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Stem cell therapy – racing to success

Last month a pair of racehorses demonstrated the success of stem cell therapy for treating tendon and ligament injuries, racing away with the $100,000 Benalla Gold Cup and third place in the Group 2 Gilgai Stakes at Flemington.

One of Australia’s foremost thoroughbred operations, Lindsay Park Stud, run by the Hayes family in South Australia’s Barossa Valley, was one of first to use the Vet Biotechnology (VBT) stem cell treatment for racing-incurred injuries.

Just over a year ago, the now seven-year-old galloper Viz Vitae was suffering from a severe tendon injury when it was purchased by Lindsay Park’s resident veterinarian Dr Campbell Baker and long-time stable supporter Paul Kerr.

Viz Vitae received treatment with its own purified and concentrated bone marrow stem cells in September 2006, and last month romped home in the Benalla Gold Cup. It was the10th individual winner for VBT’s stem cell therapy from 18 runners. The wins have generated more than $500,000 in prize money in the first 12 months.

“This horse suggests to us at Lindsay Park that no matter how severe the tendon injury, stem cells promise a complete regeneration of the damaged tissue,” Dr Baker said.

“Whilst it is too soon to comment on the long-term outcomes of Vet Biotechnology’s therapy, early results to date in terms of returning injured horses to the racetrack have been nothing short of stunning.”

Trainer Danny O’Brien’s Valedictum is another horse whose career has turned around thanks to stem cell therapy. Following a serious tendon injury in the spring of 2006, Valedictum was injected with his own bone marrow stem cells. Last month, Valedictum charged down the Straight Six at Flemington to grab third place third place in the Group 2 Gilgai Stakes.

In July last year, the David Hayes trained four-year-old gelding, Pinions, made a stunning racing return at Cheltenham Park in Adelaide, coming from well back in the field to win, running away from the rest of the field. Pinions was the first racehorse in Australia to be treated with the revolutionary stem cell therapy, which he received for an injured ligament in September 2005.

The treatment involves collecting a bone marrow sample from the animal’s sternum by a veterinarian approved by Vet Biotechnology. The mesenchymal stem cells are isolated from the sample and then grown in a laboratory. They are concentrated to four million cells per ml, for later treatment of the horse from which they were extracted. Generally two injections of one ml, each containing four million plus cells are sufficient to trigger the animal’s own cells and drive rapid recovery from serious tendon or ligament injury.

Twelve months ago, this novel therapy, although successful in Europe and the UK, was almost untried in Australia. Vet Biotechnology general manager David Bridgland says Pinions was the first Australian winner for the revolutionary new treatment.

“The resolution of care usually complete in three months, when the tendon fibres are virtually indistinguishable form the uninjured ones,” Bridgland says. “On the radiographic evidence they can be indistinguishable after six weeks but certainly by 12 weeks.” However, the rehab period of 12 months is retained to give the racehorse the maximum opportunity to return to fully functioning tendons and ligaments.

Viz Vitae
Fit as a fiddle: seven-year-old galloper Viz Vitae in his Benalla Gold Cup 2007 rug

VBL is only licensed at this stage for injuries to equine tendons and ligaments. Bridgland says cell therapy has the potential to be effective for injuries to bone, cartilage and muscle as well as tendons and ligaments, but the therapies have yet to be tested. “We are always looking to future developments, and as we develop the technology we will be looking to license it in Australia and New Zealand.”

Dr Baker says he sees great potential in the therapy. Yearlings, for example, are subject to growth-related problems – developmental orthopaedic problems – and the lesions can be picked up in the mandatory radiographic examinations at the yearling sales. “These lesions would be a good candidate for stem cell treatments,” he suggests; “further down the track a greater number of conditions could be treated, such as myocardial infarction or even spinal injuries.”

Vet Biotechnology was granted the exclusive Australasian licence for the service in 2004 by the UK-based VetCell BioScience Ltd, which developed the technology in association with the Royal Veterinary College of London. The Newcastle Stock Exchange-listed company holds the only Australian Pesticides and Veterinary Medicines Authority (APVMA) registration for stem cell therapies in Australia.

In 2006 four-year-old gelding Pinions, made a stunning racing return at Cheltenham Park in Adelaide on July 22 coming from well back in the field to win, running away from the rest of the field. The David Hayes trained Pinions had been treated with stem cell therapy for an injured ligament in September 2005.

One of Australia’s foremost thoroughbred operations, Lindsay Park Stud, run by the Hayes family in South Australia’s Barossa Valley, is the one of first to use the VBT stem cell treatment for racing-incurred injuries.

Vet Biotechnology general manager David Bridgland says Pinions is the first Australian winner for the revolutionary new treatment, and follows the successful return to the racecourse and winning ways of horses treated in Europe and the UK.

Pinions
Pinions in his comeback race at Cheltenham Park, Adelaide, after his stem cell therapy

Another winner is the Bart Cummings’ Cups hope Accumulate, who returned to racing at Rosehill at the beginning of September. Accumulate is among the first horses in Australia to have their bone marrow stem cells purified, expanded and implanted to aid their recovery. Accumulate was 10 lengths from the leader on the home turn and ran home strongly along the rails to finish eighth, and was beaten by only 3.8 lengths.

