IRAP Therapy - Gene Therapy
The technology for IRAP production was pioneered in Germany about 12 years ago.
It has been used with success in many human patients in Europe. Recently,
the technology has been introduced to the US. Dr. Thaler introduced IRAP therapy
to his practice in 2006. The progressiveness of this therapy provides an alternative
to the traditional intra articular injections using steroids with hyaluronic acid
or hy visc. All horses by their very nature are athletes. Tremendous pressures
are applied across joint surfaces by both concussion against ground surfaces and
by compression of the horse’s own muscles. In fact more force is applied to the
joint surfaces by the horse’s own muscle contraction than by the reaction of striking
the ground surface! As a result of trauma and the induced low grade inflammation,
degenerative joint disease slowly progresses in our horses (and admittedly in us).
Recent research at Colorado State School of Veterinary Medicine verifies that the
presence of low grade inflammation is the inciting cause of most arthritic conditions.
Joint inflammation (including synovitis, capsulitis and arthritis) is caused by the
release of degenerative substances. The production of these substances is mediated by
interleukin 1 (IL1). IL1 binds to a receptor on the inside of the joint lining where
it stimulates the production of degenerative substances. IRAP (interleukin receptor
antagonist protein) blocks the binding of IL1.
The exciting news is that IRAP is made from the horses own blood! No foreign
medicines are added to the horse during treatment. The horse’s own blood is drawn
in the field and transported back to the office. The blood (50-100 cc) is aspirated
into a special syringe. The syringe contains coated glass beads that stimulate the
white blood cells to manufacture and release IRAP proteins. After 24 hours, the
serum is filtered and aspirated into 2 ml syringes. The total number of syringes
will vary with each horse but typically 10-12 syringes are prepared from one blood
draw. The syringes are then frozen until needed. The IRAP is then injected
directly into the affected joint.
A joint therapy requires 1-4 ml of IRAP. Severe inflammation may require weekly
injections for a month to normalize discomfort while other horses may require
treatment on an as needed basis much like traditional maintenance injections in
joints. In terms of effectiveness: IRAP has about 70% of the anti-inflammatory
ability of steroids. So while IRAP does not have quite the “punch” of steroids,
it has hardly any of the negative effects of steroids. IRAP therapy is ideal for
post surgical treatment and for steroid intolerant horses (Cushing’s, laminitis,
obese, insulin resistant, easy keepers). Additionally it can be used as
maintenance therapy throughout a competition season to reduce the amount of steroid use.
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