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A U E R S & T > Chapter 8 - Regenerative Medicine > Flashcards

Chapter 8 - Regenerative Medicine Flashcards

1
Q

What condition was initially treated with autologous bone marrow concentrate in the study that inspired regenerative therapy in horses?
A. Superficial flexor tendonitis
B. Suspensory ligament desmitis
C. Osteoarthritis
D. Cartilage injuries

A

B. Suspensory ligament desmitis

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2
Q

What percentage of horses responded favorably to the autologous bone marrow concentrate treatment in the study?
A. 50%
B. 75%
C. 90%
D. 100%

A

C. 90%

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3
Q

What was one of the main limitations of the initial study involving bone marrow concentrate?
A. Lack of comparison with historical controls
B. No data on cellular composition of bone marrow used
C. High rate of adverse effects
D. Long preparation time for therapy

A

B. No data on cellular composition of bone marrow used

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4
Q

Which type of products, according to the text, is not typically used as a point-of-care treatment?
A. Platelet-rich plasma
B. Autologous conditioned serum
C. Expanded mesenchymal stem cells
D. Bone marrow concentrate

A

C. Expanded mesenchymal stem cells

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5
Q

Which is NOT mentioned as a common source for mesenchymal stem cells used in regenerative therapies?
A. Bone marrow
B. Adipose tissue
C. Amnion
D. Tendons

A

D. Tendons

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6
Q

What is a significant challenge still faced in regenerative veterinary medicine, as noted in the text?
A. Lack of products available for therapy
B. Inconsistent success rates of treatments
C. Lack of scientific awareness and practical applicability
D. Over-regulation of treatments

A

C. Lack of scientific awareness and practical applicability

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7
Q

Platelet-rich plasma (PRP) is primarily used to enhance tissue healing due to:
A. Its ability to stimulate immune responses
B. The delivery of growth factors and clotting system proteins
C. Its antimicrobial properties
D. High oxygen-carrying capacity

A

B. The delivery of growth factors and clotting system proteins

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8
Q

What type of surgery was PRP first used for in human medicine?
A. Cardiovascular surgery
B. Oral and maxillofacial surgery
C. Orthopedic surgery
D. Dermatologic surgery

A

B. Oral and maxillofacial surgery

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9
Q

Which growth factor is NOT mentioned as being present in PRP?
A. PDGF
B. IGF-I
C. TNF-α
D. TGF-β1

A

C. TNF-α

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10
Q

What is the estimated half-life of platelets after reaching the injury site?
A. 24 hours
B. 1-2 days
C. 3-4 days
D. 5-7 days

A

D. 5-7 days

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11
Q

Which of the following has been considered a risk with other cell-based regenerative therapies, but not with PRP?
A. Tissue rejection
B. Mutagenic activity and tumor formation
C. Allergic reactions
D. Infection

A

B. Mutagenic activity and tumor formation

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12
Q

What type of cells does PRP stimulate for tendon and ligament healing?
A. Neutrophils
B. Macrophages
C. Fibroblasts
D. Osteoclasts

A

C. Fibroblasts

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13
Q

Which type of PRP is generated through a soft spin centrifugation system?
A. Leukocyte-rich PRP
B. Platelet-poor PRP
C. Pure PRP (P-PRP)
D. Leukocyte and platelet-rich fibrin

A

C. Pure PRP (P-PRP)

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14
Q

PRP generated with a “hard” spin will likely contain which component?
A. Only plasma and platelets
B. Plasma, platelets, and leukocytes
C. Platelets and red blood cells
D. Red blood cells and plasma only

A

B. Plasma, platelets, and leukocytes

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15
Q

Which PRP preparation is characterized by a lack of anticoagulant and a dense fibrin network?
A. P-PRP
B. L-PRF
C. L-PRP
D. PPP

A

B. L-PRF (Leukocyte and platelet-rich fibrin)

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16
Q

The variability in PRP products has led to:
A. Uniform success across studies
B. Confusion in clinical study interpretations
C. An increase in adverse reactions
D. Reduced availability of PRP kits

A

B. Confusion in clinical study interpretations

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17
Q

In which type of PRP preparation might higher platelet concentrations actually reduce collagen synthesis in equine tendons?
A. P-PRP
B. L-PRP
C. PPP
D. PRF

