1026-8.
- Alfredson H. Ultrasound and Doppler-guided mini-surgery to treat midportion Achilles tendinosis: results of a large material and a randomised study comparing two scraping techniques.. Br J Sports Med 2011 Apr;45(5):407-10.
- de Jonge S, de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL. One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial.. Am J Sports Med 2011 Aug;39(8):1623-9.
- Sadoghi P, Rosso C, Valderrabano V, Leithner A, Vavken P. The role of platelets in the treatment of Achilles tendon injuries.. J Orthop Res 2013 Jan;31(1):111-8.
- Willberg L, Sunding K, Ohberg L, Forssblad M, Fahlström M, Alfredson H. Sclerosing injections to treat midportion Achilles tendinosis: a randomised controlled study evaluating two different concentrations of Polidocanol.. Knee Surg Sports Traumatol Arthrosc 2008 Sep;16(9):859-64.
- Vannini F, Di Matteo B, Filardo G, Kon E, Marcacci M, Giannini S. Platelet-rich plasma for foot and ankle pathologies: a systematic review.. Foot Ankle Surg 2014 Mar;20(1):2-9.
- Kearney RS, Parsons N, Metcalfe D, Costa ML. Injection therapies for Achilles tendinopathy.. Cochrane Database Syst Rev 2015 May 26;(5):CD010960.
- Filardo G, Di Matteo B, Kon E, Merli G, Marcacci M. Platelet-rich plasma in tendon-related disorders: results and indications.. Knee Surg Sports Traumatol Arthrosc 2018 Jul;26(7):1984-1999.
- Avella CS, Ely ER, Verheyen KL, Price JS, Wood JL, Smith RK. Ultrasonographic assessment of the superficial digital flexor tendons of National Hunt racehorses in training over two racing seasons.. Equine Vet J 2009 May;41(5):449-54.
- Patterson-Kane JC, Becker DL, Rich T. The pathogenesis of tendon microdamage in athletes: the horse as a natural model for basic cellular research.. J Comp Pathol 2012 Aug-Oct;147(2-3):227-47.
- 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.
- Williams RB, Harkins LS, Hammond CJ, Wood JL. Racehorse injuries, clinical problems and fatalities recorded on British racecourses from flat racing and National Hunt racing during 1996, 1997 and 1998.. Equine Vet J 2001 Sep;33(5):478-86.
- U.S. Department of Health and Human Services, Food and Drug Administration, Center for Biologics Evaluation and Research. Guidance for Industry: Preparation of IDEs and INDs for Products Intended to Repair or Replace Knee Cartilage. 2011.
- European Medicines Agency, Committee For Advanced Therapies (CAT). Reflection paper on in-vitro cultured chondrocyte containing products for cartilage repair of the knee. 2010.
- Smith RK, Korda M, Blunn GW, Goodship AE. Isolation and implantation of autologous equine mesenchymal stem cells from bone marrow into the superficial digital flexor tendon as a potential novel treatment.. Equine Vet J 2003 Jan;35(1):99-102.
- Godwin EE, Young NJ, Dudhia J, Beamish IC, Smith RK. Implantation of bone marrow-derived mesenchymal stem cells demonstrates improved outcome in horses with overstrain injury of the superficial digital flexor tendon.. Equine Vet J 2012 Jan;44(1):25-32.
- Geburek F, Lietzau M, Beineke A, Rohn K, Stadler PM. Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies.. Stem Cell Res Ther 2015 Jun 26;6(1):126.
- Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, Deans R, Keating A, Prockop Dj, Horwitz E. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement.. Cytotherapy 2006;8(4):315-7.
- Richardson LE, Dudhia J, Clegg PD, Smith R. Stem cells in veterinary medicine--attempts at regenerating equine tendon after injury.. Trends Biotechnol 2007 Sep;25(9):409-16.
- Brehm W, Burk J, Delling U, Gittel C, Ribitsch I. Stem cell-based tissue engineering in veterinary orthopaedics.. Cell Tissue Res 2012 Mar;347(3):677-688.
- Uder C, Brückner S, Winkler S, Tautenhahn HM, Christ B. Mammalian MSC from selected species: Features and applications.. Cytometry A 2018 Jan;93(1):32-49.
