In 2013, Scientific American magazine came out with an article on stem cell therapy. It’s called, “A Dangerous Game: Some Athletes Risk Untested Stem Cell Therapy.”
Scientific American is just not a magazine that everyone reads. As far as I know, very few people hang out by the newsstand waiting for their next issue. Even many of those who might have hung out by the newsstand can’t anymore – the magazine has been in publication since 1845. Albert Einstein wrote for it.
The point is that it’s a fantastic magazine, bringing news about science to the general public. This time, they’ve looked at stem cells. It’s a great article. It’s fully of interesting facts. You can read it if you CLICK HERE.
I’ve written about stem cells before – and, if you don’t recall, what is happening regarding the use of such things in equine medicine is quite different from what’s going on in human medicine, where the procedure of culturing stem cells from a patient’s own blood or bone marrow and injecting them back into the patient has been ruled illegal. in 2012, the FDA ruled that, in humans, the process of culturing stem cells from blood and bone marrow is illegal. CLICK HERE to read my blurb from July 28, 2012, with a link to the court decision).
Anyway, in the horse world, it seems that just about everyone is in on the stem cell game. Veterinarians are suggesting them for a variety of indications: tendon injuries, joint problems, laminitis, and even wounds. They have jumped on the bandwagon of “new” and “promising” and “novel,” led by the glowing testimonials put out by stem cell companies (and veterinary clinics). And they are pitching their wares to horse folks who, concerned about their horses, either:
1. Have extra money to spend/throw away
2. Are enthralled with the idea of something “new”
3. Don’t mind the math equation New + Expensive = Doesn’t Make any Difference in How Things Ultimately Turn Out (When it Goes Right)
So, with that being said, let’s play a little game here. We’re going to take quotes from stem cell websites, and then we’re going to follow those quotes with quoted pulled out of the Scientific American article. You’ll be amazed at the difference between what’s being said to the horse owning public (and veterinarians), and what’s actually known. Here goes.
WEB: “Company X (names changed to protect… well… something) has treated stars of racing, eventing, dressage, polo, trotting, endurance, showing, hunting, barrel racing, cutting and plenty of all-rounders and pony club ponies too.”
SA: “The term ‘stem cell’ makes it sound cutting edge and exciting,” says Paul Knoepfler, a cell biologist at the University of California, Davis, who also writes frequently on policy surrounding stem cells. “But the role of these cells in sports medicine is essentially all hype.”
WEB: “Company Y enables veterinarians and horse owners to utilize the latest technology in regenerative therapy including regenerative stem cell and platelet therapy for tendon, ligament, and joint injuries by collecting stem cells from the bone marrow and umbilical cord blood and providing state-of-the-art platelet therapy to veterinarians.”
SA: “Even a syringe of one’s own stem cells taken from one part of the body and squirted into another ‘may multiply, form tumors, or may leave the site you put them in and migrate somewhere else’ the FDA warns on its Web site.” (Wondering where the FDA website it? CLICK HERE to read the article, “FDA Warns About Stem Cell Claims.”)
WEB: “In a breakthrough for the performance horse industry, Company A is partnering with the Company B (who is even in another country!) to harness equine stem cells to repair tendon, ligament, cartilage and bone damage in horses.”
SA: “In some animal studies, for example, the regenerated tissue is not as strong or flexible as the original. In other cases, an overgrowth of scar tissue makes the injected tendon or ligament adhere to the overlying skin. By preventing different tissues from gracefully sliding past one another, these adhesions sometimes pull an even bigger tear in an already serious wound.”
WEB: “Company Z…. is able to acquire the most living stem cells of any company currently offering this technology.”
SA: ““You can inject all the best cells,” [the director of the Center for Cellular and Molecular Engineering at the University of Pittsburgh School of Medicine, Dr. Rocky] Tuan says, “but if you don’t have the right combination of healing goodies around them, it’s useless.”
The Scientific American article even has a couple of paragraphs about horses! I’ve pulled those out for you, too.
“In the July 2012 issue of Equine Disease Quarterly, Wesley Sutter of Lexington Equine Surgery and Sports Medicine in Kentucky cautioned: “To date, no published controlled clinical studies show efficacy in use of stem cell treatment for any of the conditions being treated.”
DWR NOTES: In case you didn’t know, the Equine Disease Quarterly is produced by the Gluck Center, of the University of Kentucky’s College of Agriculture. It has a very prestigious place in the world of horse research. In fact, if you’re really into equine health information, you should subscribe (for free)!
You should read Dr. Stutter’s entire commentary, which you can access if you CLICK HERE. Dr. Sutter concludes by saying, “Stem cells hold promise. However, clinical acceptance has greatly outpaced the scientific progress. Evidence needs to be supplied, with both professional organizations and those producing stem cells taking the lead. Finally, practitioners using stem cells also have a responsibility to accurately represent these therapies to their clients [emphasis added].”
Here’s the next quote, about horses, from the Scientific American article.
“Carol Gillis, a longtime veterinarian and researcher who specializes in soft-tissue injuries in racehorses, says that the more than 22,000 ultrasound images she has captured in her studies and clinical practice have convinced her that with a tightly regimented exercise program, tendons and ligaments will heal, producing strong, well-organized fibers—all without the use of stem cells. The reason that many soft-tissue injuries end a horse’s racing career, Gillis explains, is because most owners allow the animal to run free too soon, when the pain from the initial injury has faded but the tissue is still fragile.”
DR. RAMEY NOTES: Although I’m quite confident that I haven’t seen more than 22,000 ultrasound images, I have written about rehabbing tendon and ligament injuries. You can CLICK HERE to read my article, which also has a link to Dr. Gillis’ protocol.
Look, I’m all for new therapies. We need new therapies. Stem cells may even turn out to have some broad applications in horses (and in human medicine, too). But in my opinion, they aren’t ready for prime time yet. Otherwise stated, while there’s some encouraging preliminary data (especially in humans), and while study is ongoing (and should be ongoing), the stem cell therapies currently used to treat horses are supported by very limited evidence of effectiveness. I think it’s very unfortunate that these therapies have been commercialized before there’s good evidence to back them up. Unless it can be shown that horses that receive stem cells heal faster, or better, they will just have turned out to be an expensive waste of time and money.
The way to test new therapies is not to take something that is unproven and implausible, stick it in a horse, and expect you, the horse owner, to pay through the nose for it. The way to test new therapies is to do proper scientific investigations. And – the good news – they are being done (while, at the same time, they are being peddled like peanuts at a baseball game).
If you’re really looking to get a lot of information about stems cells, I’d recommend that you go outside of Google®, horse chat rooms, and company-sponsored websites, and take a look at the information provided by the International Society for Stem Cell Research (CLICK HERE). In particular, I’d take a look at their page, “A Closer Look at Stem Cell Treatments,” (CLICK HERE), and click on the the article, “Nine Things to Know About Stem Cell Treatments” (CLICK HERE).
In the Scientific American article, Dr. Gillis essentially says that stem cell treatments of tendon and ligament injuries don’t make any difference. Dr. Sutter basically says, “Tell the truth,” which, to me, is saying something that shouldn’t be necessary. I mean, you shouldn’t have to look for articles in magazines like Scientific American to find out what the truth is, but it sure is good that at least somebody is telling things like they are.