What are Stem Cells?
Stem cells are cells that are able to self-renew (able to replicate many times in the same state) and able to become or ‘differentiate into’ many types of cell. There are broadly two types of mammalian stem cell: embryonic and adult. Embryonic stem cells are ‘totipotent’ and can become any cell in the body and therefore could form a whole organism. Adult stem cells, such as those used by the Nupsala procedure, are only ‘multipotent’ and are more limited in their differentiation but can become any cells within a closely related family. This limited differentiation actually makes them easier to control in the lab. Using adult stem cells avoids the controversy and restrictions associated with the use of embryonic stem cells.
Mesenchymal Stem Cells
Nupsala Stem Cell Therapy uses mesenchymal stem cells (MSCs), which are adult stem cells that are able to become tendon cells (tenocytes), bone cells (osteocytes), cartilage (chondrocytes) and fat cells (adipocytes). These can be harvested from adipose tissue, bone marrow or from the Wharton’s Jelly of the umbilical cord. Vets routinely use the sternum (breastbone) or tuber coxae (hip) as a source of bone marrow in equine patients. This is done under sedation with little or no discomfort to the horse (at no point is general anaesthetic necessary). In humans this would be taken from the ilium (part of the pelvis).
Background to Stem Cell Therapy
Stem cells have the unique capacity to generate a range of specialised cell types, so for years researchers have looked for ways to use them to replace damaged or diseased tissues. As long ago as 1961 it was shown that mesenchymal stem cells (MSCs) could develop into tendon cells in the lab and by the end of the 1990s the regeneration of new tendon-like tissue had been shown in vivo.
Equine mesenchymal stem cells
In 2005 Hankemeier et al. demonstrated that the implantation of MSCs induced a better quality and stronger repair in rat patella tendon. These earlier results are supported by recent data generated both experimentally and by clinical follow-up which show significantly improved quality and function of equine tendons post-injury (Smith et al. data submitted for publication).
Tendon & Ligament Treatment
Autologous MSCs for use in the treatment are extracted from a sample of the injured horse’s bone marrow which is taken either from the sternum or tuber coxae under standing sedation and local anaesthesia. The sample is then packaged and couriered to the laboratory where the stem cells are extracted and cultured – a process that takes an average of 18 days. The cultured cells are re-suspended in bone marrow supernatant before being returned to the veterinary surgeon for ultrasound directed implantation directly into the lesion. The horse then undergoes a carefully controlled rehabilitation programme which takes approximately one year and encourages a return to full fitness and full work.