RESUMO
Suspensory ligament injuries are a common injury in sport horses, especially in competing dressage horses. Because of the poor healing of chronic recalcitrant tendon injuries, this represents a major problem in the rehabilitation of sport horses and often compromises the return to the initial performance level. Stem cells are considered as a novel treatment for different pathologies in horses and humans. Autologous mesenchymal stem cells (MSCs) are well known for their use in the treatment of tendinopathies; however, recent studies report a safe use of allogeneic MSCs for different orthopedic applications in horses. Moreover, it has been reported that pre-differentiation of MSCs prior to injection might result in improved clinical outcomes. For all these reasons, the present case report describes the use of allogeneic tenogenically induced peripheral blood-derived MSCs for the treatment of a proximal suspensory ligament injury. During conservative management for 4 months, the horse demonstrated no improvement of a right front lameness with a Grade 2/5 on the American Association of Equine Practitioners (AAEP) scale and a clear hypo-echoic area detectable in 30% of the cross sectional area. From 4 weeks after treatment, the lameness reduced to an AAEP Grade 1/5 and a clear filling of the lesion could be noticed on ultrasound. At 12 weeks (T 4) after the first injection, a second intralesional injection with allogeneic tenogenically induced MSCs and platelet-rich plasma was given and at 4 weeks after the second injection (T 5), the horse trotted sound under all circumstances with a close to total fiber alignment. The horse went back to previous performance level at 32 weeks after the first regenerative therapy and is currently still doing so (i.e., 20 weeks later or 1 year after the first stem cell treatment). In conclusion, the present case report demonstrated a positive evolution of proximal suspensory ligament desmitis after treatment with allogeneic tenogenically induced MSCs.
RESUMO
Polymer coating can optimize the surface characteristics of metallic coronary stents and serve as a vehicle for local drug delivery. Major problems, however, include the lack of biocompatibility of the polymers used and the limited amount of drug that can be loaded onto the stent. Stainless-steel stents were spray-coated or spray-coated combined with a barrier coating using a fluorinated polymethacrylate PFM-P75 impregnated with different methylprednisolone concentrations. When spray-coated with highly concentrated methylprednisolone ( 33%) fluorinated polymethacrylate PFM-P75, the surface became progressively more rough. Adding a barrier coating, however, could decrease these surface irregularities of methylprednisolone-loaded PFM-P75 spray-coated stents. In vitro, most of the methylprednisolone was released in the first 48 hours. A barrier coating could dramatically slow down the drug release from 80% to 13% during the first 48 hours. Histomorphometric analysis showed that the inflammatory response and neointimal hyperplasia of methylprednisolone-loaded stents were lower than in control stents. Neointimal hyperplasia of methylprednisolone-loaded PFM-P75 stents spray-coated with a barrier coating was decreased compared to the non-barrier-coated methylprednisolone-loaded stents. In conclusion, spray coating enables the use of high methylprednisolone concentrations. A barrier coating could significantly slow down the methylprednisolone release. Methylprednisolone-loaded PFM-P75-coated stents could significantly inhibit the inflammatory response and neointimal hyperplasia. The response to methylprednisolone was related to the dose used and the release time of the drug.
