Effects of glycosaminoglycan polysulphate on the organisation of collagen fibres in experimentally induced tendonitis in horses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Equine tendonitis therapy using mesenchymal stem cells and platelet concentrates: A randomized controlled trial

Introduction. Tendon injury is a major cause of lameness and decreased performance in athletic equines. Various therapies for tendonitis have been described; however, none of these therapies results in complete tissue regeneration, and the injury recurrence rate is high even after long recovery periods involving rest and physiotherapy. Methods. A lesion was induced with collagenase gel in the superficial digital flexor tendon in the center portion of the metacarpal region of eight equines of mixed breed. After two weeks, the lesions of the animals in the treated and control groups were treated through the intralesional administration of mesenchymal stem cells derived from adipose tissue (adMSCs) suspended in platelet concentrate (PC) and with phosphate buffered saline (PBS), respectively. Serial ultrasound analyses were performed every two weeks. After 16 weeks of therapy, a biopsy was performed for histopathological, immunohistochemical and gene expression (type I collagen (COL1A1), type III collagen (COL3A1), tenascin-C (TNC), tenomodulin (TNMD), and scleraxis (SCX)) analyses. Results: Differences in the ultrasound and histopathological analyses were observed between the groups. Improved results were reported in the group treated with adMSCs suspended in PC. There was no difference in the gene expression levels observed after the different treatments. The main results observed from the histopathological evaluation of the treated group were as follows: a prevention of the progression of the lesion, a greater organization of collagen fibers, and a decreased inflammatory infiltrate. A lack of progression of the lesion area and its percentage was observed in the ultrasound image, and increased blood flow was measured by Power Doppler. Conclusions: The use of adMSCs combined with PC for the therapy of experimentally induced tendonitis prevented the progression of the tendon lesion, as observed in the ultrasound examination, and resulted in a greater organization and decreased inflammation, as observed in the histopathological evaluation. These data demonstrate the therapeutic potential of this therapy for the treatment of equine tendonitis. © 2013 Carvalho et al.; licensee BioMed Central Ltd.

Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of mesenchymal stem cell migration after equine tendonitis therapy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intralesional polysulphated glycosaminoglycan as treatment of equine collagenase induced tendinitis: clinical, ultrasonographic and histopathologic evaluation

Estudou-se o efeito de aplicações intratendíneas do polissulfato de glicosaminoglicanas (PSGAG) no tratamento de tendinite induzida pela colagenase. Dois grupos (GI e GII) de cinco eqüinos da raça Puro-Sangue Árabe, machos e fêmeas, com idades entre dois e seis anos, foram submetidos à tendinite do tendão flexor digital superficial do membro torácico esquerdo por aplicação intratendínea de 1,0ml de colagenase (2,5mg/ml). Decorridos sete dias da indução da lesão, os eqüinos do GI receberam cinco aplicações intralesionais de 1,0ml (125mg) de PSGAG, a intervalos de quatro dias, enquanto que os do GII receberam aplicações de solução fisiológica em igual volume e freqüência. Efetuaram-se avaliações clínicas e ultra-sonográficas, periodicamente, durante 150 dias. Todos os animais apresentaram claudicação e aumento local de sensibilidade, de temperatura e de volume 24 horas após a indução da lesão. Com exceção do aumento de volume, que permaneceu visível até o final do experimento, observou-se regressão de todos os sinais em todos os animais. A avaliação ultra-sonográfica evidenciou lesões de tamanho, forma e posição variados, de maior severidade entre o sétimo e 23º dia. Ao término do experimento, o grau de ecogenicidade encontrava-se entre 1 e 2, e o grau de paralelismo entre 0 e 2. A análise histopatológica evidenciou áreas cicatriciais com intensa fibroplasia e neovascularização, fibras colágenas pouco organizadas e endotendão hipercelular e espessado. Não se observou diferenças significativas entre os grupos quanto ao processo de reparação das lesões, concluindo-se que a aplicação intralesional de PSGAG não produziu efeito benéfico para tratar tendinite induzida por colagenase.

