Antimicrobial Properties of Equine Stromal Cells and Platelets and Future Directions

In summary, increased recognition of the prevalence of antibiotic resistance and biofilm-based infections in clinical practice has prompted the evaluation of alternative antimicrobial treatments, including regenerative and biologic therapies such as MSC and platelet products. While initial in vitro and in vivo data, as well as case-controlled studies in veterinary species, indicate efficacy, including in the face of bacterial biofilms as would be the case in septic arthritis, current challenges include compliance with regulations from governing bodies regarding the use of cell-based products and allogeneic products as well as practicality of administration at the time of presentation if autologous cell-based products are implemented. Future directions of this field may focus on exosome-based or lyophilized versions of MSCs and the lysate version of platelet products to overcome these hurdles in the face of mounting pressure from antibiotic-resistant organisms in practice. Combined use of MSCs and platelet lysate products should also be considered and is just starting to be explored.