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Stem cells are master cells of the body — cells from which all other cells with specialized functions are created. Under the right conditions in the body or a laboratory, stem cells divide to form more cells, called daughter cells. These daughter cells either become new stem cells (self-renewal) or become specialized cells (differentiation) with a more specific function, such as blood cells, brain cells, heart muscle or bone. Stem cells are unique — no other cell in the body has the ability to self-renew or to differentiate. (www.mayoclinic.com)
Stem Cell Therapy in the News
Quadriplegic donkey walks again
Stem cells aid recovery from spinal-cord injury
Posted: Monday, November 15, 2010 2:27 PM
ELI the DONKEY
by Denise Steffanus
Eli the donkey’s recovery from incomplete quadriplegia could be the most important breakthrough in traumatic spinal-cord injuries and for the stem-cell treatment that restored his mobility—a breakthrough that could impact not only equids but all mammals, including humans.
Quadriplegia is considered incomplete if there is lack of mobility yet some sensory or motor function below the affected area.
On May 13, little Eli was inexplicably savaged by his longtime companion Watson, a jack nearly twice his size. During the attack, Watson grabbed Eli by the neck and shook him furiously like a rag doll, which caused severe spinal-cord trauma midway down his cervical spine.
Over the next few days, as Eli’s spinal cord swelled from the trauma, he experienced a rapid progression of weakness in his front end and hindquarters. With Eli’s condition quickly deteriorating, attending veterinarian Steve Goss, D.V.M., recommended that Eli be sent about 30 miles away to Alamo Pintado Equine Medical Center in Los Olivos, California, for specialized treatment. Alamo Pintado’s staff is credited with overcoming nearly insurmountable odds to save the lives of major stakes winners Thorn Song and most recently Global Hunter (Arg).
Eli arrived at Alamo Pintado on May 18, weak and unstable on all four legs.
“We did a normal treatment of [dimethyl sulfoxide], anti-inflammatories, and hyperbaric oxygen therapy, but he was deteriorating very fast right in front of us,” said Doug Herthel, D.V.M., Alamo Pintado’s founder and chief of staff. “So on May 22, Dr. Carter Judy did an MRI, and that gave us the definitive diagnosis.”
Eli suffered severe trauma to the spinal cord and its blood supply, and the resultant swelling caused compression of the cord within the spinal canal. The diagnosis was delivered by veterinary radiologist Travis Saveraid, D.V.M.
Herthel also sought the opinion of Mike Kistler, M.D., in Cortez, Colorado, a senior member of the American Society of Neuroradiology with more than 25 years of experience in human spinal trauma. Kistler also is a horseman who considered a career in veterinary medicine before turning to human neuroradiology.
“In a human, a comparable injury would have been sustained by diving into shallow water, and the majority of those injuries would have a poor prognosis, with paralysis,” Kistler said.
Kistler’s interpretation of the MRI results was that Eli’s spinal cord had suffered significant bruising and circulation damage, and that the prognosis was poor. Kistler speculated that it would be unlikely that Eli’s injury would resolve on its own, even with traditional treatment. Moreover, because an equid’s overall health declines when it cannot stand, he felt Eli most likely would not survive his injury or its complications.
Under the supervision of internal medicine specialist Tania Kozikowski, D.V.M., Eli received intense supportive care, treatment with anti-inflammatories to reduce the swelling in his spinal cord, and 24-hour-a-day nursing. Yet his condition continued to decline rapidly. On May 24, he lay paralyzed in all four limbs and could not lift his head, urinate, or defecate. He had developed pneumonia and was unable to maintain his body temperature, even with supportive care. Eli was on the verge of death.
Herthel is a pioneer in stem-cell therapy. Over the past 15 years, he has treated more than 5,000 horses with good results. But the bulk of these cases have been tendon and ligament injuries, and more recently laminitis and arthritis. He knew of no research to support the use of stem-cell therapy as a treatment for spinal-cord injuries. But, in theory, it made a lot of sense to him.
“The option to use stem cells was based on what we know adult stem cells can do—promote angiogenesis [formation of new blood vessels] and anti-inflammatory action,” Herthel said. “These injuries to the spinal cord created a lack of circulation and blood supply, which would cause cell death. Eventually, you just end up with a sac of fluid where the injured spinal cord used to be. So our goal was to get rid of the inflammation, similar to what we would use corticosteroids for. But more important were the angiogenesis properties of the mesenchymal stem cells and their ability to protect the cells in the spinal cord and promote the growth of new cells. They also inhibit the formation of scar tissue.”
On May 25, Herthel presented Eli’s owner with the option of euthanizing her beloved pet or opting for the experimental stem-cell therapy. She chose to give Eli one last chance.
“We had to do something fairly rapidly, and it was an extreme longshot,” Herthel said. “We had nothing to lose, but, still, we were extremely nervous.”
