Zoobiquity is a term that was coined when I was writing a book with Kathryn Bowers about the intersection of human and animal medicine. There’s a tremendous amount of commonality, which you might think is obvious. But, over centuries of modern human times, we’ve forgotten about how essentially animal we are.
- Dr. Barbara Natterson-Horowitz, professor of medicine, UCLA Division of Cardiology, co-author of the New York Times bestselling book, Zoobiquity: The Astonishing Connection Between Human and Animal Health
Nearly 200 people — including veterinarians, physicians, researchers, graduate students and aspiring veterinarians and doctors — attended Zoobiquity Colorado, a national meeting on regenerative medicine advances that was sponsored by the College of Veterinary Medicine and Biomedical Sciences at Colorado State University and the Gates Center for Regenerative Medicine at the University of Colorado.
Zoobiquity Colorado kicked off with a CSU showcase on Oct. 5, with seminars from some of the university’s leading researchers; tours of the C. Wayne McIlwraith Translational Medicine Institute, the James L. Voss Veterinary Teaching Hospital, and the Orthopaedic Research Center; and the opportunity to try out virtual reality and human anatomy programs developed in the Department of Biomedical Sciences.
CSU highlights orthopaedics, stem cell therapies
Dr. Wayne McIlwraith, University Distinguished Professor and founding director of the Orthopaedic Research Center, talked about pivotal events in his career that led to revolutionary developments in the use of arthroscopic surgery in race horses.
As a young veterinary surgery resident at Purdue University in 1976, McIlwraith attended an arthroscopic surgery class in human medicine. This was his first experience in translational research and medicine from a human patient to horse patients. And, yes, he was the only veterinarian in the class.
Initially there were more than a few skeptics arguing against the use of this procedure in horses. But McIlwraith helped silence those critics after he operated on Spend a Buck, an American thoroughbred, in late 1984. Five months after the procedure, Spend a Buck won the Kentucky Derby by more than five lengths, and led from start to finish.
“That’s what convinced most of the equine racing world about the benefits of arthroscopy,” said McIlwraith.
Now, the procedure is widely accepted for horses and has revolutionized care for equine patients in much the same way it did for humans.
Dr. Laurie Goodrich, a professor of orthopaedics in the Department of Clinical Sciences, explored the question: Why do we need regenerative medicine?
She discussed cartilage injuries in horses and the need for new therapies that would provide faster joint healing in equine patients. Stem cell therapy has shown promise in horses to treat osteoarthritis, and to help with cartilage repair and fracture healing as well as tendinopathy, a disease that causes tenderness and pain in tendons.
“We still need comparisons between the different types of stem cells that exist,” Goodrich said. “We need larger and more clinical trials. We hope to treat our patients better, faster and more effectively.”
Joining forces to save limbs
On Saturday, Oct. 6, keynote speakers included Professor Frank Barry from the University of Ireland Galway, whose research with goats inspired the use of stem cell therapies at CSU and Johnny Huard, director of the Center for Regenerative Sports Medicine at the Steadman Philippon Research Institute, who talked about stems cells and aging.
Wei Lang and Dr. Lynne Boxer, a veterinarian, from the U.S. Food and Drug Administration, also addressed government regulation.
Read about a panel discussion on regenerative medicine at Zoobiquity Colorado from the University of Colorado.
Pairs of scientists and clinicians from human and veterinary medicine presented on topics including limb salvage, orthopaedic surgery, infection management, cancer, stem cell therapy, inflammation, and Ehlers-Danlos syndrome, a group of inherited disorders that affect connective tissues.
Dr. Jason Stoneback, director of Orthopedic Trauma and Fracture Surgery at University of Colorado Hospital on the Anschutz campus, and Dr. Nicole Ehrhart, professor of surgical oncology at CSU, described the medical challenges that exist when trying to save a human or animal’s limb following cancer or an accident.
In humans, bones from the pelvis are used to repair a damaged limb, but there is typically a smaller amount of bone available than what is needed, said Stoneback, and infection is always a challenge.
Ehrhart described how pets develop limb-threatening conditions similar to humans. Given that sarcomas – cancers that grow in connective tissue – are much more common in pets than in humans, treating companion animals provides a way to learn more about the conditions. Unmet challenges in limb salvage surgery include overcoming high infection and implant failure rates, she said.
“We have the same problems [as human doctors] and some solutions on the horizon,” Ehrhart said. “By joining forces, there’s a lot more hope for the future.”