A

A. P-PRP

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18
Q

In the study described, which growth factor concentration was found to be highest in PRP compared to bone marrow aspirate?
A. IGF-I
B. TGF-β1
C. FGF
D. Oc

A

B. TGF-β1

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19
Q

What was observed in tissue explants cultured with 100% PRP?
A. Increased catabolic cytokines
B. Superior tendon matrix gene expression patterns
C. Reduced growth factor release
D. Lower DNA content

A

B. Superior tendon matrix gene expression patterns

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20
Q

PRP is considered more effective for which type of tissue in terms of anabolic effects, according to studies?
A. Ligament
B. Bone
C. Tendon
D. Cartilage

A

C. Tendon

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21
Q

What product was found to increase matrix molecule expression in suspensory ligament tissue?
A. PRP
B. Platelet-poor plasma (PPP)
C. Acellular bone marrow
D. Whole blood

A

C. Acellular bone marrow

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22
Q

Which preparation is suggested to be beneficial for anterior cruciate ligament repair due to its effects on tissue matrix?
A. L-PRP with high neutrophil content
B. P-PRP with low platelet concentration
C. PRF with a high fibrin content
D. Acellular bone marrow aspirate

A

D. Acellular bone marrow aspirate

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23
Q

What is the effect of using PRP at concentrations greater than 30% in growth media for mesenchymal stem cells?
A. Increased cell proliferation
B. Decreased cell viability
C. Constant proliferation rate
D. No effect

A

B. Decreased cell viability

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24
Q

hat is the primary reason commercial PRP kits may not always be suitable for horses?
A. Different platelet activation rates in equines
B. Increased risk of infection
C. Lack of FDA regulation for veterinary use
D. Kits are designed for human use and not validated for horses

A

D. Kits are designed for human use and not validated for horses

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25
Q

What substance is typically used as an anticoagulant in PRP preparation?
A. Heparin
B. Sodium citrate
C. EDTA
D. ACD-A

A

D. ACD-A

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26
Q

Which of the following is a marker of appropriate ligament matrix remodeling?
A. TGF-β1
B. PDGF
C. COMP
D. IL-1β

A

C. COMP

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27
Q

For which injury in horses is PRP considered a potential alternative to traditional therapy?
A. Joint inflammation
B. Cartilage degradation
C. Tendon and ligament injuries
D. Bone fractures

A

C. Tendon and ligament injuries

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28
Q

Which tissue showed the most anabolic response to acellular bone marrow in vitro studies?
A. Flexor tendon
B. Cartilage
C. Ligament
D. Bone

A

C. Ligament

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29
Q

Which factor was found to influence the concentration of cytokines in autologous conditioned serum (ACS)?

A) The time of day when blood was collected
B) The size of the tendon lesion
C) The stress status of the patient
D) The number of PRP injections administered

A

C) The stress status of the patient

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30
Q

Which of the following investigative techniques was used to assess the improvement of tendon collagen organization in PRP-treated tendons?

A) Ultrasound tissue characterization (UTC) imaging
B) Magnetic resonance imaging (MRI)
C) Computed tomography (CT)
D) Color Doppler ultrasonography

A

A) Ultrasound tissue characterization (UTC) imaging

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31
Q

In the study of sport horses with proximal suspensory ligament desmitis, how many horses required a second PRP injection to reduce the cross-sectional area (CSA) of the lesion?

A) 16
B) 12
C) 4
D) 8

A

c) 4

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32
Q

What was the median time for the return to racing in the Standardbred horses after PRP treatment and rehabilitation?

A) 12 weeks
B) 32 weeks
C) 24 weeks
D) 52 weeks

A

B) 32 weeks.

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33
Q

What is the primary mechanism through which IL-1 receptor antagonist protein (IL-1ra) functions in joint disease?

A) It increases the expression of VEGF to promote cartilage healing
B) It prevents the interaction of IL-1 with its receptor, reducing inflammation
C) It stimulates the production of cartilage matrix proteins
D) It enhances fibroblast activity to increase tendon strength

A

B) It prevents the interaction of IL-1 with its receptor, reducing inflammation.

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34
Q

In the study involving Orthokine (ACS), what cytokine showed a significant increase when processed using the Dechra system?

