Veterinary Regenerative Medicine
Professor Roger Smith, MA, VetMB, PhD, DEO, DiplECVS, MRCVS (Chair and official Representative of the European chapter)
Lisa A. Fortier, DVM, PhD, DiplACVS (Vice Chair and official Representative of the America�s chapter)
Iris Ribitsch, Dr. med.vet (Secretary and official Representative of the European chapter)
Yoshinori Kasashima, DVM. PhD (JAP - Representative of the Asian Pacific chapter)
Prof. Dr. med.vet. Walter Brehm (GER)
Prof. Dr. med. und Dr. med.vet. Reinhold Erben (AUT)
Dr. med.vet. Julien Troillet (GER)
Dr. med.vet. Johannes Edinger (AUT)
Dr. med.vet. Emir Chaher (PORT)
Professor Wayne McIlwraith, PhD, DVM, DiplACVS (USA)
Prof. Dr.med.vet. Rene van Weeren (NL)
Michael Schramme, PhD, DiplACVS/ECVS (FRA)
Prof. Dr.med.vet. Antonio Crovace (ITA)
Proposed Title of the theme:
Veterinary Regenerative Medicine
Rational of the theme:
When it comes to translating research from bench to bedside many of the pioneering innovations are achieved by cooperating teams of natural scientists, human and veterinary medical scientists. The symbiosis is particularly apparent in the rapidly growing field of regenerative medicine. The veterinary profession has had an important role in the translational process offering the missing link between basic science and human clinical applications. Many natural occurring diseases encountered in humans also pose a problem in veterinary patients with similar pathology and aetiopathogenesis. These diseases certainly raise the interest in regenerative medical treatments on the veterinary side but at the same time offer a perfect model for human patients, much better than artificially created diseases in lab animals which do not accurately reflect the clinical situation in humans. Tight cooperation between basic science human and veterinary medicine would therefore not only be beneficial for veterinary patients but would drive the field of regenerative medicine forward for the benefit of both human and veterinary patients. Formation of a thematic group .Veterinary regenerative Medicine. will essentially contribute to maximize international collaboration not only developing treatment strategies for veterinary patients but also generating preclinical data for the translation into human patients. Offering expertise in the pathophysiology of naturally occurring diseases in animals and their treatment plus a profound knowledge on species specific characteristics will pave the way into using large animal models offering a more representative scientific output. However such a thematic group not only holds a great scientific potential but may also serve as a platform for everybody interested and involved in veterinary regenerative medicine and will introduce a broad scale of clinical experience using regenerative medicine practices to the community:
Currently most regenerative medical therapies applied in veterinary patients are focused on musculoskeletal disorders in horses and dogs. Currently tendon injuries, degenerative joint disease and bone regeneration/ repair (fracture repair, non-union fractures, implant improvement and developmental disorders) are being treated. Most advanced is certainly the treatment of equine tendon injuries:
Tendon injuries are a frequently occurring problem in the equine athlete associated with athleticism and ageing. Due to the equine quadruped-specific anatomy characterized by the proximally located muscles and the distally located tendons in combination with the hyper-extended metacarpophalangeal joint, equine tendons and ligaments are exposed to enormous forces during athletic workout. Maximal strains in the superficial digital flexor tendon (SDFT) are reported to be at 16%, which comes up to the functional limit, during galloping in thoroughbreds (Richardson et al., 2007). The incidence of SDFT tendinitis in horses is reported to be as high as 8-43% (Dowling et al., 2000).
Most therapies do not lead to tendon regeneration but only to inferior scarring repair causing significantly reduced tendon elasticity (Smith, 2008). Therefore, in horses for example even after apparent initial recovery, reinjury rates of up to 80% are reported (Dowling et al., 2000).
Numerous experimental as well as first clinical trials document promising results using mesenchymal stromal cells applied intra-lesionally (Smith et al., 2003; Crovace et al., 2007; Pacini et al., 2007; Smith, 2008; Schnabel et al., 2009). In horses it was shown that the reinjury rate following MSC therapy was reduced to 13-36% (Smith, 2008). MSC implantation seems to result in a tissue more like normal matrix rather than fibrous scar tissue formed after natural repair which inevitably weakens a tendon.
Another technique routinely used in veterinary regenerative medicine is the application of PRP (platelet rich plasma). Regardless of the not standardized production procedures and the many remaining open questions there seems to be a multitude of possible indications for using PRP such as wound healing, tendinopathies, bone defects, delayed bone regeneration, arthropathies.
Autologous conditioned serum is frequently being used to treat degenerative joint disease in horses and dogs - ACS therapies have an analgesic as well as anti-inflammatory effect and showed promising results in studies.
Of course large placebo controlled studies for all these treatments are missing. The formation of a TERMIS subgroup will provide the prerequisites for required large multi centered studies by facilitating and promoting contact and networking between scientists in the field of veterinary regenerative medicine worldwide.
One of the major goals of the subgroup will therefore be the search for evidence based results of these treatments - putting years of clinical experience onto a scientifically well founded basis.
Aims and activities:
- Bridging between basic science and human clinical applications to pave the way for future translation of new procedures.
- Offer and develop large animal models for the translation of the technologies to treat equivalent human disease.
- To facilitate and promote contacts and networking between scientists in the field of veterinary regenerative medicine around the world.
- To propose, jointly coordinate and realize research projects - multi centered studies - to provide a scientifically well founded basis for the treatments.
- To improve the exchange of scientific expertise and perspectives in this field through provision of an international platform.
- To organize and participate in regular conferences.
- To promote the discussion between science and clinical practice via public documentation of the Society's activities as well as publishing of academic publications, research and science reports.
- To foster the developments of young scientists in the field of regenerative veterinary medicine.
Crovace,A., Lacitignola,L., De,S.R., Rossi,G., And Francioso,E. (2007); Cell Therapy For Tendon Repair In Horses: An Experimental Study; Vet. Res. Commun. 31 Suppl 1, 281-283.
Dowling,B.A., Dart,A.J., Hodgson,D.R., And Smith,R.K. (2000); Superficial Digital Flexor Tendonitis In The Horse; Equine Vet. J. 32, 369-378.
Pacini,S., Spinabella,S., Trombi,L., Fazzi,R., Galimberti,S., Dini,F., Carlucci,F., and Petrini,M. (2007). Suspension of bone marrow-derived undifferentiated mesenchymal stromal cells for repair of superficial digital flexor tendon in race horses. Tissue Eng 13, 2949-2955.
Richardson,L.E., Dudhia,J., Clegg,P.D., And Smith,R. (2007); Stem Cells In Veterinary Medicine--Attempts At Regenerating Equine Tendon After Injury; Trends Biotechnol. 25, 409-416.
Schnabel,L.V., Lynch,M.E., Van Der Meulen,M.C., Yeager,A.E., Kornatowski,M.A., And Nixon,A.J. (2009); 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.
Smith,R.K., Korda,M., Blunn,G.W., And Goodship,A.E. (2003); 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. 35, 99-102.
Smith,R.K. (2008); Mesenchymal Stem Cell Therapy For Equine Tendinopathy; Disabil. Rehabil. 30, 1752-1758.