Practical Autologous Product Use

Stem cells
Stem cells are broadly defined as undifferentiated cells that are capable of self-renewal and differentiation into specific lineages, i.e. of the 3 germ layers which are the ecto- derm, endoderm, and mesoderm. Stem cells are classified both by potency and type (tissue source). Multipotent stem cells are able to give rise to more than 1 cell type but are generally restricted to 1 germ layer (for example, give rise to cartilage and adipose tissue which are both mesoderm in origin), while pluripotent stem cells are to give rise to all cell types within the body from all 3 germ layers. types of multipotent stem cells include adult-derived mesenchymal stem cells (MSCs), which are discussed below, and hematopoietic stem cells. types of pluripotent stem cells include embryonic stem cells (ESCs) and induced pluripotent stem (ipS) cells which are both discussed below.

Adult-derived mesenchymal stem cells
Adult-derived mesenchymal stem cells (MSCs) can be obtained from bone marrow, fat, umbilical cord blood, muscle, and many other tissues including cartilage, trabecular bone and tendon. two techniques are commonly used for the treatment of equine mus- culoskeletal injuries with MSCs. one relies on a cultured cell population derived from bone marrow while the other utilizes a mixed cell population derived from adipose tis- sue. Each technique has its strengths and weaknesses and both in vivo and clinical evi- dence will be discussed in the lecture.1-4

1) Bone marrow derived MSCs (BM-MSCs): BM-MSCs are chosen as they appear to perform superiorly to MSCs recovered from other tissues (including tendon) in terms of differen- tiation into known cell types. furthermore BM-MSCs have received the most attention scientifically and hence are the best characterized. Bone marrow is collected from the sternum (or the tuber coxae) under standing sedation, followed by isolation and expan- sion of the nucleated adherent cell population (containing the MSCs) in the laboratory. a 3 week culture period is then needed to expand these selected cells until in excess of 10x106 cells are available for implantation either under standing sedation into a tendon or ligament lesion using ultrasound guidance or under general anesthesia into a carti- lage defect using arthroscopic guidance. [...]