A) IL-1ra
B) TNF-α
C) VEGF
D) TGF-β

A

B) TNF-α

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35
Q

Which of the following is NOT a known limitation in the current clinical studies involving PRP for tendon and ligament injuries?

A) Lack of rigorous control groups
B) Inconsistent platelet and leukocyte concentrations in PRP
C) Insufficient comparison between PRP and bone marrow aspirate
D) Insufficient long-term data on PRP’s effects on bone healing

A

D) Insufficient long-term data on PRP’s effects on bone healing.

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36
Q

What is the main purpose of autologous protein solution (APS)?
a) To provide antibiotics for infections
b) To treat osteoarthritis
c) To prevent cancer
d) To increase muscle mass

A

b) To treat osteoarthritis

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37
Q

What cytokine is highly concentrated in APS?
a) IL-6
b) IL-1ra
c) IL-10
d) TNF-alpha

A

b) IL-1ra

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38
Q

How long does it take to process APS using the nSTRIDE/Pro-Stride system?
a) 5 minutes
b) 10 minutes
c) 20 minutes
d) 24 hours

A

c) 20 minutes

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39
Q

What is used to filter the APS product in the second step of processing?
a) Centrifuge
b) Polyacrylamide beads
c) Calcium chloride
d) Gelatin

A

b) Polyacrylamide beads

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40
Q

What is the significance of the IL-1ra
β ratio in APS-treated patients with osteoarthritis?
a) Higher ratios are correlated with improved pain scores
b) Lower ratios result in less effective treatment
c) The ratio has no correlation with outcomes
d) A ratio below 100 is considered optimal

A

a) Higher ratios are correlated with improved pain scores

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41
Q

What percentage of patients with a high IL-1ra
β ratio were considered responders at 6 months?
a) 50%
b) 60%
c) 85.7%
d) 100%

A

c) 85.7%

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42
Q

Which study data is missing from equine APS studies?
a) Lameness grade
b) Inflammatory cytokines
c) Joint range of motion
d) Peak vertical force

A

b) Inflammatory cytokines

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43
Q

What is the most common source of mesenchymal stem cells (MSCs) used in equine medicine?
a) Blood
b) Bone marrow and adipose tissue
c) Liver
d) Skin

A

b) Bone marrow and adipose tissue

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44
Q

What is the purpose of culture expansion of MSCs?
a) To increase the number of MSCs and their therapeutic dosage
b) To reduce the risk of rejection
c) To prevent tumor formation
d) To shorten the treatment time

A

a) To increase the number of MSCs and their therapeutic dosage

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45
Q

What commercial kit is used to prepare bone marrow concentrate (BMC)?
a) Pro-Stride
b) VetStem Biopharma
c) Terumo Harvest BMAC
d) IL-1ra Separator

A

c) Terumo Harvest BMAC

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46
Q

What additional step is needed to process adipose-derived stromal vascular fraction (SVF)?
a) Filtration
b) Digestion
c) Incubation
d) Centrifugation

A

b) Digestion

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47
Q

What is the regulatory concern surrounding adipose-derived SVF according to the FDA?
a) It’s a highly manipulated product
b) It requires genetic modification
c) It cannot be stored
d) It has a high risk of infection

A

a) It’s a highly manipulated produc

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48
Q

Which of the following is an example of nonadult stem cells in horses?
a) Bone marrow-derived MSCs
b) Umbilical cord blood
c) Adipose-derived MSCs
d) Peripheral blood

A

b) Umbilical cord blood

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49
Q

What is a key regulatory concern with pluripotent stem cells in horses?
a) High production costs
b) Tumor formation risk
c) Slow regeneration rates
d) Inconsistent effectiveness

A

b) Tumor formation risk

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50
Q

How are induced pluripotent stem cells (iPSCs) created?
a) By modifying embryonic stem cells
b) By genetic reprogramming of adult somatic cells
c) By isolating cells from umbilical cord blood
d) By centrifugation of stem cells

A

b) By genetic reprogramming of adult somatic cells

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51
Q

Why are iPSCs not widely used in veterinary medicine despite their potential?
a) They are too expensive and labor-intensive to generate
b) They have no therapeutic benefits
c) They cause immune rejection
d) They have short survival times in the body

