Veterinarian scientists Lauren Schnabel and Jessica Gilbertie and are on a mission to create an FDA-approved, off-the-shelf, scientifically proven orthobiologic for the treatment of musculoskeletal injuries in horses. Their startup company, Qentoros, features a unique product called BIO-PLY that uses the power of platelets to treat orthopaedic injuries in equine athletes.

Tell us how your company Qentoros was started!

Dr. Schnabel: When Jess was a PhD student with me, and she’s faculty at Virginia Tech now, she had actually come from UPenn and was doing work there with our collaborator Dr. Tom Schaer looking at the antimicrobial properties of platelets. Her PhD was focused on refining the best platelet-derived product for the treatment of synovial fluid infections. A lot of her work also focused on how bacteria behaved in synovial fluid- specifically how biofilms form. Septic joints are very common in horses and can be difficult to treat due to antimicrobial resistance.

We had several grants that we worked on during Jess’s PhD. We did in vitro studies and a large in vivo horse study where we infected horse joints with Staphylococcus aureus, the most common bacteria that is in these septic joints. The horses were treated with either BIO-PLY and the antibiotic Amikacin or Amikacin alone, and the horses that received both did much better overall in terms of their sepsis and protection of their cartilage. We were super happy with those results and started using them in the clinic shortly after that for some pilot cases, and now we are working with the FDA in a clinical trial.

Dr. Gilbertie: In order for us to take this product out of the lab that Lauren and I have been working on into the commercial space, Lauren and I made a startup company called Qentoros. That company is run by our amazing CEO Mike Miller, and Lauren and I are on the board to handle the science and medicine side. We are currently building out our manufacturing space in Blacksburg to get this product from the lab out to veterinarians. We have been working with the FDA to get this off the ground, and that is why we are still in the clinical trial stage.

Can you share more about your product and the current clinical trials?

Dr. Schnabel: The name BIO-PLY comes from the bioactive fraction of platelet lysate. We collect blood from our donor herd of horses to isolate platelets, and they are lysed and fractionated. The product itself includes the enriched and concentrated factors that can then be used for injections.

Dr. Gilbertie: We have worked with over one hundred horses in our pilot trial with different batches from different lots, which has given us refinement of our dosing strategy, volume, how often we give the product and what cases do well with the product. This has shown us lot-to-lot consistency, which is great. Of those horses, we are able to compare our results to historical data versus a placebo group because a placebo group would be inhumane. Of the data we have collected so far from those horses, we have found that horses succumb to these infections about 20% of the time, and we have a mortality rate less than 5% of the time with our product. For return to performance, historically it has been about 50% of horses that will go back to the same level of athletic performance, and we are seeing an 80% return-to-function, which is really exciting. We are able to treat infections that are traditionally incredibly resistant. We can use BIO-PLY because it hits not only resistant infections, but also the ones that are in deep biofilm spaces. We mostly have been working on septic arthritis but have also been playing around with osteomyelitis cases, and those have been going really well, so we are looking into expanding into other orthopaedic infections.

What got you both into veterinary orthopaedic research?

Dr. Schnabel: I actually had really never done much benchtop research at all until after my internship. I attended veterinary school at Cornell and had done an internship at a big hospital called Rood and Riddle in Lexington, Kentucky. I did a gap year before my surgery residency and worked in the lab of Dr. Lisa Fortier and Dr. Alan Nixon where I got involved in some amazing projects with them. They worked a lot with human orthopaedic surgeons from Hospital for Special Surgery. I worked a lot on platelet-rich plasma at that time and stem cells, and we did the first big in vivo study with bone marrow-derived stem cells in horses. Seeing how this research was applied in the clinic is what really inspired me. I loved seeing the translational aspect to human medicine and the immediate aspect of getting things to the clinic to work on our equine patients. I continued that research throughout my surgical residency and then applied for my PhD and stayed there before starting my faculty position. During that year I was so inspired by those projects and seeing just how much more we can do for our patients. It’s the most exciting part of my job here.

Dr. Gilbertie: For me, and Lauren’s going to laugh at this, I always kind of wanted to be Lauren. My goal was to be an academic surgeon and researcher. After I went to veterinary school, I did an internship in equine medicine and surgery, and I realized that full life in the clinic was not for me. I went and did a fellowship at UPenn, and I loved my year working with Dr. Thomas Schaer. That’s when I really started to fall in love with bacteriology and microbiology. I started to think that maybe there were some adjunctive therapies, like platelet-rich plasma, that we could use to improve antibiotics. I did some early stage testing there, and with Tom’s blessing, I spun that out to Lauren’s lab for my PhD. We took things to the next level by making this off-the-shelf product, and we did the in vivo study in Lauren’s lab to get the ball rolling. I kind of have both hats now where I do microbial drug development, but because I am a clinical microbiologist, I still get to have a little taste of the clinic life. I also do a lot of teaching, which I absolutely love. I love my students, and it is so exciting to see them study veterinary medicine, and it’s awesome to bring them into the lab.

I love coming up with better diagnostics for infectious diseases, seeing what kinds of resistance is happening and how we can make new therapeutic antimicrobials for those. My other pet project is on canine pyoderma, which is a really bad Staphylococcus pseudintermedius infection in dogs that is highly resistant. It is exciting to see BIO-PLY go from something that Lauren and I were just playing with on the benchtop to something that makes really impactful changes to how veterinarians can treat septic arthritis.

What do you think has been the biggest challenge in your research journey and in starting your company?

Dr. Schnabel: Right now, it’s just navigating the whole FDA process. The FDA pathway in veterinary medicine is very small, and it is not as clear as in human medicine. Things take a very long time to get going.

Dr. Gilbertie: Exactly, and Lauren and I do not have much experience in that realm, so we have new hats to wear and new responsibilities to learn.

Dr. Schnabel: You want to do everything in the right way, and it’s just a lot less clear for orthobiologics in equine medicine versus for humans. This business side is also challenging since it is completely new to us as well. We really lucked out on our CEO because he has just been fantastic.

Dr. Gilbertie: My biggest challenge right now is just finding a balance between being on faculty and all the demands I have there, being an entrepreneur and startup owner, and being a mom. But for me, it’s totally worth it because I am so excited to see where the company is going. I hope to instill a good work ethic in my kids from watching me juggle all of these responsibilities.