Information for Vets

Scientific background
Osteoarthritis (OA) is a degenerative disease affecting the whole joint; its main features include damaged cartilage on the surface of the bones. As a result, chronic pain and inflammation develops leading to lameness; movement becomes difficult, and the quality of life declines significantly. Both genetic (resulting in defects in cartilage matrix production) and other factors (age, inactive life style, damage) may be responsible for the disease (Cucchiarini et al. J. of Exp. Orth. 2016, 3:22). Considering the short-lived benefits of treatments available currently (non-steroid anti-inflammatory drugs, physiotherapy, viscosupplementation, arthroscopic lavage and debridement) and the low regenerative capacity of the cartilaginous tissue, OA is presently incurable.
However, the intra-articular administration of mesenchymal stem cells (MSCs) – which are being used increasingly nowadays - may provide a long term solution (Perdisa et al. Stem Cells Int. 2015:597652). MSCs are present in every tissue; their primary function includes the regeneration of connective tissue elements. Most of our knowledge comes from bone marrow-derived MSCs but, recently, adipose MSCs have come to the fore since they are abundant and easily accessible.
Several preclinical and clinical trials have confirmed the beneficial effects MSCs exert on OA; they have been proven to halt disease progression and further degradation of the cartilage and to enable the discontinuation of anti-inflammatory drugs (Vilar et al. BMC Vet. Res. 2016, 12:223). MSCs ensure cartilage regeneration in two ways: they differentiate into cartilage cells and initiate endogenous regenerative processes via the factors they produce. MSCs also exert an immunosuppressive effect thus changing the inflamed microenvironment characteristic of OA favourably (Shi Y et al. Cell Res 2010, 20:510).
Autologous MSC treatment is the current main stream practice in regenerative medicine. However, since genetic factors may lie behind defective cartilage formation, autologous stem-cell treatment may always provide a long term solution. To overcome the effect of genetic factors, we use MSCs derived from orthopedically healthy dogs and transplant them locally into the joint of the sick dog, achieving a long lasting symptom-free period or even full recovery. Using allogeneic MSCs is as safe as autologous MSCs as shown in a recent randomized, masked, placebo-controlled efficacy study (Harman et a. Front. in Vet. Sci. 2016, 3:81).
To date, more than 100 cases of moderate or severe osteoarthritis have been treated in clinical studies in dogs and horses employing this minimally-invasive MSC transplantation. We published our results and the efficiency of our method in January, 2017. Statistical analysis of the efficiency of the treatment was performed on a homogenous group of 39 cases, which included dogs suffering from elbow OA and excluded those cases in which the hip, knee, or shoulder joints were affected. The degree of lameness was monitored 6, 9, and 12 months after stem-cell therapy by questioning the owners about the lameness of their dog during walk. The results are summarised in the following figure. Our results demonstrate that lameness due to cartilage wear was significantly reduced by our stem-cell suspension, and this effect was detectable for a long period, even after one year.

Therapeutic effect of adipose tissue-derived mesenchymal stem cells — Lameness was rated by the owners using a questionnaire modified from Black et al (Vet. Ther. 2007, 8:272). Results were substantiated by the nonparametric Wilcoxon test. *P <0.001, N = 39.

Further details of the analysis are available here.

Why are we developing stem-cell treatment? Because

it is non-invasive, a single injection is effective. it reduces discomfort and, potentially, pain relievers can be discontinued. it prevents disease progression and enhances reversal. only these cells are capable of regenerating damaged cartilage; no other procedure is available. its effect is long lasting.