Equis ISSN 2398-2977

Interleukin-1 receptor antagonist protein therapy

Synonym(s): IRAP therapy

Contributor(s): Graham Munroe

Introduction

  • Interleukin-1 receptor antagonist protein (IRAP) is an anti-carbolic, autologous biologic therapy obtained from the serum of a venous blood sample   Blood: collection  , taken from the horse being treated.
  • Interleukin-1 receptor antagonist (IL-1ra) is an anti-inflammatory protein that counteracts the destructive effects of inflammatory proteins such as Interleukin-1 (IL-1) within the inflamed joint.
  • Equine IRAP is not a pure protein but a composite of many blood-derived substances, and is more correctly termed equine autologous conditioned serum (ACS).
  • It has been shown to have a chondroprotective effect in experimental osteoarthritis models and also improved lameness in carpal chip models.
  • Most commonly used as intra-articular treatment for osteoarthritis   Musculoskeletal: osteoarthritis (joint disease)  ; or prophylactically for its anti-inflammatory and chondroprotective effects following arthroscopy   Joint: arthroscopy - overview  .

Print off the Owner factsheet on Interleukin-1 receptor antagonist protein (IRAP) therapy to give to your clients.Indications

  • Inflammatory arthropathies, including:
  • Particularly useful in Sport horses where positive drugs tests for pharmaceuticals need to be avoided during the active season.
  • Many practitioners apply it to more chronic cases that have been undergoing regular intra-articular corticosteroid treatment to maintain an osteoarthritic joint, and where the effects of this treatment are lessening.
  • In human medicine, IRAP has been used for intra-articular treatment of rheumatoid arthritis, osteoarthritis, lumbar pain of neurogenic origin (by perineural injection), and for muscle injury (by direct intralesional injection).

Contraindications

  • Not recommended for use in:
    • Joints where there are bone fragments, fractures, meniscal or ligamentous injury unless it has been successfully treated arthroscopically.
    • Bone cysts   Bone: subchondral cysts  .
    • Very advanced-stage osteoarthritis (poor stress rate)   Musculoskeletal: osteoarthritis (joint disease)  .
    • Anecdotally some clinicians recommend it is not used in tendon sheaths and bursae because of previous experience of post-injection reactions.

Action

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Production

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Administration

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Aftercare

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Expected response to treatment

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Further Reading

Publications

Refereed papers
  • Recent references fromPubMedandVetMedResource.
  • Textor J (2011)Autologous biological treatment for equine musculoskeletal injuries: Platelet-rich plasma and IL-1 receptor antagonist protein. Vet Clin North Am Equine Pract 27(2), 275-298PubMed.
  • Ferris D J et al(2011)Current joint therapy usage in equine practice: A survey of veterinarians 2009. Equine Vet J 43(5), 530-535PubMed.
  • Hraha T H et al(2011)Autologous conditioned serum: The comparative cytokine profiles of two commercial methods (IRAP and IRAP II) using equine blood. Equine Vet J43(5), 516-521PubMed.
  • Rindermann G et al(2010)Autologous conditioned plasma as therapy of tendon and ligament lesions in seven horses. J Vet Sci11(2), 173-175PubMed.
  • Frisbie D D et al(2007)Clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum in horses with experimentally induced osteoarthritis. Am J Vet Res68(3), 290-296PubMed.


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