- Burk J, Berner D, Brehm W, Hillmann A, Horstmeier C, Josten C, Paebst F, Rossi G, Schubert S, Ahrberg AB. Long-Term Cell Tracking Following Local Injection of Mesenchymal Stromal Cells in the Equine Model of Induced Tendon Disease.. Cell Transplant 2016 Dec 13;25(12):2199-2211.
- Smith RK, McIlwraith CW. Consensus on equine tendon disease: building on the 2007 Havemeyer symposium.. Equine Vet J 2012 Jan;44(1):2-6.
- Burk J, Ribitsch I, Gittel C, Juelke H, Kasper C, Staszyk C, Brehm W. Growth and differentiation characteristics of equine mesenchymal stromal cells derived from different sources.. Vet J 2013 Jan;195(1):98-106.
- Paebst F, Piehler D, Brehm W, Heller S, Schroeck C, Tárnok A, Burk J. Comparative immunophenotyping of equine multipotent mesenchymal stromal cells: an approach toward a standardized definition.. Cytometry A 2014 Aug;85(8):678-87.
- Rantanen N, Jorgensen J, Genovese R. Ultrasonographic Evaluation of the Equine Limb: Technique. Diagn Manag Lameness Horse 2nd ed. 2011. p. 182–205.
- Vallance SA, Vidal MA, Whitcomb MB, Murphy BG, Spriet M, Galuppo LD. Evaluation of a diode laser for use in induction of tendinopathy in the superficial digital flexor tendon of horses.. Am J Vet Res 2012 Sep;73(9):1435-44.
- Crovace A, Lacitignola L, Rossi G, Francioso E. Histological and immunohistochemical evaluation of autologous cultured bone marrow mesenchymal stem cells and bone marrow mononucleated cells in collagenase-induced tendinitis of equine superficial digital flexor tendon.. Vet Med Int 2010;2010:250978.
- Martinello T, Pascoli F, Caporale G, Perazzi A, Iacopetti I, Patruno M. Might the Masson trichrome stain be considered a useful method for categorizing experimental tendon lesions?. Histol Histopathol 2015 Aug;30(8):963-9.
- Kittler J, Illingworth J. Minimum error thresholding. Pattern Recogn 1986;19:41–47.
- Hillmann A, Ahrberg AB, Brehm W, Heller S, Josten C, Paebst F, Burk J. Comparative Characterization of Human and Equine Mesenchymal Stromal Cells: A Basis for Translational Studies in the Equine Model.. Cell Transplant 2016;25(1):109-24.
- Pfaffl MW. Transcriptional biomarkers.. Methods 2013 Jan;59(1):1-2.
- Schnabel LV, Lynch ME, van der Meulen MC, Yeager AE, Kornatowski MA, Nixon AJ. Mesenchymal stem cells and insulin-like growth factor-I gene-enhanced mesenchymal stem cells improve structural aspects of healing in equine flexor digitorum superficialis tendons.. J Orthop Res 2009 Oct;27(10):1392-8.
- Bourin P, Bunnell BA, Casteilla L, Dominici M, Katz AJ, March KL, Redl H, Rubin JP, Yoshimura K, Gimble JM. Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT).. Cytotherapy 2013 Jun;15(6):641-8.
- Conze P, van Schie HT, van Weeren R, Staszyk C, Conrad S, Skutella T, Hopster K, Rohn K, Stadler P, Geburek F. Effect of autologous adipose tissue-derived mesenchymal stem cells on neovascularization of artificial equine tendon lesions.. Regen Med 2014;9(6):743-57.
- 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.
- Burk J, Gittel C, Heller S, Pfeiffer B, Paebst F, Ahrberg AB, Brehm W. Gene expression of tendon markers in mesenchymal stromal cells derived from different sources.. BMC Res Notes 2014 Nov 20;7:826.
- Geburek F, Mundle K, Conrad S, Hellige M, Walliser U, van Schie HT, van Weeren R, Skutella T, Stadler PM. Tracking of autologous adipose tissue-derived mesenchymal stromal cells with in vivo magnetic resonance imaging and histology after intralesional treatment of artificial equine tendon lesions--a pilot study.. Stem Cell Res Ther 2016 Feb 1;7:21.
