Use of regenerative medicine in the treatment of endometritis in mares: A systematic review and meta-analysis.

The research article explores the effectiveness of regenerative medicine methods, such as plasma products, autologous conditioned serum, and others, in treating endometritis in mares. The findings suggest these therapies, particularly those involving mesenchymal stem cells and their derivatives, may be an effective and safer treatment option.

Study Methodology

• The study was a comprehensive systematic review and meta-analysis observing the efficacy of regenerative medicine products in treating endometritis in mares.
• It included all studies exploring the use of regenerative therapies such as plasma products, autologous conditioned serum, and mesenchymal stem cells (MSCs), among others.
• Two authors independently gathered data and carried out a risk bias assessment for each study. The treatment effects were analyzed using risk ratios for dichotomous data, with 95% confidence intervals.
• The data was synthesized using a fixed-effects model and the quality of the evidence for each outcome was evaluated using GRADE criteria.

Results of the Study

• Fifteen trials were included in the meta-analysis, with a separate sub-meta-analysis conducted on platelet-derived products as well as on MSCs.
• The analysis showed a positive effect of regenerative therapies on horses afflicted with post-breeding persistent and chronic degenerative endometritis (PBIE/CDE), particularly therapies that involved MSCs and their derivatives.
• The positive outcomes included an anti-inflammatory effect, characterized by reduced intrauterine fluid accumulation, neutrophils, and cytokine concentrations.
• Some additional benefits included improvements in pregnancy, foaling, and embryo recovery rates in some cases.

Study Implications

• Despite the limited number of randomized controlled studies and the significant variability among protocols, including the timing of treatment, type, and volume of products used, the research suggested promising results for the use of regenerative products for treating PBIE/CDE in mares.
• The findings suggest that these therapies, particularly those involving MSCs and their derivatives, are not only effective but could also promote safer treatment options in endometritis therapy, given the ongoing public health crisis of antibiotic resistance.
• Further, the paper argues for the need for standardized protocols to ensure consistency in research and application of regenerative therapy.