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Regenerative
Medicine
Regenerative medicine refers to a ‘biological’
approach to treatment of damaged tissue by
replacing or regenerating cells and tissues in
an attempt to restore and re-establish their
normal function. We are aiming to regenerate
tissues by replacing the damaged with new
tissue and to stimulate the body’s own repair
mechanisms enhancing healing. The ultimate
aim is the regeneration of new tissue,
which will provide better function than if
the body, was left to repair itself normally
with scar tissue.
In the horse, regenerative therapies have
become very popular particularly in the field
of orthopaedics, where they are frequently
used in the treatment of lameness’, particularly
tendon, ligament and joint disease. In all
these cases, our aim is to provide a scaffold
for tissue construction followed by the correct
cells, which will hopefully establish themselves
correctly. All this is helped by positive
anabolic stimulation frequently provided by
added growth factors.
Graham Hunter BVM&S GPCert(EqP) CertEP CertAVP(ESO) MRCVS
Veterinary Surgeon
Graham Hunter
XLEquine Practice
Ardene House
Veterinary Practice
1)
Mesenchymal Stem Cells
(MSC)
MSC’s represent the most significant
step into what we call regenerative
medicine. Stem cells are normally
harvested from the horse’s own sternum
or pelvis. Bone marrow is drawn out
from either of these locations and sent
away to a laboratory where the stem
cells are isolated and cultured to
increase their numbers. Around three
weeks later, they are injected back into
the same horse’s damaged tendon or
ligament. This injection uses ultrasound to
guide the accurate placement of the cells
into the correct location. Stem cells can
be isolated from fat or indeed harvested
from umbilical cord blood. Bone marrow
derived stem cells are considered the
best and most practical source.
PRP is generated through centrifuging the
horse’s own blood and then removing the
red and white blood cells and most of the
plasma, leaving a concentrated sample
of platelets. Platelets are a rich source of
growth factors which are injected into a
damaged tendon, ligament or joint. They
de-granulate and release their growth
factors promoting the formation of a fibrin
scaffold and encouraging new cells to
migrate into the area for tissue repair.
One of the main advantages of PRP is
that the blood can be taken, the sample
processed and treatment administered all
on the same day. There is no requirement
for an external laboratory.
Regenerative medicine
treatments include:
5
EQUINE MATTERS
REGENERATIVE MEDICINE
What do we mean by regenerative medicine?
Do we really
have practical, useful techniques available so that we can
safely regenerate tissue?
What can we really do and what
could we use these techniques for?
l
Stem Cells
l
Platelet Rich Plasma (PRP)
l
Urinary Bladder Matrix (ACell®)
l
Bone Marrow (BM)
l
Individual Growth Factors
l
Bone Marrow Aspirate Concentrate
(BMAC)
l
Autologous Conditioned Serum
(Irap®)
Regenerative therapies available
in the UK today
2)
Platelet Rich Plasma (PRP)