A

a) They are too expensive and labor-intensive to generate

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52
Q

What characteristic distinguishes embryonic stem cells from adult stem cells?
a) Embryonic stem cells are multipotent
b) Embryonic stem cells are pluripotent
c) Adult stem cells are easier to culture
d) Adult stem cells have unlimited proliferation

A

b) Embryonic stem cells are pluripotent

53
Q

What is the role of the FDA in regulating stem cell products?
a) To classify stem cell products and oversee their use
b) To manufacture stem cell products
c) To provide funding for stem cell research
d) To set pricing for stem cell treatments

A

a) To classify stem cell products and oversee their use

54
Q

What is the primary source of hematopoietic stem cells initially studied for their regenerative capacity?
a) Bone marrow
b) Skin tissue
c) Liver cells
d) Adipose tissue

A

a) Bone marrow

55
Q

What is the “niche” in stem cell biology?
a) A reservoir for stem cells in tissues
b) A type of pluripotent stem cell
c) A laboratory tool for culturing cells
d) A growth factor for tissue repair

A

a) A reservoir for stem cells in tissues

56
Q

Which of the following is a potential issue with aging and disease in stem cell activation?
a) It increases self-renewal
b) It prevents stem cells from activating
c) It speeds up tissue regeneration
d) It enhances differentiation into other cells

A

b) It prevents stem cells from activating

57
Q
  1. What process allows stem cells to replicate indefinitely?
    a) Differentiation
    b) Self-renewal
    c) Apoptosis
    d) Niche formation
A

b) Self-renewal

58
Q

What are the FDA’s main criteria for defining autologous stem cell products?
a) Minimal manipulation and homologous use
b) Maximum differentiation and rapid proliferation
c) Donor-recipient matching and high potency
d) Minimal manipulation and maximum storage
Correct answer: a) Minimal manipulation and homologous use

A

a) Minimal manipulation and homologous use

59
Q

What are “Yamanaka factors” used for?
a) Inducing stem cell differentiation
b) Reprogramming adult cells into iPSCs
c) Enhancing tissue regeneration
d) Activating adult stem cells in the niche

A

b) Reprogramming adult cells into iPSCs

60
Q

What is the major challenge with nonadult sources of MSCs like umbilical cord blood?
a) High rejection rates
b) Regulatory requirements
c) Slow cell proliferation
d) Lack of differentiation potential

A

b) Regulatory requirements

61
Q

Which tissue is the most common source of adult MSCs for nonexpanded use in equine medicine?
a) Skin
b) Bone marrow
c) Brain
d) Kidney

A

b) Bone marrow

62
Q

What process do stem cells undergo to become specialized cells?
a) Self-renewal
b) Differentiation
c) Proliferation
d) Apoptosis

A

b) Differentiation

63
Q

What is the main concern with FDA enforcement of stem cell products under the Autologous Type I category?
a) Their cost
b) Their manipulation level
c) Their effectiveness
d) Their commercial viability

A

b) Their manipulation

64
Q

What is the primary issue with healing in tendon and ligament injuries in horses?

A) Excessive inflammation
B) Rapid reinjury and loss of use
C) Poor blood supply to injured areas
D) Inability to produce new collagen
A

B) Rapid reinjury and loss of use

65
Q

What occurs during the remodeling phase of tendon healing?

A) Collagen breaks down and is replaced by elastin
B) Fibrous scar tissue replaces the organized collagen network
C) New blood vessels form to supply the injured area
D) Inflammation subsides and fibroblasts stop functioning
A

B) Fibrous scar tissue replaces the organized collagen network

66
Q

Why is a scarred tendon more prone to reinjury compared to a healthy tendon?

A) Reduced collagen production
B) Inferior elasticity
C) Increased inflammation
D) Poor blood supply
A

B) Inferior elasticity

67
Q

How do MSCs primarily contribute to tendon healing according to current beliefs?

A) By directly differentiating into tenocytes in vivo
B) By promoting fibrous scar tissue formation
C) Through paracrine mechanisms
D) By replacing damaged tendon with bone tissue
A

C) Through paracrine mechanisms

68
Q

Which of the following is NOT a known mechanism by which MSCs aid tissue healing?

