Translational human and equine regenerative medicine in musculoskeletal conditions

Abstract

Translational regenerative medicine, integrating human and veterinary approaches within the “One Health” framework, increasingly uses horses as models for human musculoskeletal conditions due to shared anatomical and functional features. Osteoarthritis and tendon disorders affect both species, often resulting from high-impact or repetitive strain activities. Regenerative medicine offers therapeutic opportunities by promoting tissue repair and modulating inflammation. Cellular orthobiologics such as mesenchymal stromal/stem cells (MSCs) show promise for treating osteoarthritis and tendon injuries in humans and horses, while non-cellular orthobiologics—including platelet-rich plasma, interleukin-1 receptor antagonist protein, and alpha-2 macroglobulin—provide growth factors and anti-inflammatory molecules that support tissue regeneration. However, challenges remain, including variable product manufacture, inconsistent MSC isolation and characterization protocols (particularly in equine applications), and regulatory or public scepticism toward these therapies. Standardized production methods and improved clinical integration are needed. Combinatory use of cellular and non-cellular orthobiologics offers strong translational potential to improve musculoskeletal repair across species.

HIGHLIGHTS • Equine–human musculoskeletal research aligns with One Health principles. • Cost, lifespan, and ethics limit horses as human translational models. • Standardized orthobiologic production protocols are needed to improve reliability. • Regulatory and public scepticism continue to hinder adoption of cell therapies. • New technologies and combined therapies may improve clinical outcomes.