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Efficacy Of Oral Joint Supplements: Which Ingredients Actually ‘Work?’

Dr. Rachel Tucker, an associate at Liphook Equine Hospital in the United Kingdom, was on a quest to determine which ingredients, if any, contained in popular equine joint supplements actually worked.

Many oral supplements claim a wide array of effects, including maintaining joint health, offering anti-inflammatory benefits, improving welfare, reducing joint stiffness and pain, and slowing osteoarthritis progression, reports The Horse.

Since most supplements are sold as food products, they are not required to conform to regulations or quality — or to have demonstrated efficacy.

Tucker considered ingredients effective if they achieved a desired response in the joint. They must also be bioavailable when administered orally, and have an appropriate formulation and concentration that matches published studies.

Chondroitin sulfate is a building block of joints; it is bioavailable and reaches synovial fluid and cartilage. It has an anti-inflammatory effect on human joint tissues and has been shown to reduce pain and swelling, as well as to prevent joint space narrowing. Equine-specific studies, however, have shown that chondroitin sulfate has no measurable effect on the horse.

Glucosamine is present in cartilage and synovial fluid; the amino monosaccharide prevents joint breakdown and acts as an anti-inflammatory. Research has shown conflicting evidence: some studies show that glucosamine has slow or no utilization in tissue, while others find that it does have an effect on pain or function.

Boswellia serrata, also called Indian frankincense, claims to be an anti-inflammatory. There have been no veterinary studies on Boswellia serrata's use, so additional investigation is needed, Tucker said. It has shown some benefit in humans who have taken it.

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Turmeric use in humans has demonstrated anti-inflammatory and antioxidant properties, but it has poor bioavailability. Only one veterinary study has been done to date, and the vets involved thought it showed significant improvement in dogs that consumed it.

While Tucker concluded that there is no concrete evidence that supplements work, they are safe to feed horses.

Bisphosphonate Use In Young Horses The Focus Of Texas A&M Study

Texas A&M researchers have created a study to evaluate off-label bisphosphonate use in horses. Originally meant to mitigate navicular pain in mature horses, off-label use of the drug in younger horses may promote bone degradation.

Though the number of equine fatalities from horse racing is decreasing, California, Kentucky, and New York have seen increased racing fatalities in 2018. Lead researcher Dr. Jessica Leatherwood says that a primary concern regarding these breakdowns is the off-label use of bisphosphonates; the study will assist in determining the effects of the drug on developing skeletons.

There is currently no scientific data exploring the effects of bisphosphonate use on young, exercising horses. The study, “Bisphosphonate Pharmacokinetics and Comprehensive Effects on Juvenile Cartilage, Bone Growth and Healing: Implications for Animal Welfare,” received a $500,000 grant from the U.S. Department of Agriculture's National Institute of Food and Agriculture. The particular bisphosphonate that will be studied is clodronate disodium, which is easy to administer and popular.

Racing commissions acknowledge the off-label use of bisphosphonates, but laboratories are unable to reliably test for the drug, limiting the ability to regulate off-label use.

Radiographs are often a key to racehorse sales, particularly in young horses where they expose skeletal health. Off-label use of bisphosphonates may mask potential flaws and cause microdamage accumulation, which could lead to breakdowns. The concern over bisphosphonate use isn't limited to racing; some sport horse disciplines are also limiting or restricting their use.

Horse and sheep models will be used in the study. As sheep are typically processed before they are two years old, they will offer insight into the potential changes in bone and biomechanical properties. The team hypothesizes that younger animals will clear the bisphosphonates more rapidly than older animals, that the drug alters bone in young, exercising horses, and that it will also have anti-inflammatory effects on the joint.

The findings could help shape new regulatory policies on bisphosphonate use in young horses.

Cryopreservation Of Equine Stem Cells For Cartilage Repair

Cryopreservation is the next exciting stage of research in stem cell therapy. Dr. Thomas Koch and his team are working to preserve cartilage chips for long-term storage, which would enable off-the-shelf use to treat localized cartilage defects. Defects that very often shorten or end horses' athletic careers.

Cryopreservation (or vitrification) is the formation of a solid from an aqueous solution without the formation of ice crystals. Using cartilage chips created from equine umbilical cord blood, this next stage in research has the potential to change the way cartilage defects are treated.

If cryopreserved, stored cells can be used; treatment would be very efficient, with no need to harvest stem cells from the patient. This means fewer visits, less waiting and faster treatment.

Listen to the following video where Dr. Koch discusses the future of this ground-breaking research, targeting a common issue (cartilage defects) across disciplines and even species (horse/human).

An injection of funding from Ontario Equestrian allowed for a preliminary study to find out if they were able to vitrify equine cartilage stem cells well from cadavers. “We are very excited to have received this support,” says Koch. “The preliminary study will allow for future funding sources from both equine specific and human medicine.”

The Ontario Veterinary College is currently working in collaboration with a world-renown cartilage vitrification specialist, Dr. Jomha Nadr, and his team at the University of Alberta, Edmonton to establish a robust vitrification protocol for eCB-MSC-derived neocartilage. The work will generate pivotal data to support the clinical evaluation of cryopreserved allogenic eCBMSC cartilage chips to repair focal cartilage defects in research horses. Fully implemented, this therapy would provide a safe, efficacious, and technically simple treatment for horses as well as provide an opportunity for a Canadian biotechnology business to bank and distribute vitrified cartilage tissue in unlimited quantities to the world market.

The future of regenerative therapies are exciting, and the potential applications are wide ranging, from treating cartilage defects to potentially delaying the onset of osteo-arthritic changes to treating bacterial infections and inflammation. “We believe this work has the long-term potential to benefit both horses and humans through the development of novel off-the-shelf cell-based therapies for damaged joint cartilage,” says Koch.