A) Stimulating angiogenesis
B) Activating tissue-intrinsic stem cells
C) Inducing inflammation
D) Stimulating fibroblasts to produce extracellular matrix
A

C) Inducing inflammation

69
Q

What type of MSC was first used in a polo pony for treating tendon injuries?

A) Adipose-derived MSCs
B) BM-MSCs
C) Tendon-derived MSCs
D) Umbilical cord-derived MSCs
A

B) BM-MSCs

70
Q

What was the vehicle used for the BM-MSCs in the first reported case of tendon treatment?

A) Collagen matrix
B) Saline solution
C) Plasma
D) Hyaluronic acid
A

C) Plasma

71
Q

In studies, what beneficial effect was observed in tendons treated with BM-MSCs?

A) Increased collagen type II production
B) Decreased neovascularization
C) Improved tendon fiber organization
D) Enhanced scar tissue elasticity
A

C) Improved tendon fiber organization

72
Q

What is one advantage of adipose tissue-derived MSCs observed via Doppler ultrasonography?

A) Higher collagen type III production
B) Better vascularization in treated tendons
C) Faster proliferation of tenocytes
D) Lower risk of mineralization
A

B) Better vascularization in treated tendons

73
Q

In the study comparing racehorses treated with BM-MSCs and conventional methods, what percentage of MSC-treated horses returned to racing?

A) 60%
B) 70%
C) 82%
D) 90%
A

C) 82%

74
Q

What was the median reinjury time for the control group in the racehorse study?

A) 3 months
B) 7 months
C) 9 months
D) 12 months
A

B) 7 months

75
Q

According to the study on National Hunt horses, what was the reinjury rate for horses treated with BM-MSCs?

A) 25.7%
B) 18%
C) 53%
D) 56%
A

A) 25.7%

76
Q

What additional tendon structures, aside from superficial digital flexor tendon lesions, are MSCs being used to treat?

A) Tendon sheaths and bursae
B) Sesamoidean ligaments and suspensory branches
C) Patellar tendons and Achilles tendons
D) Periosteal ligaments and joint capsules
A

B) Sesamoidean ligaments and suspensory branches

77
Q

What is one limitation mentioned about current research on MSCs for tendon healing?

A) Lack of clinical trials for superficial digital flexor tendon injuries
B) Uncertainty about the best number of cells to use for treatment
C) MSCs do not show any effects on soft tissue healing
D) MSC treatments have shown no long-term benefits
A

B) Uncertainty about the best number of cells to use for treatment

78
Q

What recent effort is being explored to improve the differentiation of MSCs into tenocytes before implantation?

A) Using viral vectors to introduce growth factors like BMPs
B) Co-culturing MSCs with osteoblasts
C) Exposing MSCs to tendon-derived proteins only after injection
D) Treating MSCs with high-intensity ultrasound
A

A) Using viral vectors to introduce growth factors like BMPs

79
Q

Which growth factor is specifically implicated in promoting the formation of tendon-like tissue in vivo?

A) BMP-2
B) BMP-7
C) BMP-12
D) TGF-β
A

C) BMP-12

80
Q

What is the key difference in BM-MSCs treated with BMP-12 versus BMP-2?

A) BMP-2 leads to tendon fiber disorganization
B) BMP-2 leads to mineralization while BMP-12 does not
C) BMP-12 increases collagen type II production
D) BMP-12 causes necrosis of tendon cells
A

B) BMP-2 leads to mineralization while BMP-12 does not

81
Q

Which tendon-related markers were observed to increase after BM-MSCs were exposed to BMP-12?

A) Decorin and tenomodulin
B) Collagen type III and COMP
C) Elastin and scleraxis
D) Tenascin and collagen type IV
A

A) Decorin and tenomodulin

82
Q

In dynamic bioreactor studies, which cell type expressed the highest levels of tendon markers?

A) BM-MSCs
B) Adipose tissue-derived MSCs
C) TN-MSCs
D) Umbilical cord-derived MSCs
A

C) TN-MSCs

83
Q

What is a potential challenge mentioned for future clinical applications of TN-MSCs?

