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Equine veterinary journal2011; 44(5); 594-599; doi: 10.1111/j.2042-3306.2011.00530.x

Scintigraphic evaluation of intra-arterial and intravenous regional limb perfusion of allogeneic bone marrow-derived mesenchymal stem cells in the normal equine distal limb using (99m) Tc-HMPAO.

Abstract: Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objective: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to diffuse MSC distribution. Methods: Six horses were used in the study. MSCs were labelled with hexamethyl propylene amine oxime (HMPAO) and technetium-99m. RLP was performed through the median artery of one forelimb and the cephalic vein of the opposite limb under general anaesthesia. The tourniquet was left in place for 45 min. Scintigraphic images were obtained at 0, 45, 75 min, 6 h and 24 h post injection. Results: Distribution of labelled MSCs through the entire distal limb was achieved with all 6 IA RLP, but 3 out of 6 IV RLP showed poor or absent uptake distal to the metacarpus. Mesenchymal stem cell persistence was 39% (30-60%) and 28% (14-50%) (median [minimum-maximum]) at 6 h for IA and IV RLP, respectively. Severe arterial thrombosis occurred in one horse after IA RLP. Conclusions: Both IA and IV RLP of the distal limb result in MSC persistence in perfused tissues. The IA perfusion resulted in more reliable cell distribution to the pastern and foot area. Conclusions: Regional limb perfusion of MSCs might be used in cases where intralesional injection is not possible or in order to avoid iatrogenic needle damage. Further work is needed to assess the safety of IA RLP before its clinical use.
Publication Date: 2011-12-30 PubMed ID: 22212017DOI: 10.1111/j.2042-3306.2011.00530.xGoogle Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

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This study examines how mesenchymal stem cells (MSCs), injected intra-arterially and intravenously, distribute in a horse’s lower limb. The aim was to discover alternative administration methods for situations where direct access to lesions isn’t possible or where it’s important to minimize damage caused by needle insertion.

Research Methods

  • The researchers involved six horses in the study.
  • Mesenchymal stem cells were marked with hexamethyl propylene amine oxime (HMPAO) and technetium-99m before being infused into the horses via the median artery of one forelimb and the cephalic vein of the opposing limb under general anaesthesia.
  • A tourniquet controlled the flow of cells and was maintained in place for 45 minutes in each instance.
  • Scintigraphic imaging—a diagnostic tool that uses radioactive substances to generate 2D images and track the flow and gathering of certain components in the body—was carried out promptly after the injection, at 45 minutes, 75 minutes, 6 hours, and 24 hours subsequently.

Key findings

  • The study found that entire lower limb distribution of the marked MSCs was achieved with all six cases of intra-arterial regional limb perfusion (RLP). However, three of the six cases of intravenous RLP produced poor or non-existent absorption distal to the metacarpus.
  • Further findings highlighted the persistence of MSCs—39% median for intra-arterial and 28% median for intravenous infusion—at 6 hours post-injection.
  • One notable adverse effect was an incidence of severe arterial thrombosis in one horse after intra-arterial RLP.

Conclusions

  • The researchers conclude that both intra-arterial and intravenous RLP could result in the continued presence of MSCs in the treated tissues of a horse’s lower limb.
  • Intra-arterial perfusion appears to ensure a more dependable cell distribution to the pastern and foot area.
  • The study suggests the potential use of RLP of MSCs in instances where direct lesional injection isn’t viable or when it’s imperative to limit iatrogenic needle damage.
  • However, the study also underlines the necessity for further investigation into the safety of intra-arterial RLP due to the observed side effect of severe arterial thrombosis.

Cite This Article

APA
Sole A, Spriet M, Galuppo LD, Padgett KA, Borjesson DL, Wisner ER, Brosnan RJ, Vidal MA. (2011). Scintigraphic evaluation of intra-arterial and intravenous regional limb perfusion of allogeneic bone marrow-derived mesenchymal stem cells in the normal equine distal limb using (99m) Tc-HMPAO. Equine Vet J, 44(5), 594-599. https://doi.org/10.1111/j.2042-3306.2011.00530.x

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 44
Issue: 5
Pages: 594-599

Researcher Affiliations

Sole, A
  • Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, CA, USA.
Spriet, M
    Galuppo, L D
      Padgett, K A
        Borjesson, D L
          Wisner, E R
            Brosnan, R J
              Vidal, M A

                MeSH Terms

                • Animals
                • Bone Marrow Cells / physiology
                • Female
                • Forelimb / blood supply
                • Infusions, Intra-Arterial
                • Injections, Intravenous
                • Male
                • Mesenchymal Stem Cell Transplantation / veterinary
                • Radionuclide Imaging / methods
                • Radionuclide Imaging / veterinary
                • Radiopharmaceuticals / pharmacology
                • Technetium Tc 99m Exametazime / pharmacology
                • Transplantation, Homologous

                Citations

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