“The European results have shown that the therapy significantly increases the chance of a horse returning to full work and competition,” Bridgland said. “These Australian results certainly support the effectiveness of the treatment.”

The treatment involves collecting a bone marrow sample from the sternum by a veterinarian approved by Vet Biotechnology after which the mesenchymal stem cells are isolated and then grown in a laboratory. They are concentrated to four million cells per ml, for later treatment of the horse from which they were extracted. Generally two injections of one ml, each containing four million plus cells, Bridgland says.

Vet Biotechnology was granted the exclusive Australasian licence for the service in 2004 by the UK-based VetCell BioScience Ltd., which developed the technology in association with the Royal Veterinary College of London. The Newcastle Stock Exchange-listed company holds the only Australian Pesticides and Veterinary Medicines Authority (APVMA) registration for stem cell therapies in Australia.

It was set up by the directors: Paul Mariani and Lusia Guthrie in response to the demand for a ‘rattles’ vaccine, which was the company’s first research project. Its first GM, Hugo Le Messurier saw the opportunity to develop the horse performance side of stem cell therapy. Research at Royal Veterinary College London developed the technology used by BVT specifically for injuries to tendons and ligaments in racehorses.

Le Messurier developed the stem cell therapy from bone marrow – extracting the bone marrow, separating the components out, concentrating the mesenchymal cells (the adult stem cells) to a concentration of 4million+ cells per ml, which can be re-injected into the tendon or ligament in two doses of 1ml of 4million cells.

aspiration
Collecting the stem cells by aspiration from the horse’s sternum

“The resolution of care usually complete in 3 months, when the tendon fibres are virtually indistinguishable form the uninjured ones,” Bridgland says. “On the radiographic evidence they can be indistinguishable after six weeks but certainly by 12 weeks.” However, the rehab period of 12 months is retained to give the racehorse the maximum opportunity to return to fully functioning tendons and ligaments.

The first bone marrow treatments were offered in July 2005, “so we’re starting to see the horses that were treated in July, August and September returning to the track now, Bridgland says. “Pinions was a bit different – he was back in 10 months.”

Lindsay Park vet Dr Campbell Baker says the stud was always looking for ways to treat damaged ligaments and ‘bowed tendons’ or severe tendinitis. This is a severe racing-incurred injury, and will often end the racing career of a Group 1 racehorse such as Northerly or Better Loosen Up. Better Loosen Up, which had won the Japan Cup, was treated with the standard therapy for bowed tendons, and returned to racing, but was never quite as good as before his injury, a fact Dr Baker puts down to the development of scar tissue on the tendon.

“Pinions had a very extensive lesion – when we measured it with ultrasonography the lesion was about 80 per cent of the tendon. The horse always showed reasonable capabilities in racing so we were glad to try the newest therapy.”

Bone marrow stem cells were collected from Pinions’ sternum and then there was a three-four week wait while they were purified and concentrated in the lab. They were then injected back into the tendon at four different sites, guided by ultrasound. The horse was kept comfortable for two weeks before returning to paddock exercise and gradual training to strengthen the tendon without overstraining it.

Dr Baker says the way the Pinions races shows the stem cell treatment prevented the development of scar tissue on the tendon. “When he races he really stretches out, you can see there’s no scar tissue holding him back, but Better Loosen Up was never quite as good again.”

Cord cell service
VBT has just launched a cord cell collection and storage process which is undergoing validation trials at several thoroughbred horse studs, including validation.

Large numbers of contamination-free adult stem cells have already been obtained from the first three test umbilical cord samples obtained after foaling at Lindsay Park.
The first cord cells were taken at Lindsay Park stud on Thursday August 11. The mare foaled around midnight on the 10th. “I took the cells myself as a training exercise for the stud grooms at Lindsay Park,” Bridgland says.

Lindsay Park Stud has 120 horses in training at any time, and has stables in Sydney and Melbourne. There are generally four stallions standing at stud covering 300-400 mares, and about 150 foals are born each year.

Dr Baker says the advantage of the cord cells is that once collected and cryogenically stored, they are ready for use whenever required. “With the bone marrow stem cells there is a 3-4 week wait while the cells are concentrated, but for optimal healing you need to get them in the area of injury as soon as possible. If you’ve already got your cord cells you’re ready for implantation.”

Other participants in the validation are Arrowfield Stud and Widden Stud in New South Wales, Victoria’s Swettenham Stud (formerly Collingrove Stud) and Eureka Thoroughbreds in Queensland

VBT is only licensed at this stage for injuries to equine tendons and ligaments. Bridgland says cell therapy has the potential to be effective for injuries to bone, cartilage and muscle as well as tendons and ligaments, but the therapies have yet to be tested. “We are always looking to future developments, and as we develop the technology we will be looking to license it in Australia and New Zealand.”

Dr Baker says he sees great potential in the therapy. Yearlings, for example are subject to growth-related problems – developmental orthopaedic problems – and the lesions can be picked up in the mandatory radiographic examinations at the yearling sales. “These lesions would be a good candidate for stem cell treatments,” he suggests “further down the track a grater number of conditions could be treated, such as myocardial infarction or even spinal injuries.
“It’s an exciting field. We got very excited when we saw Pinions first scan post-implant and it showed healing after three or four months and no scar tissue.”

©Sue Cartledge

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