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Frontiers in veterinary science2021; 8; 697551; doi: 10.3389/fvets.2021.697551

Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model.

Abstract: Autologous protein solution (APS) has been used anecdotally for intralesional treatment of tendon and ligament injuries, however, its use in these injuries has never been studied . Our objective was to evaluate the effect of APS on tendon healing in an equine superficial digital flexor (SDF) tendonitis model. We hypothesized intralesional injection of APS would result in superior structural and biomechanical healing. SDF tendonitis was induced in both forelimbs of eight horses using collagenase injection. One forelimb was randomly assigned to receive an intralesional injection of APS, while the other was injected with saline. Ultrasonographic examinations were performed at weeks -1, 0, 2, 4, 8, and 12 following treatment. At 12 weeks, horses were euthanized and SDF samples harvested. Histologic evaluation, biomechanical testing, gene expression analysis, total glycosaminoglycan (GAG) and total DNA quantification were performed. Collagen type III () expression was significantly higher ( = 0.028) in saline treated tendon than in normal tendon. Otherwise, there were no significant differences in gene expression. There were no significant differences in histologic or ultrasonographic scores between groups. Mean total DNA content was significantly higher ( = 0.024) in saline treated tendons than normal tendons, whereas total DNA content was not significantly different between APS treated tendon and normal tendon. Elastic modulus was higher in APS treated than saline treated tendon, but the difference was not significant. Reduced expression of in APS treated tendon may indicate superior healing. Increased total DNA content in saline treated tendon may indicate ongoing healing processes, vs. APS treated tendons which may be in the later stages of healing. Limitations include a relatively short study period and inconsistency in size and severity of induced lesions. Intralesional injection of APS resulted in some improvements in healing characteristics.
Copyright © 2021 Gaesser, Underwood, Linardi, Even, Reef, Shetye, Mauck, King, Engiles and Ortved.
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Publication Date: 2021-07-05 PubMed ID: 34291103PubMed Central: PMC8287003DOI: 10.3389/fvets.2021.697551Google Scholar: Lookup
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  • Journal Article

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 research sought to understand the effects of autologous protein solution (APS) on the healing of tendon injuries in horses. The study specifically focused on tendonitis in the superficial digital flexor (SDF) of horses, comparing the results of APS treatment with a control group that received a saline treatment.

Research Methodology

  • The study involved eight horses whose SDF tendonitis was artificially induced using collagenase injections in both forelimbs.
  • One forelimb in each horse was chosen at random to receive an APS treatment, while the other received a saline injection. This ensured each horse served as its own control, adding robustness to the experiment.
  • Follow-ups were conducted via ultrasonographic examinations over a period of 12 weeks.
  • At the end of the 12 week period, the horses were euthanized and the SDF samples harvested for further examination.
  • The harvested tendons were subjected to histologic evaluations, biomechanical testing, gene expression analysis, total glycosaminoglycan (GAG) and total DNA quantification to understand the healing process and effects of the treatment.

Findings

  • The study found that the collagen type III gene (COL3A1) expression was significantly higher in the tendons treated with saline. However, there were no other significant differences in gene expression between the two groups.
  • Both histologic and ultrasonographic scores showed no significant differences between APS and saline treated groups.
  • The mean total DNA content was significantly higher in the saline-treated tendons compared to the normal values. On the other hand, the total DNA content of tendons treated with APS was not significantly different from normal tendons.
  • While the elastic modulus, a measure of the tendon’s resistance to elastic deformation, was higher in the APS treated tendons than the saline-treated ones, the difference was not statistically significant.

Conclusions and Implications

  • The reduced COL3A1 gene expression and the normal DNA content in the APS treated tendons may indicate better healing compared to the saline-treated tendons.
  • The researchers suggest the ongoing higher DNA synthesis in the saline-treated tendons may indicate that these tissues are still in a healing phase, while the APS treated ones may already be in the later stages of healing.
  • However, they note the limitations of the study including a short study period and inconsistency in the severity of induced lesions.
  • The study concluded that while APS treatments did show improvements in certain healing characteristics, further research is required to determine its effectiveness conclusively.

Cite This Article

APA
Gaesser AM, Underwood C, Linardi RL, Even KM, Reef VB, Shetye SS, Mauck RL, King WJ, Engiles JB, Ortved KF. (2021). Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model. Front Vet Sci, 8, 697551. https://doi.org/10.3389/fvets.2021.697551

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 8
Pages: 697551
PII: 697551

Researcher Affiliations

Gaesser, Angela M
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
Underwood, Claire
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
Linardi, Renata L
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
Even, Kayla M
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
Reef, Virginia B
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
Shetye, Snehal S
  • McKay Orthopaedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Mauck, Robert L
  • McKay Orthopaedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
King, William J
  • Owl Manor, Warsaw, IN, United States.
Engiles, Julie B
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
  • Department of Pathobiology, New Bolton Center, School of Veterinary Medicine, University of Pennyslvania, Philadelphia, PA, United States.
Ortved, Kyla F
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.

Grant Funding

  • U01 TR002953 / NCATS NIH HHS

Conflict of Interest Statement

WK is the Director of Research and Development at Owl Manor, who's product was investigated in this study. The remaining 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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