Page 932 - Adams and Stashak's Lameness in Horses, 7th Edition

898 Chapter 8

the expression of anti‐inflammatory cytokines, including various soft tissue inflammatory conditions or trauma.
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IL‐1Ra and IL‐10. In a recent randomized controlled The choice and amount of steroid seem to be empirical
VetBooks.ir SDFT were treated with either ACS or saline. In ACS‐ greatly impact the efficacy of the injections.
and clinician dependent; however, this does not seem to
study, naturally occurring tendinopathies of the forelimb
16
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treated limbs, lameness and swelling were significantly
decreased, while ultrasonography revealed a decrease in
size and increased echogenicity in the treated groups fol- MISCELLANEOUS
lowing a single intralesional injection. Recurrence of ten-
don injury was not reported in any of the horses in this Sarapin is occasionally utilized as an intralesional
study up to 2–4 years’ post‐diagnosis. Five of eight ACS‐ treatment for lesions associated with chronic nerve pain.
treated horses returned to previous levels of work, while Sarapin is an extract derived from the pitcher plant and
four of five control horses also returned to previous work. is believed to have a numbing effect in chronic pain. The
A newer class of biologics, autologous protein solution only study performed in the horse however could not
(APS), contains high concentrations of growth factors detect analgesic effects of sarapin in a model of acute
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and anti‐inflammatory cytokines, such as IL‐1 receptor pain using heat. Nonetheless, this therapy is commonly
antagonist, IL‐10, IGF‐1, and TGF‐β, and has had prom- utilized to treat various forms of desmitis and muscle
ising results intra‐articularly. APS has a similar process- soreness with a widely believed suspicion that a tempo-
4
ing time and centrifugation style to PRP. APS is distinct in rary analgesic effect is produced. Sarapin is often com-
that a second centrifugation step further concentrates the bined with other medications such as corticosteroids
cell solution in the presence of polyacrylamide beads and is used primarily to treat lameness conditions of the
resulting in a solution with higher concentrations of inter- axial skeleton such as back and sacroiliac problems.
leukin‐1 receptor antagonist proteins than PRP. To date,
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APS has not been investigated intralesionally.
Autologous bone marrow aspirate (ABMA) has been References
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sional treatment modality, by which stem cells and ulates the extracellular matrix metabolism of porcine nucleus pul-
growth factors may be administered into a lesion with- posus and anulus fibrosus cells cultured in alginate beads. Spine
(Phila PA 1976) 2006. doi:10.1097/01.brs.0000214942.78119.24.
out conditioning or culture. In a recent study of race- 2. Andrews JL, Sutherland J, Ghosh P. Distribution and binding of
horses with SDFT injuries treated with intralesional glycosaminoglycan polysulfate to intervertebral disc, knee joint
ABMA at the time of desmotomy of the distal accessory articular cartilage and meniscus. Arzneimittelforschung 1985;
ligament of the SDFT (DAL-SDFT), Thoroughbreds 35:144–148.
showed an 82% return to racing with 59% starting five 3. Anitua E, Andia I, Ardanza B, et al. Autologous platelets as a
source of proteins for healing and tissue regeneration. Thromb
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and treatment, 76% had one or more starts, and 62% 4. Bertone AL, Ishihara A, Zekas LJ, et al. Evaluation of a single
had five or more starts. The success rates of horses intra‐articular injection of autologous protein solution for treat-
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Perilesional corticosteroids are occasionally used tilage in an osteochondral defect model. J Equine Vet Sci
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usage, because they may delay collagen formation. 8. Caplan A, Fink D, Goto T, et al. Mesenchymal stem cells and tis-
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