A) Difficulty in integrating into the injured tissue
B) Uncertainty about their safety and efficacy in allogeneic use
C) High rate of rejection by the host immune system
D) Lack of differentiation into tendon cells
A

B) Uncertainty about their safety and efficacy in allogeneic use

84
Q

What makes the regeneration of articular cartilage particularly challenging?
A) Lack of vascularity and innervation
B) High vascularity and fast healing
C) Overactive chondrocyte production
D) High likelihood of infection

A

A) Lack of vascularity and innervation

85
Q

Why are stem cells considered for cartilage regeneration?
A) They naturally integrate into cartilage without any external support
B) They have the potential to differentiate into chondrocytes
C) They immediately repair cartilage defects upon injection
D) They are highly effective in clinical trials

A

B) They have the potential to differentiate into chondrocytes

86
Q

hich growth factor was shown to increase cellular density and collagen type II mRNA expression in equine BM-MSCs monolayer cultures?
A) BMP-12
B) FGF
C) TGF-β1
D) VEGF

A

C) TGF-β1

87
Q

In the study comparing BM-MSCs and adipose-derived MSCs, which cell type showed a higher capacity for producing hyaline-like cartilage morphology?
A) Adipose-derived MSCs
B) BM-MSCs
C) UCB-MSCs
D) Both cell types performed equally well

A

B) BM-MSCs

88
Q

What was a major limitation observed in MSCs differentiating into chondrocytes in vitro compared to in vivo results?
A) MSCs were more effective in vivo
B) In vitro differentiation always led to reinjury
C) In vitro differentiation did not always translate to effective in vivo chondrocyte function
D) MSCs could not survive in vivo conditions

A

C) In vitro differentiation did not always translate to effective in vivo chondrocyte function

89
Q

What method was used to achieve chondrogenic differentiation in equine MSCs in vitro?
A) Monolayer culture
B) Micromass pellets
C) Scaffolds
D) All of the above

A

D) All of the above

90
Q

. Which of the following growth factors was found to promote chondrogenic differentiation in both BM-MSCs and adipose-derived MSCs?
A) TGF-β3
B) BMP-12
C) FGF-1
D) BMP-2

A

A) TGF-β3

91
Q

In the study involving equine UCB-MSCs and BM-MSCs, which cell type produced higher gene expression of aggrecan and collagen type II?
A) UCB-MSCs
B) BM-MSCs
C) Both produced equal gene expression
D) Neither cell type expressed those genes

A

A) UCB-MSCs

92
Q

What was a significant issue found with the extracellular matrix (ECM) produced by MSCs in some studies?
A) It was too dense
B) The ECM was mechanically inferior compared to that produced by articular chondrocytes
C) It caused inflammation in the joint
D) It was prone to rapid degradation

A

B) The ECM was mechanically inferior compared to that produced by articular chondrocyte

93
Q

hich marker was used to indicate chondrogenic differentiation in both UCB-MSCs and BM-MSCs?
A) Sox 9
B) COMP
C) BMP-12
D) Aggrecan

A

A) Sox 9

94
Q

What unexpected outcome occurred in one of the studies involving BM-MSCs in a platelet-enriched fibrin scaffold for treating cartilage defects?
A) Complete healing of the cartilage
B) Ectopic bone formation
C) Overproduction of collagen type II
D) Severe inflammation and tissue rejection

A

B) Ectopic bone formation

95
Q

Which of the following MSC sources produced mechanically superior cartilage-like extracellular matrix compared to chondrocytes in foal and adult horse studies?
A) Adipose-derived MSCs
B) BM-MSCs
C) UCB-MSCs
D) Tendon-derived MSCs

A

B) BM-MSCs

96
Q

What is a significant advantage of injecting BM-MSCs in suspension compared to scaffold implantation?
A) Higher long-term success rate
B) Reduced cost, recovery time, and morbidity
C) More accurate chondrogenic differentiation
D) Higher rate of cartilage regeneration

A

B) Reduced cost, recovery time, and morbidity

97
Q

In studies using TGF-β1 to differentiate MSCs, what concentration was shown to have the most significant effect on equine BM-MSCs?
A) 1 ng/mL
B) 5 ng/mL
C) 10 ng/mL
D) 15 ng/mL