- Yang Y, Zhang J, Qian Y, Dong S, Huang H, Boada FE, Fu FH, Wang JH. Superparamagnetic iron oxide is suitable to label tendon stem cells and track them in vivo with MR imaging.. Ann Biomed Eng 2013 Oct;41(10):2109-19.
- Addicott B, Willman M, Rodriguez J, Padgett K, Han D, Berman D, Hare JM, Kenyon NS. Mesenchymal stem cell labeling and in vitro MR characterization at 1.5 T of new SPIO contrast agent: Molday ION Rhodamine-B™.. Contrast Media Mol Imaging 2011 Jan-Feb;6(1):7-18.
- Bourzac CA, Koenig JB, Link KA, Nykamp SG, Koch TG. Evaluation of ultrasmall superparamagnetic iron oxide contrast agent labeling of equine cord blood and bone marrow mesenchymal stromal cells.. Am J Vet Res 2014 Nov;75(11):1010-7.
- Wang L, Deng J, Wang J, Xiang B, Yang T, Gruwel M, Kashour T, Tomanek B, Summer R, Freed D, Jassal DS, Dai G, Glogowski M, Deslauriers R, Arora RC, Tian G. Superparamagnetic iron oxide does not affect the viability and function of adipose-derived stem cells, and superparamagnetic iron oxide-enhanced magnetic resonance imaging identifies viable cells.. Magn Reson Imaging 2009 Jan;27(1):108-19.
- Delling U, Brehm W, Metzger M, Ludewig E, Winter K, Jülke H. In vivo tracking and fate of intra-articularly injected superparamagnetic iron oxide particle-labeled multipotent stromal cells in an ovine model of osteoarthritis.. Cell Transplant 2015;24(11):2379-90.
- Astanina K, Simon Y, Cavelius C, Petry S, Kraegeloh A, Kiemer AK. Superparamagnetic iron oxide nanoparticles impair endothelial integrity and inhibit nitric oxide production.. Acta Biomater 2014 Nov;10(11):4896-4911.
- Schäfer R, Ayturan M, Bantleon R, Kehlbach R, Siegel G, Pintaske J, Conrad S, Wolburg H, Northoff H, Wiskirchen J, Weissert R. The use of clinically approved small particles of iron oxide (SPIO) for labeling of mesenchymal stem cells aggravates clinical symptoms in experimental autoimmune encephalomyelitis and influences their in vivo distribution.. Cell Transplant 2008;17(8):923-41.
- Williams IF, McCullagh KG, Goodship AE, Silver IA. Studies on the pathogenesis of equine tendonitis following collagenase injury.. Res Vet Sci 1984 May;36(3):326-38.
- Little D, Schramme M. Ultrasonographic and MRI evaluation of a novel tendonitis model in the horse. Vet Surg 2006;35:E15.
- Nixon AJ, Dahlgren LA, Haupt JL, Yeager AE, Ward DL. Effect of adipose-derived nucleated cell fractions on tendon repair in horses with collagenase-induced tendinitis.. Am J Vet Res 2008 Jul;69(7):928-37.
- De Becker A, Riet IV. Homing and migration of mesenchymal stromal cells: How to improve the efficacy of cell therapy?. World J Stem Cells 2016 Mar 26;8(3):73-87.
- Chapel A, Bertho JM, Bensidhoum M, Fouillard L, Young RG, Frick J, Demarquay C, Cuvelier F, Mathieu E, Trompier F, Dudoignon N, Germain C, Mazurier C, Aigueperse J, Borneman J, Gorin NC, Gourmelon P, Thierry D. Mesenchymal stem cells home to injured tissues when co-infused with hematopoietic cells to treat a radiation-induced multi-organ failure syndrome.. J Gene Med 2003 Dec;5(12):1028-38.
- Carvalho AM, Yamada AL, Golim MA, Álvarez LE, Hussni CA, Alves AL. Evaluation of mesenchymal stem cell migration after equine tendonitis therapy.. Equine Vet J 2014 Sep;46(5):635-8.