With the little donkey’s life hanging by a thread, there was no time to harvest and process stem cells from Eli’s bone marrow. So Herthel used donor (allogenic) stem cells derived from the bone marrow of a Thoroughbred racehorse that had been previously harvested and banked. He injected 70-million stem cells into Eli’s spinal canal at a point behind his poll and 20-million stem cells intravenously.
“Mesenchymal stem cells can selectively target injured tissue and promote functional recovery,” Herthel said. “They can be attracted to damaged tissue by chemical signals released from damaged cells.”
Within 48 hours, Eli improved and began to show some movement, even while recumbent. But he had lost significant muscle mass and was extremely weak. Fortunately, Eli never lost the ability to eat, so Herthel’s staff was able to maintain his nutrition as part of his supportive care, while treating his pneumonia with antibiotics.
“Eli’s owner drove 60 miles round trip daily to visit him and to provide lots of carrots, horse cookies, and TLC,” Herthel said.
On June 1, Eli had improved to the point where he was able to urinate, so his catheter was removed. The next day, he was lowered into Alamo Pintado’s recovery pool via sling, just to get him upright. Unfortunately, he was still not able to stand even with its support.
The first significant indication that Eli was responding to the stem-cell treatment came on June 8, when he was able to stand in his stall with the help of two veterinary technicians.
The effects of the first stem-cell treatment began to decline on June 10, when attendants noted that Eli had begun to weaken and was unable to stand, even with assistance. Herthel said this was not unexpected.
“We know that these stems cells do their work, but they don’t last forever, so we have to retreat several times,” he said. “It seems that after three treatments is when we see the biggest benefit, based on our experience with joint treatments.”
On June 11, Eli received a second treatment of 88-million stem cells from the same Thoroughbred donor, injected into his spinal canal, and 30-million stem cells intravenously. Again, within 48 hours, Eli became strong enough to stand and take a few steps with the help of three assistants. When the effects of the second treatment began to wear off 12 days later, Herthel administered the third and final dose of 100-million stem cells into Eli’s spinal canal and 20-million stem cells intravenously.
On July 2, Eli rolled up on his sternum without assistance for the first time, and on July 28, he was able to bray for the first time since his injury.
But the big moment of celebration came on July 31, when attendants found Eli standing in his stall.
“We couldn’t figure out how he got up,” Herthel said. “So we went back and looked at the [intensive care unit] video, and we saw him get up on his own. It wasn’t pretty, but he got up, and that’s what counts. After that third treatment, he just got better and better, and his muscle mass came back.”
Eli was released to his owner on September 15. He continues to improve on her Santa Barbara-area farm, being turned out during the day to romp in his paddock and housed in his stall at night. Herthel said he expects Eli to enjoy a normal existence, barring unanticipated complications later in his life.
Not only has this case opened the door for use of stem-cell therapy in treating traumatic spinal-cord injuries in all species, it has provided important knowledge to further this research. One essential theory that Eli’s case has confirmed is that adult stem cells, even from a donor, do not evoke an adverse reaction.
“Each time we gave the stem cells, we took a sample of Eli’s spinal fluid, and it was normal,” Herthel said. “You would think that giving foreign cells from a horse would cause some kind of inflammatory reaction, especially in the spinal fluid. But each time, Eli’s spinal fluid was normal, and that’s pretty amazing. That’s what makes these adult stem cells so useful.”
Skeptics will claim that anecdotal evidence of the successful treatment of one animal does not prove that stem-cell therapy was responsible for Eli’s cure. Kistler disagrees.
“The fact that Eli recovered after this initial injury over two to three months would indicate that the intervention is what promoted the recovery,” he said. “I think that’s a fair assumption.”
Herthel acknowledged that science cannot be based on a single case study, but he believes that Eli’s story will open the door to further research.
“This case breaks a barrier,” Herthel said. “We’re certainly not going to be afraid to use stem-cell therapy again if we have an animal with spinal-cord damage because we know it’s safe.”
Stem Cells Aid Partially Paralyzed Donkey's Recovery (courtesy of thehorse.com)
This Thanksgiving, one California owner is especially thankful for Eli, a donkey she nearly lost after he sustained a devastating pasture injury earlier this year. A dedicated veterinary team and many months of therapy led to Eli's return to her barn this year. Something else to be thankful for? Eli's case could represent a breakthrough in the use of stem cells in not only equine medicine, but also in the treatment of human spinal injuries and paralysis.
Doug Herthel, DVM, with the support of Eli's owner--whose name has not been made public--and a team of equine medical professionals, used innovative stem cell therapy that they say reversed incomplete quadriplegia in the 15-year-old donkey.
On May 13 Eli was grabbed violently by the neck, lifted, and shaken by his longtime pasturemate. Aside from a few surface wounds, Eli seemed none the worse for wear.
"Initially, Eli was standing and stable," primary care veterinarian Steve Goss, DVM, of South Coast Equine, Santa Barbara, Calif., noted, "But within two to three days, his condition deteriorated."
