October 2017 - Understanding Regenerative Medicine
Written by CRM
Thursday, 28 September 2017 23:21
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Innovative stem cells, PRP, IRAP and Prostride therapies use biological samples from the horse to help healing.

Stem Cells and PRP therapy

Circle Oak Equine in Petaluma offers the latest in regenerative medicine technologies.  Stem cells and platelet-rich plasma (PRP) are two different types of regenerative medicine. Each of these therapies uses biologic samples (e.g., cells or platelets) taken from a sick or injured horse and processes them to behave in a certain way (e.g., concentrate them, stimulate them to become a certain cell type, or produce a certain protein).

These “modified” biologic products are then injected into or applied to the horse from which the sample was originally collected to treat a specific injury. Thus, these therapies are referred to as “autologous” because the patient is being treated with a product derived from his or her own body. Autologous therapies are safe and associated with minimal side effects.  Regenerative medicine is one of the most recent and potentially helpful therapies introduced to the equine industry over the last several years.

Indications for regenerative medicine treatments such as Stem Cells or PRP include:

  • Osteoarthritis
  • Tendon injuries
  • Ligament injuries
  • OCD
  • Cartilage damage
  • Fracture repair

PROSTRIDE therapy (IRAP/ACT therapy)

IRAP (Interleukin 1 receptor antagonist protein) is a natural anti-inflammatory protein released by leukocytes at the site of injury. This protein is collected from blood by processing the leukocytes using a proprietary method. IRAP counteracts inflammation by blocking the inflammatory protein interleukin-1 within joints where, if unblocked, it can lead to pain and damage.

Other IRAP devices use autologous conditioned serum, require a 24-hour incubation period, and are subsequently frozen for multiple injection aliquots.

The ACT Protein Separator used with the ACT Protein Concentrator collects white blood cells and uses a proprietary method to reprogram the cells to be anti-inflammatory, secreting IRAP. Collection and activation of macrophages suppresses joint inflammation and regenerates cartilage in early stage osteoarthritic joints (canine and equine studies have clearly demonstrated efficacy).

Pro-Stride Injection will reduce pain associated with arthritis and deliver naturally occurring anti-inflammatory proteins. Pro-Stride Injection is capable of slowing cartilage degradation and improving mobility.

  • Pain relief for up to one year  (A. Bertone, Am J Vet Res 2014; 75:141-151)
  • Concentrated solution of anti-inflammatory proteins including IRAP
  • <20 minute blood processing, one-time visit, single injection
  • Natural, autologous drug-free therapy
  • Slows cartilage degradation
  • Ambulatory based treatment
  • Improves mobility

IRAP Therapy

Interleukin Receptor Antagonist Protein - or IRAP - is used for the treatment of osteoarthritis. IRAP therapy has been shown to be effective in treating arthritic joints that have not responded to more traditional intra-articular therapy.

Levels of IRAP and other anti-inflammatory proteins in the blood can be increased and produced for joint injection by incubating a 50ml sample of blood from your horse for 24 hours in a syringe produced by Arthrex VetSystems.  The syringe contains glass beads coated with a substance to enhance production of anti-inflammatory proteins including IRAP.  The syringe must reach the incubator as soon as possible after the blood has been harvested from your horse.

After 24 hours, the syringe is centrifuged, and the serum collected.  The amount of serum collected from each 50ml syringe of blood is usually between 20-25ml.  This yields 5-6 doses of IRAP, but the number of doses available for use from each collection is dependent on the specific joint.

Once the serum has been harvested, it is filtered and then frozen in single dose aliquots.  A small sample of each batch of serum is submitted for microbial culture to ensure to the best of our ability that that product that is released for joint injection is sterile. Injections are released for use four days after original blood collection.  Injections are kept frozen until immediately before use, and if necessary can be shipped frozen to your veterinarian.

Indications for use of IRAP in the joint include horses with a well-defined synovitis/capsulitis, particularly those horses that do not respond well to conventional anti-inflammatory joint medication and horses that have had arthroscopic surgery.

In general two to three treatments of the joint are performed, at 8-14 day intervals.  The volume injected at each treatment is 1-8ml, depending on the joint.  First injection after surgery may be given at seven days.

Article provided courtesy of Circle Oak Equine Sports Medicine & Rehabilitation in Petaluma.