title: Pilot experimental study on amniotic epithelial mesenchymal cell transplantation in natural occurring tendinopathy in horses. Ultrasonographic and histological comparison.
abstract: BACKGROUND
  amnion-derived stem cells are considered a promising alternative source for tendon tissue regeneration.
  
  
  OBJECTIVE
  aims of this paper were to illustrate the ultrasound and histological outcomes following the treatment of acute and chronic superficial digital flexor tendon spontaneous lesions in horses with ovine amniotic epithelial cells xenotransplantation.
  
  
  METHODS
  six adult horses suffering from unilateral acute (4 cases) and chronic (2 cases) tendinopathy (clinical and ultrasound diagnosis) were enrolled. At baseline, ovine amniotic epithelial cells were grafted, in sterile conditions and under ultra-sound control, into the most damaged area. Ultra-sound controls were performed at 30, 60, 90, 120, 150 and 180 days after cells implantation; after horse euthanasia (180 days) tendon samples were collected and submitted to histological examination (cellularity, extracellular matrix fiber organization, blood vessels).
  
  
  RESULTS
  at baseline, in the acute cases, the ultra-sound exam showed a focal, dis-homogeneous, hypo-echoic area into the superficial digital flexor tendon, with loss of the normal fibrillar pattern, while in the chronic cases the damaged tendon area appeared thickened and completely hyper-echoic. At the final follow-up tendon echotexture was more regular, the cross-sectional area similar to the contra-lateral limb, and the collagen fibers were oriented in parallel to the longitudinal axis of the tendon both in the acute and chronic cases, suggesting a positive healing response. These findings were supported by the histological analyses which showed an almost complete restoration of normal tendon architecture with an optimal alignment of tendon fibers.
  
  
  CONCLUSIONS
  the present pilot study supports the hypothesis that amniotic epithelial cells are provided of an excellent healing potential and shows a very good correlation between the ultrasound findings and the histologic features.
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Aurelio
authors: A
authors: Muttini
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Valentina
authors: V
authors: Russo
authors: Viral Vaccines Institute, Serum and Diagnostics, Abruzzo and Molise Region Experimental Animal Health Care Institute "G. Caporale" (IZSAM), Teramo, Italy.
authors: Elisabetta
authors: E
authors: Rossi
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Mauro
authors: M
authors: Mattioli
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Barbara
authors: B
authors: Barboni
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Umberto
authors: U
authors: Tosi
authors: Department of Physical and Rehabilitation Medicine, University of Salerno, Azienda Ospedaliera San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy; Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK.
authors: Nicola
authors: N
authors: Maffulli
authors: Department of Comparative Biomedical Sciences,University of Teramo, Italy.
authors: Luca
authors: L
authors: Valbonetti
authors: Department of Medicine and Science of Aging, University G. d'Annunzio, Chieti-Pescara, Chieti Scalo, Italy.
authors: Michele
authors: M
authors: Abate
keywords: amniotic epithelial cell; histology; tendon; ultrasound; xenotrasplantation