Dr. Lisa Fortier is committed to discovering the most effective regenerative therapies for tendon and cartilage damage. Although her primary concern is to improve the quality of life for horses, her work is relevant to human medicine, as the horse is recognized as a marvelous model for diseases that afflict people, too.
With generous support from the Zweig Fund, Fortier and her team conduct biologically-based research designed to improve the cellular response to injury of tendon and cartilage. Enhancing the healing response on a cellular and molecular level, Fortier says, may ultimately improve the quality of repair, improve the prognosis for return to performance, and decrease the incidence of re-injury. Their research is based on a trilogy: stem cells, growth factors, and a suitable scaffold. In addition, the goal with any new therapy developed is to complete the procedure using a simple joint scope with just one visit to the operating room for which some new and improved equipment is necessary. The long-term goal is to develop a regenerative methodology that can be utilized by all equine surgeons, not just those in an academic setting.
In her research, Fortier uses self-derived adult stem cells. They are abundant, pose no risk of rejection from the patient’s immune system, and her lab group has developed and verified a marker that can be used to enrich the stem cells from a bone marrow sample. We now need to take advantage of this information and develop a method to isolate stem cells from a bone marrow sample right in the operating room. To complete the trilogy, platelet rich plasma provides the growth factors (stored in platelets) and the scaffold (a framework to which stem cells cling, thus holding them in the desired location).
“Generation of the optimal platelet rich plasma is one of the issues driving our equipment needs,” said Fortier. “There are more machines than cereals in the grocery store to do this, but they all produce a different ratio of platelets and white blood cells. We need platelets to enhance repair, but a minimal number of white blood cells because our work indicates that the presence of white blood cells can be directly correlated to the loss of normal tissue. One of the major projects in the laboratory is to determine what the optimal ratio of platelets to white blood cells is and then to use this information to drive the industry towards generation of a machine to match our needs.”
To make regenerative medicine-based surgery a realistic option for our clients, Fortier says it needs to be a one-day, one trip to the operating room procedure. “We need to be able to collect bone marrow directly before surgery, extract the stem cells and generate the platelet rich plasma while the horse is being prepared for surgery,” said Fortier. “This way, when the horse is ready, we will have the necessary stem cells and platelet rich plasma to complete the repair procedures.”
Fortier earned her DVM at Colorado State and completed a PhD and large animal surgery residency at Cornell. She is the president of the International Cartilage Repair Society, and she and her husband, Dr. Alan Nixon, Professor of Large Animal Surgery at the College, have three children.