Scientific Foundations

Selected Studies and
Further Information

Here you will find a selection of publications on autologous, adipose-derived cell products in horses: for tendon and ligament injuries, joint disease and chronic laminitis, as well as on the underlying biological mechanisms.

Tendon Injuries & Tendinitis

  1. Nixon et al. (2008)

    A | Autologous adipose-derived cell fraction · Controlled experimental model · 8 horses

    Effect of adipose-derived nucleated cell fractions on tendon repair in horses with collagenase-induced tendinitis

    → Treated tendons had significantly better histological fiber architecture, alignment, and density, as well as fewer inflammatory cells and less type III collagen, compared with PBS controls.

    Am J Vet Res. 2008;69:928–937. DOI: 10.2460/ajvr.69.7.928 · Original publication / PubMed

  2. Carvalho et al. (2013)

    A | Autologous adipose-derived MSCs + platelet concentrate · Randomized, assessor-blinded, controlled · 8 horses

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

    → In an experimental tendinitis model, autologous, cultured adipose-derived MSCs combined with platelet concentrate prevented further progression of the lesions and produced better collagen organization and less inflammatory infiltration than PBS controls.

    Stem Cell Res Ther. 2013;4:85. DOI: 10.1186/scrt236 · Original publication / PubMed · Full text

  3. Conze et al. (2014)

    A | Autologous adipose-derived MSCs · Controlled experimental model · 9 horses

    Effect of autologous adipose tissue-derived mesenchymal stem cells on neovascularization of artificial equine tendon lesions

    → Treatment with autologous, cultured adipose-derived MSCs produced significantly greater neovascularization of treated superficial digital flexor tendon (SDFT) lesions, assessed by both Doppler ultrasonography and histology.

    Regen Med. 2014;9:743–757. DOI: 10.2217/rme.14.55 · Original publication / PubMed

  4. Ricco et al. (2013)

    B | Allogeneic adipose-derived MSCs + PRP · Clinical case series · 19 horses

    Allogeneic adipose tissue-derived mesenchymal stem cells in combination with platelet rich plasma are safe and effective in the therapy of superficial digital flexor tendonitis in the horse

    → Among 19 horses with acute or subacute superficial digital flexor tendinitis, 89.5% returned to their previous competitive level by 24 months; the authors reported a reinjury rate of 10.5%.

    Int J Immunopathol Pharmacol. 2013;26(1 Suppl):61–68. DOI: 10.1177/03946320130260S108 · Original publication / PubMed

Ligament Injuries & Suspensory Ligament Desmitis

  1. Rich (2014)

    A | Autologous adipose-derived regenerative cells (ADRCs/SVF) · Retrospective clinical study · 83 horses, 176 suspensory ligament injuries

    Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells

    → This retrospective clinical study evaluated 83 sport horses with 176 suspensory ligament injuries treated with autologous adipose-derived stem and regenerative cells (ADRCs), followed by standardized rehabilitation. Overall, 84.3% of treated horses successfully returned to their previous or a higher level of athletic performance for at least one year without re-injury. Favorable outcomes were observed in both forelimb (84.6%) and hindlimb injuries (82.1%), with a particularly high success rate of 86.7% in proximal suspensory ligament desmitis. No treatment-related adverse events or post-injection inflammatory reactions were reported.

    Rich FR. (2014). Stem Cell Discovery, 4, 44–53. DOI: 10.4236/scd.2014.42005 · Original publication

  2. M’Cloud et al. (2024)

    B | Evidence synthesis covering different MSC products · Systematic review (21 studies), meta-analysis (17 studies)

    Stem cells and platelet-rich plasma for the treatment of naturally occurring equine tendon and ligament injuries: a systematic review and meta-analysis

    → In the meta-analysis, MSC treatments, either alone or combined with PRP, were associated with a lower risk of reinjury following tendon and ligament injuries.

    J Am Vet Med Assoc. 2024;262(S1):S50–S60. DOI: 10.2460/javma.23.12.0723 · Original publication / PubMed

Osteoarthritis, Bone Spavin & Cartilage Lesions

  1. Nicpoń, Marycz & Grzesiak (2013)

    A | Autologous adipose-derived MSCs · Clinical comparative study · 16 horses

    Therapeutic effect of adipose-derived mesenchymal stem cell injection in horses suffering from bone spavin

    → Ten horses with bone spavin received autologous, cultured adipose-derived MSCs (with three corticosteroid-treated and three untreated controls). The authors reported longer-lasting clinical improvement, including the absence of observable lameness in the MSC group at the 180-day assessment.

    Pol J Vet Sci. 2013;16(4):753–754. DOI: 10.2478/pjvs-2013-0107 · Original publication / PubMed

  2. Yamada et al. (2013)

    A | Autologous adipose-derived MSCs · Controlled experimental cartilage-defect model · 4 horses, 8 joints

    Mesenchymal stem cell enhances chondral defects healing in horses

    → Autologous, cultured adipose-derived MSCs delivered in fibrin glue improved the macroscopic and histological organization of repair tissue. Some synovial inflammatory parameters showed favorable trends.

    Stem Cell Discov. 2013;3:218–225. DOI: 10.4236/scd.2013.34027 · Original publication

  3. Tyrnenopoulou et al. (2016)

    A | Autologous SVF · Clinical case report · 1 horse

    Successful management of an equine carpal chip fracture by intra-articularly injected adipose-derived stromal vascular fraction after arthroscopic removal

    → Following arthroscopic removal of a carpal chip fracture and subsequent intra-articular treatment with autologous SVF, improvement in lameness and a return to racing were documented, with no recurrence during 20 months of follow-up.