A

B) 5 ng/mL

98
Q

Which type of MSC was shown to express the highest levels of tendon marker genes like scleraxis and type I collagen in dynamic bioreactor studies?
A) Adipose-derived MSCs
B) BM-MSCs
C) UCB-MSCs
D) Tendon-derived MSCs (TN-MSCs)

A

D) Tendon-derived MSCs (TN-MSCs)

99
Q

Which experimental method showed early but not long-term improvement in cartilage defects when using BM-MSCs?
A) Monolayer culture
B) BM-MSCs in fibrin matrix
C) BM-MSCs in micromass pellets
D) BM-MSC injection in suspension

A

B) BM-MSCs in fibrin matrix

100
Q

What was a noted complication of early biopsy in a cartilage regeneration study using BM-MSCs?
A) Infection at the biopsy site
B) Potential trauma affecting long-term outcomes
C) Decreased collagen production
D) Complete failure of chondrogenesis

A

B) Potential trauma affecting long-term outcomes

101
Q

Which approach was suggested to potentially treat the entire synovial environment rather than just local cartilage defects?
A) Injection of BM-MSCs in suspension
B) Scaffold implantation with BM-MSCs
C) Using UCB-MSCs with a hydrogel
D) Arthroscopic implantation

A

A) Injection of BM-MSCs in suspension

102
Q

What could be a possible explanation for ectopic bone formation when using BM-MSCs in a platelet-enriched scaffold?
A) Misapplication of MSCs
B) Osteogenic signals from growth factors released by platelets
C) Incorrect scaffold design
D) Too high of a dose of MSCs

A

B) Osteogenic signals from growth factors released by platelets

103
Q

In a clinical retrospective study, what percentage of horses with meniscal injuries that received BM-MSCs returned to work?
A) 50%
B) 64%
C) 75%
D) 85%

A

C) 75%

104
Q

In the larger unpublished multicenter case series involving horses treated with BM-MSCs, what percentage of horses with soft tissue injuries returned to work?
A) 60%
B) 73%
C) 85%
D) 90%

A

C) 85%

105
Q

In the multicenter case series, what was the mean follow-up time for horses treated with BM-MSCs?
A) 12 months
B) 18 months
C) 21 months
D) 24 months

A

C) 21 months

106
Q

Which of the following factors was not found to have a significant association with outcome in the multicenter case series of horses treated with BM-MSCs?
A) Age
B) Severity of lesion
C) Breed
D) Type of MSCs used

A

A) Age

107
Q

What was the significant outcome observed in horses with surgically created full-thickness cartilage defects treated with BM-MSCs and hyaluronic acid?
A) Significant clinical improvements in mobility
B) Increase in aggrecan concentration in repair tissue
C) Complete joint regeneration
D) Significant increase in joint fluid production

A

B) Increase in aggrecan concentration in repair tissue

108
Q

In studies involving BM-MSCs for early osteoarthritis (OA), what effect was noted in synovial fluid treated with BM-MSCs?
A) Increased collagen type II production
B) Increased PGE2 production
C) Decreased PGE2 production
D) No change in synovial fluid compositio

A

C) Decreased PGE2 production

109
Q

Which delivery method for MSCs has not been compared in studies evaluating its efficacy for tendon injuries?
A) Intralesional injection
B) Intraarterial delivery
C) Intravenous regional perfusion
D) Intrasynovial injection

A

D) Intrasynovial injection

110
Q

In a study involving the treatment of early OA with BM-MSCs, adipose-derived SVF, or placebo, which parameter was significantly different between the treatment groups?
A) Clinical outcome
B) Biochemical markers
C) PGE2 production in synovial fluid
D) MRI scores

A

C) PGE2 production in synovial fluid

111
Q

What potential complication is associated with intraarterial delivery of MSCs?
A) Inflammation
B) Thrombosis
C) Infection
D) Decreased MSC viability

A

B) Thrombosis

112
Q

What has been identified as a major challenge in defining the optimal use of biologic products like MSCs?
A) Defining the correct cell numbers and dosages
B) Finding appropriate animal models
C) Obtaining FDA approval
D) Creating new types of scaffolds

A

A) Defining the correct cell numbers and dosages

113
Q

Which therapy has shown short-term improvement in subjective lameness scores in horses with naturally occurring osteoarthritis?
A) BM-MSCs combined with a scaffold
B) Platelet-rich product combined with MSCs
C) Adipose-derived MSCs alone
D) Intraarticular hyaluronic acid injections