Research benefits horses and humans
Dr. David Frisbie, CSU professor of equine surgery and director of the Translational Medicine Institute, and Karin Payne, an assistant professor and director of the Regenerative Orthopedics Lab at CU Orthopedics, discussed the use of microfracture and stem cells with patients.
Frisbie said that the first case in which he used stem cell therapies to treat a horse was eye-opening. He worked with a client whose horse had been lame for six months after an injury to its stifle, which is similar to a human knee joint. The results were remarkable, and led to a larger clinical study with 33 horses. Some 76 percent of horses treated in the study were able to go back to what they’d been doing before the injury.
Payne discussed the use of arthroscopy, spinal fusion and total joint replacement in aging adults. Seeing success in the use of microfracture with horses was very important in translating that procedure into care for humans.
Microfracture involves the surgeon creating very small holes in the bone surrounding the knee during arthroscopic surgery. Bone marrow cells and blood form a clot to cover the damaged area, which provides a base for new tissue growth. In the equine realm, surgeons can improve upon this procedure using stem cell therapies. But Payne said stem cells aren’t currently being used much with human patients.
Stem cells can fight bone infection in animals and people
Dr. Valerie Johnson, a fellow in the Department of Microbiology, Immunology, and Pathology at CSU and an emergency medicine specialist, discussed the use of stem cell therapies to help improve treatment for orthopedic infections with Dr. Laura Damioli, an assistant professor of medicine and infectious disease at University of Colorado Hospital.
Orthopaedic infections are some of the most difficult to treat, and are incredibly difficult to eradicate, said Johnson, whose team has had success using stem cells and antibiotics to help clear infections in animals. They are also studying toll-like receptors, proteins that play a key role in the immune system by detecting bacteria and other properties of foreign invaders.
Damioli said in human medicine, there are safety concerns — though no adverse events have been reported — related to the use of stem cells in treating bone and joint infections. A major issue she deals with is biofilm formation on implants or bone, which makes it impossible to use antibiotics to treat an infection, in both humans and animals.
“As you get deeper into the biofilm, antibiotics are more resistant,” she explained.
Osteomyelitis, or an infection in the bone, is also a challenge.
“The bone starts dying, and it becomes embedded with bacteria,” Damioli said. The only way to get rid of it is to cut it out. But if any dead bone or hardware is left behind, it’s possible the patient will need to take medications to fight infection for the rest of his or her life.
“Personally, I’d like to see us get faster compassionate use,” she said “My patients, I’m sending them to hospice care. Why can’t we give them stem cells?”
Immunotherapy for kids and dogs with cancer
Dr. Steve Dow, professor of immunology in the CSU Department of Clinical Sciences, and Dr. Terry Fry, co-director of the Human Immunology and Immunotherapy Initiative on the CU Anschutz Medical Campus, shared new insights into childhood cancer gained from clinical trials in dogs.
Fry acknowledged how far the field has come, with a nod to the work of immunologist James Allison, one of the two recipients of the 2018 Nobel Prize in Physiology or Medicine for his work in cancer immunotherapy. (He shared the prize with Tasuku Honjo, distinguished professor at the Kyoto University Institute for Advanced Study.)
Although some patients with some tumors have dramatic responses, these responses are uneven and unpredictable, said Fry.
“There are patients we know that are probably cured with a single infusion,” said Fry. “Some patients can be cured. But if you look at this the other way, more than half of the patients will relapse within a year.”
Dow said that dogs, which develop cancer naturally, are a good model for using immunotherapy to treat cancer. Veterinarians from CSU are, in fact, working with clinicians at Children’s Hospital Colorado to implement a clinical trial for pediatric osteosarcoma, a common cancer in both humans and dogs.
While dogs get malignant cancers at about twice the rate as humans do, osteosarcoma tumors arise in the same sites in the bone with dogs and humans, progresses at the same rate and metastasizes at same site.
Clinicians already know how to slow tumors from metastasizing with chemotherapy. Armed with that knowledge, CSU veterinarians in Dow’s lab — led by Assistant Professor Dan Regan — used Losartan, a drug that has been used to treat high blood pressure and kidney disease in humans, in combination with chemotherapy to treat osteosarcoma in dogs.
Dow said the team saw very positive results with this therapeutic combination, which prompted CSU to initiate a conversation with clinicians Children’s Hospital Colorado.
“This has led to the development of a clinical trial in pediatric osteosarcoma, a first-in-human trial using high-dose Losartan with Sunitinib,” an accepted human chemotherapy drug, he said.
The trial should start in late 2018 or early 2019. “We are super-excited to see this happen,” said Dow. “It is sort of a dream come true for us.”