Goss referred the donkey to Alamo Pintado Equine Medical Center, in Los Olivos, Calif., where he was attended to by Herthel.
Upon arrival at Alamo Pintado on May 18 Eli was unable to stand on his own due to his severe spinal cord injury, and veterinarians treated him with anti-inflammatories and hyperbaric oxygen therapy to no avail; Eli's condition continued to worsen. So Herthel began exploring experimental treatment possibilities. He had been using stem cell therapy for the past 15 years to treat tendon and ligament injuries and more recently had expanded the use of stem cell therapy into the realms of laminitis and arthritis treatment. But Eli's case would be one of the first attempts to test stem cell use on spinal cord injuries. Eli's owner agreed to try the experimental treatment.
After months of intensive stem cell treatments, Eli is finally able to walk again.
Stem cells are immature cells within a horse's body that can mature into any type of cell, whether it be heart, muscle, blood, or cartilage. Only in recent years have major breakthroughs been made with using stem cells in veterinary medicine.
With no time to grow and harvest an adequate amount of stem cells for Eli's treatment, Herthel used donor stem cells previously banked from a Thoroughbred.
"We were using millions and millions of cells for Eli," Herthel said. "As far as we could tell, the therapy was safe. Donor stem cells do not have to be cross-matched. They do not trigger a graft/host reaction."
The stem cells were injected both into the spinal canal and administered intravenously. Although Eli's condition improved initially after his first treatment, the following months were marked by both progress and decline.
"Eli would backslide, and we would think, 'This is it,' " Herthel recalled. "Several times we were within moments of putting him down."
Eli was unable to stand for most of his treatment and, therefore, bedsores became a problem. The team worked hard to change his bedding frequently and "fluff" it every two hours. They employed cushions to make him more comfortable in his stall, and they also affixed padding to his hips .
According to Herthel, Eli's physical strength and his unfailing appetite aided his recovery. His owner's daily visits, which included pounds of carrots over Eli's stay, also played a role.
"Her constant vigil was an inspiration to Eli and our staff," said Herthel.
After Eli's third stem cell treatment, the team saw the improvement they had been hoping for. Slowly, Eli began gaining additional strength in his body and was soon able to stand. Shortly thereafter he was able to walk. Finally, on Sept. 15, four months after the attack, Eli was released from the hospital.
Eli is now "running around," according to Herthel. He expects the donkey to lead a normal and healthy life.
Herthel said that Eli and his owner made an important contribution to both the veterinary community and the human health community.
"I believe we're going to use (stem cell therapy for spinal cord injuries) more and more," he said.
Veterinary Topics: Strides in stem cell therapy
Being located in the self-proclaimed Horse Capital of the World with two of the top equine clinics as their competitors, Woodford's large-animal practitioners Chris Johnson, D.V.M., and William Baker, D.V.M., want to stand out among their peers. The two surgeons have collaborated to adapt a relatively new human application of using stem cells to heal difficult fractures in horses. "I put a needle into the fracture lines of these sesamoid fractures and inject stem cells," he said. After a while, Johnson saw bony calluses begin to grow on the separated bones where previously little or no bone knitting had occurred. "We have done a few cases of fractured sesamoids over the past year, and the jury is still out on how the horses will come back," Johnson said. "Radiographically, they are healing better than we thought they would." Johnson and Baker have performed the procedure mostly on younger horses and on a few injured racehorses with badly fractured sesamoids and little hope.
Yale Women’s Ice Hockey Player Undergoes Stem-Cell Transplant
By Curtis Eichelberger
Sept. 22 (Bloomberg) -- Yale University women’s ice hockey player Mandi Schwartz was undergoing stem cell transplant surgery today in hopes of re-growing the infection-fighting white blood cells she needs to survive. Doctors, who eradicated her cancer cells with multiple chemotherapy and radiation treatments Sept. 15 through 20 at the University of Washington Medical Center in Seattle, now will use stem cells from two, anonymous umbilical-cord blood donors to re-grow healthy, cancer-free cells.
Yale’s athletic department held drives each of the past two springs, registering more than 1,600 people with the National Marrow Donor Program’s “Be The Match” registry. Drives held in Canada added another 2,600 to the Canadian version of the registry. Schwartz, 22, an economics major from Wilcox, Saskatchewan, was initially diagnosed with acute myeloid leukemia -- a cancer that starts inside the bone marrow and grows from cells that were supposed to become white blood cells -- in December of 2008. When doctors couldn’t find a bone marrow donor, they turned to umbilical cord blood. Mandi’s parents, Carol and Rick, and Mandi’s fiancée, Kaylem Prefontaine, traveled to Seattle for the operation. Her younger brothers, Jaden, and Rylan, both ice hockey players at Colorado College, visited. Jaden was selected in the first round (No. 14 overall) of the National Hockey League draft by the St. Louis Blues in June.
--Editors: Michael Sillup, Jay Beberman
To contact the reporter on this story: Curtis Eichelberger in Washington at +1-202-624-1992 or
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