- Guest DJ, Smith MR, Allen WR. Equine embryonic stem-like cells and mesenchymal stromal cells have different survival rates and migration patterns following their injection into damaged superficial digital flexor tendon.. Equine Vet J 2010 Oct;42(7):636-42.
- Dakin SG, Dudhia J, Smith RK. Resolving an inflammatory concept: the importance of inflammation and resolution in tendinopathy.. Vet Immunol Immunopathol 2014 Apr 15;158(3-4):121-7.
Citations
This article has been cited 15 times.- Soukup R, Gerner I, Mohr T, Gueltekin S, Grillari J, Jenner F. Mesenchymal Stem Cell Conditioned Medium Modulates Inflammation in Tenocytes: Complete Conditioned Medium Has Superior Therapeutic Efficacy than Its Extracellular Vesicle Fraction.. Int J Mol Sci 2023 Jun 29;24(13).
- Doll CU, Bohner M, Berner D, Buettner K, Horstmeier C, Winter K, Burk J. Approaches to standardising the magnetic resonance image analysis of equine tendon lesions.. Vet Rec Open 2023 Jun;10(1):e257.
- Quintero D, Perucca Orfei C, Kaplan LD, de Girolamo L, Best TM, Kouroupis D. The roles and therapeutic potentialof mesenchymal stem/stromal cells and their extracellular vesicles in tendinopathies.. Front Bioeng Biotechnol 2023;11:1040762.
- Bowers K, Amelse L, Bow A, Newby S, MacDonald A, Sun X, Anderson D, Dhar M. Mesenchymal Stem Cell Use in Acute Tendon Injury: In Vitro Tenogenic Potential vs. In Vivo Dose Response.. Bioengineering (Basel) 2022 Aug 22;9(8).
- Supokawej A, Korchunjit W, Wongtawan T. The combination of BMP12 and KY02111 enhances tendon differentiation in bone marrow-derived equine mesenchymal stromal cells (BM-eMSCs).. J Equine Sci 2022 Jul;33(2):19-26.
- Roth SP, Burk J, Brehm W, Troillet A. MSC in Tendon and Joint Disease: The Context-Sensitive Link Between Targets and Therapeutic Mechanisms.. Front Bioeng Biotechnol 2022;10:855095.
- Iwanaga Y, Morizaki Y, Uehara K, Tanaka S, Sakai T, Saito T. Robust Suture Combination for Rat Flexor Tendon Repair Model.. J Hand Surg Glob Online 2020 Nov;2(6):354-358.
- 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.
- Meeremans M, Van de Walle GR, Van Vlierberghe S, De Schauwer C. The Lack of a Representative Tendinopathy Model Hampers Fundamental Mesenchymal Stem Cell Research.. Front Cell Dev Biol 2021;9:651164.
- Depuydt E, Broeckx SY, Van Hecke L, Chiers K, Van Brantegem L, van Schie H, Beerts C, Spaas JH, Pille F, Martens A. The Evaluation of Equine Allogeneic Tenogenic Primed Mesenchymal Stem Cells in a Surgically Induced Superficial Digital Flexor Tendon Lesion Model.. Front Vet Sci 2021;8:641441.
- Ribitsch I, Oreff GL, Jenner F. Regenerative Medicine for Equine Musculoskeletal Diseases.. Animals (Basel) 2021 Jan 19;11(1).
- Jankowski M, Dompe C, Sibiak R, Wąsiatycz G, Mozdziak P, Jaśkowski JM, Antosik P, Kempisty B, Dyszkiewicz-Konwińska M. In Vitro Cultures of Adipose-Derived Stem Cells: An Overview of Methods, Molecular Analyses, and Clinical Applications.. Cells 2020 Jul 27;9(8).
- 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.
- Kornicka K, Geburek F, Röcken M, Marycz K. Stem Cells in Equine Veterinary Practice-Current Trends, Risks, and Perspectives.. J Clin Med 2019 May 14;8(5).
- Brandt L, Schubert S, Scheibe P, Brehm W, Franzen J, Gross C, Burk J. Tenogenic Properties of Mesenchymal Progenitor Cells Are Compromised in an Inflammatory Environment.. Int J Mol Sci 2018 Aug 28;19(9).
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