A

B) Platelet-rich product combined with MSCs

114
Q

What has recent research revealed about the effects of corticosteroids on MSCs?
A) No effect
B) Increased MSC viability
C) Detrimental effects on MSCs
D) Improvement in chondrogenic differentiation

A

C) Detrimental effects on MSCs

115
Q

Which of the following was not found to significantly affect MSC viability?
A) Aminoglycosides
B) Local anesthetics
C) Hyaluronic acid
D) Corticosteroids

A

C) Hyaluronic acid

116
Q

What consequence must be carefully considered when using allogeneic MSCs?
A) Cost-effectiveness
B) Long-term durability
C) Immunologic safety
D) Speed of cartilage repair

A

C) Immunologic safety

117
Q

Which therapeutic modality has been shown to have minimal-to-no effect on MSC viability?
A) Shock wave therapy
B) Laser therapy
C) Aminoglycosides
D) Local anesthetics

A

D) Local anesthetics

118
Q

In horses treated with BM-MSCs for full-thickness cartilage defects, what method was used to assess repair outcomes at 1 year post-treatment?
A) Arthroscopy and MRI
B) Ultrasound and blood tests
C) Radiographs and clinical exams
D) Synovial fluid analysis

A

A) Arthroscopy and MRI

119
Q

In studies evaluating MSCs for tendon injuries, what delivery method has been predominantly used?
A) Intralesional injection
B) Intraarticular injection
C) Intravenous injection
D) Oral supplementation

A

A) Intralesional injection

120
Q

Which component of synovial fluid was reduced in horses treated with BM-MSCs for osteoarthritis, indicating an anti-inflammatory effect?
A) IL-6
B) TNF-alpha
C) PGE2
D) Aggrecan

A

C) PGE2

121
Q

Why is there a need for studies comparing different MSC delivery methods?
A) To find the cheapest delivery method
B) To determine which method improves short-term results
C) To evaluate long-term safety and effectiveness
D) To create new treatment options for laminitis

A

C) To evaluate long-term safety and effectiveness

122
Q

What type of injuries have most controlled studies of MSC efficacy focused on treating in horses?
A) Joint diseases
B) Tendon core lesions
C) Bone fractures
D) Laminitis

A

B) Tendon core lesions

123
Q

What is one advantage of using intraarticular injections of MSCs for treating joint diseases in horses?
A) They are less invasive than arthroscopy
B) They provide immediate healing
C) They require fewer doses
D) They have no side effects

A

A) They are less invasive than arthroscopy

124
Q

hich factor was not found to significantly impact the return to work in horses treated with BM-MSCs?
A) Age
B) Severity of injury
C) Breed
D) Exercise regimen

A

A) Age

125
Q

Which MSC source has been shown to potentially reduce inflammation in synovial fluid by decreasing PGE2 levels?
A) Adipose-derived MSCs
B) Bone marrow-derived MSCs
C) Umbilical cord blood-derived MSCs
D) Tendon-derived MSCs

A

B) Bone marrow-derived MSCs

126
Q

What is a major challenge in determining the most effective use of MSCs for equine soft tissue injuries?
A) Identifying the correct animal model
B) Lack of clear regulatory guidelines
C) Defining optimal dosage and cell numbers
D) Poor availability of MSC sources

A

C) Defining optimal dosage and cell numbers

127
Q

What possible side effect must be closely monitored when using intraarterial delivery of MSCs?
A) Increased inflammation
B) Thrombosis
C) Tissue necrosis
D) Infection

A

B) Thrombosis

128
Q

Which type of MSC delivery method may have long-term safety concerns due to immunological risks?
A) Allogeneic MSCs
B) Autologous MSCs
C) Platelet-rich MSCs
D) Tendon-derived MSCs

A

A) Allogeneic MSCs

129
Q

Which study parameter was used to assess repair tissue firmness in horses treated for full-thickness cartilage defects?
A) Synovial fluid analysis
B) Aggrecan concentration
C) Gross examination and arthroscopy
D) Lameness scores

A

C) Gross examination and arthroscopy

A U E R S & T (15 decks)

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