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Stem cells and other biological material found in the dental sockets of newborn foals hold promise for treating arthritis and soft tissue injuries in mature horses, according to a new study from Ohio State University.
The focus of the research was dental pulp particles collected from foals who died during or shortly after birth.
“Inside the skulls of these foals are internal deep pockets that hold formed blobs of gelatinous material,” explains Alicia Bertone, DVM, PhD. “Those blobs contain stem cells that would have eventually developed into tooth, bone, bone marrow, nerve and ligament tissue within that socket, but at that point they are completely undifferentiated, meaning they could turn into any type of tissue.”
The blobs, which also contain hyaluronic 0 acid, are held together with extracellular matrix, a collection of molecules secreted by cells that provide structure and support to tissues. A company that specializes in veterinary tissue collects and processes the material to make an injectable substance, which can then be used to treat a variety of problems.
After identifying 40 horses with lameness caused by osteoarthritis or soft tissue injuries, Bertone and her team devised a two-part study to compare the effects of the dental pulp product to those of an inert control substance. First, the horses were each given a full lameness exam, then they were divided into two groups: One had the dental pulp product injected into their arthritic joints or soft-tissue injuries, while the other group was given injections of the control saline transport solution.
For the next 14 days, the researchers closely monitored the horses, performing ultrasounds, taking radiographs, drawing blood and synovial fluid for analysis, and conducting general lameness exams. Throughout this first portion of the study, the horses were confined to stalls and exercised on a treadmill twice a week.
At the end of the initial two-week period, owners of horses who had not received the dental pulp treatment were offered that option,
which all accepted. The horses returned home and owners were told to bring them back to their previous level of activity. The owners were also asked to assess their horses on study days 21 and 45 and fill out a questionnaire that covered soundness, comfort level and condition. Finally, a followup with the owners was done two and a half years later.
The researchers found that horses treated with the dental pulp product showed significantly reduced lameness on study days 7 and 14, compared to the control horses. Horses with soft tissue lesions improved more than did those with degenerative arthritis, which Bertone says may be attributable to the fact that “arthritis is just tougher to deal with, period.”
In the second half of the study, owners reported improvement by day 45 in four areas, including lameness, comfort level in the stall, comfort level during work and general attitude. Of the 16 owners who responded to the long-term follow-up and still owned the study horses, 10 reported the horses were still being ridden.
Although the study didn’t address the specific action of the dental pulp product, Bertone says it’s likely a few factors may have been at work. “What everyone likes about stem cells is they have the potential to stay where they are injected and grow into a variety of cells,” she says. “They could become tissue or otherwise support other cells migrating to the area, and that is certainly true and can aid healing. But there is also evidence that stem cells also have some antiinflammatory effect by modulating the immune response. And in a disease like arthritis, there is a significant immune component to the destruction of cartilage.”
The researchers conclude that the dental pulp product was effective in reducing lameness and can be considered a regenerative therapy option for horses with osteoarthritis or soft tissue injury.
Bertone says the dental pulp product is currently available to veterinarians under certain circumstances (veterinarians can contact VetGraft, LLC, for more information) for clinical use and may be more convenient than other sources of stem cells that require collection from the horse to be treated followed by stallside or laboratory processing. “With this product, it’s ready-made,” she says. “All a veterinarian needs to do is place an order and it’s sent overnight for use the next day.”
Reference: “Equine dental pulp connective tissue particles reduced lameness in horses in a controlled clinical trial,” Frontiers in Veterinary Science, March 2017
The researchers found that horses treated with the dental pulp product showed significantly reduced lameness on study days 7 and 14, compared to the control horses.
severity of those they found. Of the study horses, 83 percent had some degree of ulceration or erosion of the mucosa in the stomach, and 58 percent had lesions significant enough to warrant treatment.
Researchers then administered a dose of sucrose to the horses and drew blood 45 to 90 minutes later---the period when sucrose levels would be expected to spike if the horse’s stomach walls are damaged, according to previous research. The gastroscopic findings were then compared to the blood test results by an independent researcher.
The data showed no correlation between blood sucrose levels and the presence of gastric ulcers. The researchers note that most of the horses in the study had glandular ulcers (which affect the lower half of the stomach) while horses in previous studies had primarily squamous ulcers (found in the upper half). This, they say, may account for the results. They also hypothesize that the sucrose test may be too sensitive, detecting slight and clinically insignificant increases of sucrose “leakage” from gut mucosa not affected by ulcers.
The researchers call for further research into the relationship between blood sucrose levels and the presence of gastric ulcers using different populations of horses.