Afecção do tendão supra-espinal e afastamento laboral

As afecções do manguito rotador, dentre elas as relacionadas ao tendão supra-espinal, são problemas comuns na população, sobretudo devido à sobrecarga ocupacional, o que leva a altos índices de afastamento do trabalho. Buscou-se, então, comparar a necessidade de afastamento de trabalho entre os diferentes estados da afecção do tendão supra-espinal e entre cinco diferentes grupos profissionais, tendo a participação de pacientes que apresentavam diagnóstico da afecção. Os indivíduos foram agrupados quanto ao estado da doença (tendinite, ruptura parcial, ruptura total) e quanto aos aspectos biomecânicos da ocupação (ramo de serviços, construção civil, trabalhadores domésticos, lavradores e seguranças). Teste qui-quadrado de Pearson, análise de dependência e teste exato para uma proporção foram realizados. Os resultados apontaram que 62 (55%) estavam afastados da atividade laboral e que os grupos com maior número de afastados foram o do ramo de serviços (38,71%) e lavradores (22,58%), segundo Pearson. A maior freqüência de casos de afastamento foi registrada no estágio de tendinite (p<0,05) pela análise de dependência e a ocupação de lavrador parece deixar o indivíduo por mais tempo afastado (p=0,02), segundo teste de Pearson.

Autologous implant of bone marrow mononuclear cells as treatment of induced equine tendinitis

Superficial digital flexor tendonitis is an important cause of lameness in horses and its incidence ranges from 13% to 30%, depending on the horse's activity. This injury can occur in yearlings and compromise its carriers by reinjury or even impossibility to return to athletic life. In spite of the long period required for tendon repair, the scar tissue presents lack of elasticity and stiffness. As current treatment strategies produce only marginal results, there has been great interest in research of therapies that influence the quality or the speed of tendon repair. Stem cell therapy has shown promising results in degenerative diseases and cases of deficient healing processes. This study aims to evaluate the influence of autologous mesenchymal bone marrow stem cells in tendon healing, comparing treated and non-treated tendons. Superficial digital flexor tendonitis lesions were induced by collagenase infiltration in both forelimbs of 6 horses, followed by autologous implant in one of the forelimbs of each animal. The horses were evaluated using clinical, ultrasonographic, histopathologic, and immunohistochemical parameters. Tendon biopsies were performed at Day 48. Results found in the treatment group, such as high inflammatory cells infiltration, extracellular matrix synthesis, reduced amount of necrosis areas, small increase in cellular proliferation (KI-67/MIB-1), and low immunoreactivity to transforming growth factor P I, suggested the acceleration of tendon repair in this group. Further studies should be conducted in order to verify the influence of this treatment on later phases of tendon repair. Overall, after analysis of the results, we can conclude that cellular therapy with the mononuclear fraction of bone marrow has accelerated tendon repair at 48 days after treatment.

Comparação de diferentes doses de colagenase em modelo de indução de tendinite para eqüinos: estudo clínico e ultra-sonográfico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Implante autólogo de células mononucleares provenientes de medula óssea notratamento de tendinites induzidas experimentalmente em equinos: avaliação a longo prazo - 120 dias

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Implante autólogo de células mesenquimais no tratamento de tendinites induzidas em eqüinos: avaliação clínica, ultrasonográfica, histopatológica e imunoistoquímica

Pós-graduação em Medicina Veterinária - FMVZ

Laserterapia em lesões de coluna na Medicina Veterinária

Lasertherapy is a method of non-pharmacological treatment and surgery that can be used in several injuries and in various tissues, from bone fractures to tendonitis, skin wounds and damaged nerves, permitting the recovery of these structures and their functions without causing any side effects. Laser therapy aims to restore patients that suffered various injuries, such as bone fracture, inflammation, edema, tendon rupture, spinal cord injury, among others, without invasive intervention, and the results obtained in several studies and case reports have proven the high potential of this therapy to become an official treatment of various pathological changes