THE USE OF STEM CELLS AS A
REGENERATIVE THERAPY FOR
CHRONIC LAMINITIS
Nikki Engwall
Penn State University
Overview- Laminitis

Caused by:
 Endocrinatic
diseases
 Systemic infections
 Non-weight bearing lameness

Symptoms include lameness, heat in affected foot,
reluctance to walk, change in stance, change in hoof
shape
Distal Phalanx Displacement



Inflammation damages laminar attachments, causing
distal phalanx to displace
Scar tissue sometimes forms between displaced
coffin bone and hoof wall, called the laminar
wedge, measured by hoof laminar zone (HLZ)
Types of displacement
 Rotation
 Sinking
Deep Digital
Flexor Tendon
Distal Phalanx
Laminar Wedge
Hoof Wall
W
e
i
g
h
t
Deep Digital
Flexor Tendon
HLZ
Distal Phalanx
Laminar Wedge
Compressed
Digital Cushion
Common Treatments





NSAIDS and analgesics
Corrective padding and shoeing
Dorsal wall resection
Deep digital flexor tenotomy
Regardless of treatment, success rates
are low with chronic laminitis cases
Regenerative Therapy



Use of pluripotent
mesenchymal
stem cells (MSC) to repair
musculoskeletal tissue
Harvested from horse’s
blood, bone
marrow, or fat cells
Inhibit scar formation and
cell death, increase blood
flow, stimulate growth of new
cells, release growth factors
and anti-inflammatory
proteins
Use in Treating Laminitis

Study at Rood and Riddle Equine
Hospital in Kentucky tested MSC treatment in
30 horses, age 2-20 diagnosed with chronic laminitis
 Six
classified as severe rotation with moderate bone
disease, six with rotation and severe bone disease, and
18 as sinking
 Each received 20-30 million MSC in each affected foot
in one month intervals
 Average 3-4 treatments per horse
Results of Study

Treatment found to be successful if horse was
pasture sound without maintenance or heavy
medication for one year
 21
of the 30 cases were successful (70%)
 15 of the 18 sinkers were successful (83%)
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci.
Oct 2013)
Results continued

The sooner the horse received treatment, the better
 Median
time to first treatment was 71.5 days
 13 of the 15 horses treated before 71.5 days were
successful (87%)
 8 of the 15 treated later were successful (53%)
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci.
Oct 2013)
Results continued
Growth of laminar wedge has negative effect
 Scar
tissue generally forms around 90 days
 11 of the 16 horses first treated before 90 days had
improved HLZ (69%)
 2 of the 12 horses treated after formation of the
laminar wedge showed improved HLZ (17%)
 Similar to earlier study published in 2011 In JEVS, 83%
found successful using allogenic MSCs
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci.
Oct 2013)
Future applications

Questions still remain
 How
should the stem cells be given for optimum results?
 Where is the best place to give stem cells?
 What is the best kind of stem cells to use?


Lack of information on long term effects
Safety concerns and possible interactions with other
biological molecules.
In Conclusion…


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Stem cell therapy has
been known to be
successful in treating
various orthopedic
injuries, but only recently
has been studied in
treating laminitis
Recent work has shown
positive results in treating
laminitis
Early intervention is key
References
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
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Dryden, Vernon C et al. Using stem cells in clinical
cases. Journal Equine Veterinary Sci. Oct 2013
Morrison, Scott. Successful use of allogenic umbilical
cord-derived stem cells in nonresponsive chronic
laminitic cases. Journal Equine Veterinary Sci.
Oct 2011
Schnabel, Lauren V et al. Therapeutic use of stem
cells in horses: Which type, how, and when?. The
Veterinary Journal. Sept 2013
Thank You!

Are there any questions?