Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
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| ADVANCES IN STEM CELL THERAPY O steoarthritis aff licts 10 to 12 million dogs in the United States and is the most common cause of chronic pain in dogs.1 Tendon and ligament inju- ries are common in performance horses and potentially more threat- ening than a fracture to the horse’s athletic ability.2 Clinical evidence is growing that autologous adipose-derived stem/ stromal cells (AD-SCs) can dramati- cally improve healing of injuries and decrease degenerative processes.3 USE IN VETERINARY MEDICINE Horses Veterinarians have used autologous adipose-derived mesenchymal stem cells to treat tendon and ligament injuries and joint disease in horses on a commercial basis since 2003.4 This procedure involves: UÊ ÝÌÀ>VÌionÊovÊ>Êv>ÌÊÃ>m«liÊvÀomÊ the animal UÊ->m«liÊÃinÌÊÌoÊ>Êl>LoÀ>ÌoÀÞÊvoÀÊ stem/stromal cell processing Figure 1. Flow chart elucidating possible commitment, lineage progression, and maturation of adipose-derived mesenchymal stem cells UÊ*ÀoViÃÃi`Ê Ã>m«liÊ ÀiÌÕÀni`Ê ÌoÊ treating veterinarian for direct placement or injection into the injured tissue or joint. Successful outcomes from this treatment have been shown in horses treated from 2003 to 2008, with:5-8 UÊÇǯÊÀiÌÕÀnin}ÊÌoÊ«ÀioÀÊliÛilÊovÊ«iÀvoÀm>nVi UÊ9{¯ÊÃÌ>LliÊ£Ê Þi>ÀÊoÀÊmoÀiÊ >vÌiÀÊ ÌÀi>ÌminÌÊ voÀÊ >VÕÌiÊ and chronic suspensory ligament injuries UÊxǯÊÜiÌhÊjoinÌÊinjÕÀiiÃÊÀiÌÕÀnin}ÊÌoÊ«ÀioÀÊliÛilÊovÊ«iÀ- formance. No systemic adverse events were reported and less than ä°x¯Êh>`ÊloV>lÊÌiÃÃÕiÊÀi>VÌionÃ°Ê Companion Animals nÊ ÓääÇ]Ê ÌhiÃÊ ÌiVhnolo}ÞÊ Ü>ÃÊ m>`iÊ >Û>il>LliÊ ÌoÊ Ãm>llÊ DEFINING POTENCY r Totipotency JT UIF BCJMJUZ PG B TJOHMF DFMM UP EJWJEF BOE QSPEVDF BMM UIF EJGGFSFOUJBUFE DFMMT JO BO PSHBO JTN JODMVEJOH FYUSBFNCSZPOJD UJTTVFT r Pluripotency SFGFST UP B TUFN DFMM UIBU IBT UIF QPUFO UJBM UP EJGGFSFOUJBUF JOUP BOZ PG UIF HFSN MBZFST &OEPEFSN; JOUFSJPS TUPNBDI MJOJOH HBTUSPJOUFT UJOBM USBDU MVOHT .FTPEFSN NVTDMF CPOF CMPPE VSPHFOJUBM &DUPEFSN; FQJEFSNBM UJTTVFT OFSWPVT TZTUFN r Multipotency SFGFST UP DFMMT UIBU SFUBJO UIF DBQB CJMJUZ UP EJGGFSFOUJBUF JOUP B WBSJFUZ PG DFMMVMBS QIF OPUZQFT EFSJWFE GSPN HFSN MBZFS 24 Today’s Veterinary Practice July/August 2011 animal veterinarians for dogs and cats, with more than 1000 cases of connective tissue and joint repair reported ÌhÀoÕ}hÊ Óää9]9 blinded, placebo-controlled canine clinical trials.10 Recently in-office stem cell procedure kits have become available, allowing for treatment at the clinic or on the farm, depending on the species of animal receiving therapy. STEM CELL CHARACTERISTICS There are 2 kinds of stem cells: UÊ mLÀÞoniVÊ«Àin>Ì>l®ÊÃÌimÊVillÃÊ UÊ `ÕlÌÊ«oÃÌn>Ì>l®ÊÃÌimÊVillð11 Although most lay people recognize the term embryonic stem cells, the important potentials of adult stem cells have been recognized in the veterinary and human medical lit- iÀ>ÌÕÀiÊ ÃinViÊ£9ÈÎ]ÊÜhinÊ iVkiÀ]Ê iÌÊ >l]Ê Ài«oÀÌi`ÊonÊ ÌhiÊ regenerative nature of bone marrow.12 Embryonic Stem Cells mLÀÞoniVÊ ÃÌimÊVillÃÊ>Ài]Ê inÊ ÌhioÀÞ]Ê>LliÊÌoÊÌÀ>nÃvoÀmÊ into any type of tissue; they are totipotent when an egg is fertilized; then after several divisions are pluripotent.13 Although less of an issue in veterinary than human medi- cine, there are religious, political, and ethical issues that limit the use of fetal stem cells. Adult Stem Cells *oÃÌn>Ì>lÊ>`ÕlÌÊÃÌimÊVillÃ\Ê UÊ,iÌ>inÊÀi}iniÀ>ÌiÛiÊoÀÊÀi«>À>ÌiÛiÊV>«>LiliÌiiÃÊ>ÃÊÕn`iv- ferentiated cells UÊ >inÌ>inÊhomioÃÌ>ÃiÃÊinÊ>llÊÌiÃÃÕiÃ Ê >n`Ê >Ê }Ài>ÌiÀÊ Ìh>nÊ nä¯Ê ÃÕVViÃÃÊ À>ÌiÊ inÊ