In the last few years, a plethora of regenerative therapy options for horses suffering from osteoarthritis have come onto the market. Regenerative therapies focus on depositing new tissue with similar biomechanical function to the original tissue. It differs from tissue reparation, which involves scar tissue, explained Dr. Gustavo M. Zanotto, clinical associate professor of equine sports medicine at Texas A&M University's School of Veterinary Medicine and Biomedical Sciences.
Limiting inflammation and scar tissue formation makes tissue more functional, reports The Horse. Many vets are now using biologic therapies in the joint, preferring them over corticosteroid joint injections for longer-term efficacy, though there are no studies regarding long-term benefit.
Regenerative medicine involves two proteins: interlekin-1 receptor antagonist protein (IRAP) and growth factors. IRAP is often used in joints; it blocks the cytokine's destructive effects on cartilage. Growth factors stimulate cell growth and survival, tissue repair, inflammation reduction, and cell differentiation.
The use of autologous conditioned serum (ACS) involves collecting blood from the affected horse and incubating it with borosilicate glass beads, which stimulate the white blood cells to release anti-inflammatory cytokines. This is then injected back into the affected joint, stimulating the body to produce more IRAP. The affected joint becomes less painful and the product slows cartilage breakdown.
ACS can also be used to improve healing in tendon injuries.
Platelet-rich plasma (PRP) is often used for equine tendon injuries. To get PRP, the vet collects blood from the affected horse, combines it with an anticoagulant and separates the cells into platelets and red and white blood cells. These are then injected into the affected tendon. PRP can also be used in joints affected by osteoarthritis (OA).
Autologous protein solution (APS) is derived from plasma and can also be used for horses with OA. It has shown to improve lameness in a small study.
Alpha-2 macroglobulin products (A2M) are used in joints; coagulants are added to blood drawn from an affected horse, put in a centrifuge and the platelet-poor plasma is injected into a concentration kit. The concentrated A2M plasma is then injected back into the horse. It's believed that this limits the breakdown of cartilage by trapping the metalloproteinases.
Zanotto emphasized that not every horse will heal the same way, no matter what biologic product is used, and that no one modality will work for every horse. He reminded vets that they cannot control the variance in horse's blood or the products derived from them.
Read more at The Horse.
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