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Disadvantage of using autologous MSCs is that it takes 2-3 weeks to isolate and expand the cells prior to use, to get enough of them. This involves a two-step process requiring the horse to return for treatment--after diagnosis and initial sample collection.
This may hamper optimal treatment time since an adequate number of cells are not readily available. Allogeneic use of cells has the advantage of making cells readily available and provides time to select and potentially enhance cell functions prior to use.
The disadvantage is that these cells (from another horse) are recognized by the patient’s immune system (and rejected) faster than autologous cells. Also, the regulations are different; allogeneic cell product develop- ment is considered drug development. Often autologous cells are provided for use at chilled temperatures whereas allogeneic cells are often provided frozen and thawed immediately prior to use. The thawing process can influence the utility of the cells.
Today, most commercial strategies are focused on developing frozen allogeneic cell products. One approach is the use of alloge- neic stem cells from umbilical cord blood that could be basically off-the-shelf/storable and given to any horse.
THE CHALLENGES OF TREATING OSTEOARTHRITIS
There are still a number of conditions in horses and humans that are difficult to treat successfully; we don’t have good treatments for those and/or the treatments are not 100% successful. Osteoarthritis (OA) is one of those conditions for which we don’t have good
treatments. Dr. Thomas Koch (Department of Biomedical Sciences, Ontario Veterinary College) has been working with stem cells for many years and says the fact we don’t have good treatments for OA is reflected by the many different ways that horses with joint pain are being managed and treated.
“There are many products being used for patients with OA, and veterinarians have different preferences in treatment—based on personal experience, and the experience of
their mentors. This in itself indicates that no one treatment has been shown to be supe- rior. There is interesting data in humans and various veterinary species, however, showing that stem cells may be useful in treating some joint conditions,” he says.
Koch is founder and CEO of eQcell,
a company that is currently starting two blinded, randomized trials in equine synovitis and early stages of osteoarthritis--one at the University of Guelph’s Ontario Veterinary College Equine Sports Medicine and Reproductive Centre, and the other trial at the University of California-Davis Veterinary Institute for Regenerative Cures (VIRC). The Canadian study in equine fetlock and carpal joint osteoarthritis is authorized by Health Canada’s Veterinary Drug Directorate and is the first stem cell trial in Canada for treat- ment of equine osteoarthritis. The U.S. study in fetlock osteoarthritis is being conducted under VIRC’s Investigational New Animal Drug (INAD) with the FDA.
“Part of the challenge in treating OA is that even though we talk about it as though it is one entity, in human medicine we are start- ing to recognize that there may be up to 100 different underlying mechanisms that more or less manifest the same way. We can look at these problems more closely now, with new molecular technologies. Now we know that OA is just a term for a very large category of conditions,” he says.
This helps explain why some treatments work and some don’t. “It’s partly chance
EQUINE HEALTH
Equine mesenchymal stomal cells can be stored for years at ultra-low temperatures. Here in the vapor phase of liquid nitrogen (-135˚ C.).
Lameness evaluation of horse (carpal joint Lameness evaluation of horse’s fetlock. flexion test).
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