    Iran J Vet Res. 2016;17(1):59–61. PMID: 27656232 · Original publication / PubMed · Full text

  4. Bembo et al. (2016)

    A | Autologous micro-fragmented adipose tissue + PRP · Prospective clinical pilot study · 8 horses, 9 joints

    Combined use of platelet rich plasma & micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses

    → Eight sport and racehorses with clinically and radiographically confirmed degenerative joint disease (DJD) received a single intra-articular injection of autologous mechanically processed micro-fat combined with platelet-rich plasma (PRP). At three months, a substantial reduction in AAEP lameness scores was observed, with statistically significant improvement reported in the study (p = 0.021). Four horses returned to official competition, while three others resumed intensive training within 5–10 months. No serious treatment-related adverse events were reported.

    Bembo F, et al. (2016). Muscles, Ligaments and Tendons Journal, 6(2), 198–204. DOI: 10.11138/mltj/2016.6.2.198 · Original publication / PubMed

Laminitis (Chronic Laminitis)

  1. Oliveira et al. (2021)

    A | Autologous adipose-derived mesenchymal stem cells (AD-MSCs) · Placebo-controlled paired-limb study · 6 horses

    Radiographic, Venographic and Hoof Growth Evaluations in Equine Forelimbs with Chronic Laminitis Treated or Not with Mesenchymal Stem Cells Derived from Adipose Tissue

    → Six mares with stable chronic laminitis received regional intravenous perfusion of autologous adipose-derived mesenchymal stem cells into one forelimb, while the contralateral forelimb received placebo treatment. Each treated limb received three infusions of 20 million cells at 15-day intervals. Venographic examinations demonstrated significantly improved digital vascular perfusion in MSC-treated limbs (p < 0.03), particularly within the dorsal lamellar vascular network and the circumflex-lamellar junction. Furthermore, hoof wall growth was approximately 20% greater in treated limbs than in placebo controls (p < 0.03). Favorable changes in the spatial relationship between the distal phalanx and hoof capsule were also reported.

    Oliveira APL, et al. (2021). Cytotherapy, 23(4), Supplement, 31–32. DOI: 10.1016/j.jcyt.2021.02.092 · Original publication

  2. Oliveira et al. (2021)

    A | Autologous adipose-derived mesenchymal stem cells (AD-MSCs) · Placebo-controlled histological evaluation · 6 horses

    Lamellar Histological and Immunohistochemical Evaluation of the Hoof Wall in Horses with Chronic Laminitis Treated with Mesenchymal Stem Cells Derived from Adipose Tissue by Regional Perfusion

    → This complementary investigation evaluated histological changes in hoof lamellar tissue following regional intravenous treatment with autologous adipose-derived MSCs in six mares with chronic laminitis. One forelimb was treated with three infusions of 20 million AD-MSCs, while the contralateral limb received placebo. Histological examination revealed significant progression of multiple pathological changes in placebo-treated hooves, including increased overall lamellar lesion scores (p = 0.01), loss of keratinized axis integrity (p = 0.0001), stratum medium hyperplasia (p = 0.001), reduced primary epidermal lamellar homogeneity (p = 0.003), and hyperkeratosis (p = 0.05). In contrast, MSC-treated hooves exhibited progression of only the stratum medium hyperplasia score.

    Oliveira APL, et al. (2021). Cytotherapy, 23(4), Supplement, 22. DOI: 10.1016/j.jcyt.2021.02.066 · Original publication

  3. Angelone et al. (2017)

    B | Allogeneic and autologous adipose-derived MSCs + PRP · Clinical proof-of-concept case series · 9 horses

    The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept

    → Nine horses with severe chronic laminitis (grades III–IV) that had responded inadequately to prior treatment received three regional intravenous injections, one month apart, each containing 15 million adipose-derived MSCs together with 15 mL of autologous PRP, administered through a digital vein. Allogeneic cells were used at the first visit, followed by autologous, previously cultured adipose-derived MSCs at the two subsequent visits. The authors described improved hoof perfusion (venography), hoof structure, and mobility in all nine horses. All returned to activity at six months, and seven remained active at 12 months. Two horses subsequently experienced recurrence and were euthanized during longer-term follow-up. No treatment-related adverse events were reported during follow-up.

    Int J Mol Sci. 2017;18(10):2122. DOI: 10.3390/ijms18102122 · Original publication / PubMed · Full text

Biological Mechanisms: SVF, Accompanying Cells & Paracrine Factors

  1. Polly et al. (2019)

    A | Equine-specific SVF laboratory study · Experimental in-vitro study of equine adipose and tendon tissue

    Adipose-Derived Stromal Vascular Fraction and Cultured Stromal Cells as Trophic Mediators for Tendon Healing

    → Compared with cultured adipose-derived stromal cells (ASCs), SVF showed higher expression of several trophic factors, including IGF-1, SDF-1α, and TGF-β. ASC-conditioned medium promoted cell migration, and co-culture affected tenocyte gene expression.

    J Orthop Res. 2019;37:1429–1439. DOI: 10.1002/jor.24307 · Original publication / PubMed · Full text