Usimaki Alexandra, Ciamillo Sarah A, Barot Dhvani, Linardi Renata L, Engiles Julie B, Ortved Kyla F
Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Department of Pathobiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Equine Vet J. 2025 May;57(3):806-816. doi: 10.1111/evj.14203. Epub 2024 Jul 25.
Autologous protein solution (APS) has been shown to decrease lameness in horses with osteoarthritis (OA). Synovitis is an early driver of OA, providing an opportunity to intervene in the progression of disease via intra-articular (IA) therapeutics.
The objective of this study was to investigate the effects of a single IA APS injection in horses with interleukin-1β (IL-1β)-induced synovitis. We hypothesised that APS would decrease joint swelling and lameness, improve synovial fluid parameters and improve joint pathology scores in horses compared with untreated controls.
Randomised controlled in vivo experiment.
Synovitis was induced with IL-1β (65 ng) in one randomly selected tarsocrural joint. Twenty-four hours later, joints were treated with APS (Pro-Stride®) (n = 12) or left as untreated controls (n = 6). Lameness examinations and joint circumference measurements were performed on Days 0 (prior to IL-1β), 1 (prior to APS), 2, 4, 7 and 14. Synovial fluid, obtained on the same days, was analysed for protein concentration, nucleated cell count, and cytokine (IL-1β, TNF-α, IFN-γ, IL-6, IL-10) and prostaglandin E2 (PGE2) concentrations. Gross pathology and synovial membrane histopathology scoring was performed on APS-treated (n = 5), untreated control (n = 4) and normal (n = 9) tarsocrural joints.
APS did not decrease lameness or joint circumference compared with untreated controls. Synovial fluid parameters were not different between treatment groups. APS treatment did significantly decrease gross and histopathology scores.
Main limitations included the use of an induced model of the synovitis, inter-horse variability in the response to IL-1β and likely variability in the constituents of APS from individual horses.
APS treatment of tarsocrural joints with synovitis did not significantly improve lameness or alter synovial fluid parameters. APS did lead to significant improvement in gross joint appearance and synovial membrane histology suggesting that APS may have disease-modifying effects.
自体蛋白溶液（APS）已被证明可减轻骨关节炎（OA）马匹的跛行。滑膜炎是OA的早期驱动因素，为通过关节内（IA）治疗干预疾病进展提供了机会。
本研究的目的是调查单次关节内注射APS对白细胞介素-1β（IL-1β）诱导的滑膜炎马匹的影响。我们假设与未治疗的对照组相比，APS会减少马匹的关节肿胀和跛行，改善滑液参数并提高关节病理评分。
随机对照体内实验。
在一个随机选择的跗关节中用IL-1β（65 ng）诱导滑膜炎。24小时后，对关节进行APS（Pro-Stride®）治疗（n = 12）或作为未治疗的对照（n = 6）。在第0天（IL-1β注射前）、第1天（APS注射前）、第2天、第4天、第7天和第14天进行跛行检查和关节周长测量。在同一天采集的滑液分析蛋白质浓度、有核细胞计数、细胞因子（IL-1β、TNF-α、IFN-γ、IL-6、IL-10）和前列腺素E2（PGE2）浓度。对接受APS治疗的（n = 5）、未治疗的对照（n = 4）和正常（n = 9）跗关节进行大体病理和滑膜组织病理学评分。
与未治疗的对照组相比，APS没有减轻跛行或减小关节周长。治疗组之间的滑液参数没有差异。APS治疗确实显著降低了大体和组织病理学评分。
主要局限性包括使用诱导性滑膜炎模型、马匹对IL-1β反应的个体差异以及不同马匹APS成分可能存在的差异。
APS治疗滑膜炎的跗关节并未显著改善跛行或改变滑液参数。APS确实使关节外观和滑膜组织学有显著改善，表明APS可能具有改善病情的作用。
