Welcome!Welcome!

IRAP?IRAP?

• interleukin interleukin 1receptor 1receptor antagonist proteinantagonist protein

• brandname of brandname of technology used to technology used to obtain obtain Autologous Autologous Conditioned SerumConditioned Serum (ACS)(ACS)

What does Interleukin1(IL-1) do?What does Interleukin1(IL-1) do?

Following joint injury there is up Following joint injury there is up regulation of synthesis of IL-1regulation of synthesis of IL-1

IL-1 drives IL-1 drives • PainPain• InflammationInflammation• DegenerationDegeneration

What's The Big Deal?What's The Big Deal?

100% non chemical 100% non chemical – uses the body‘s – uses the body‘s own treatment own treatment mechanismmechanism

EffectiveEffective SafeSafe

Irap SyringeIrap Syringe

Sterile AcquisitionSterile Acquisition

IRAP syringe is IRAP syringe is used to draw fresh used to draw fresh venous blood from venous blood from the horsethe horse

Mild sedation Mild sedation allows a higher allows a higher yield (proportion of yield (proportion of plazma to red cells plazma to red cells is higher)is higher)

24 hour Incubation24 hour Incubation

WWhite blood cells hite blood cells produce produce therapeutic therapeutic proteinsproteins through through their physical their physical contact with the contact with the glass beads during glass beads during incubation at 37°Cincubation at 37°C

CentrifugationCentrifugation

Sterile ProcessingSterile Processing

Filtering into Syringes & FreezingFiltering into Syringes & Freezing

Injecting into Joint(s)Injecting into Joint(s)

Controlled studiesControlled studies

Benefits of ACSBenefits of ACS

100% autologous100% autologous antiinflammatoryantiinflammatory relieves painrelieves pain regenerativeregenerative all components are in physiological all components are in physiological

concentration onlyconcentration only all components act synergistically -> more all components act synergistically -> more

effectiveeffective safe: so far not a single infectionsafe: so far not a single infection

• Horses which have a well diagnosed arthritis condition with no specific pathology such as osteo-chondral bone fragments, OCD lesions, etc.

• In addition those horses that have had hyaluronic acid (HA) and/or cortico-steroids with little or no improvement.

For what type of problems ?

Post ArthroscopyPost Arthroscopy

Post-Arthroscopy joints with cartilage lesions and scratches but not totally destroyed cartilage areas.

Post SurgeryPost Surgery

Maintenance therapy for those horses with more severe joint disease

German RecommendationsGerman Recommendations

Amount: 2-8 ml depending on size of Amount: 2-8 ml depending on size of jointjoint

Frequency: every 4-8 or 8-16 daysFrequency: every 4-8 or 8-16 days Repetitions: 0- 3X (i.e. 1-4 injections Repetitions: 0- 3X (i.e. 1-4 injections

in a row)in a row) Our experience – stifles require Our experience – stifles require

higher volume – 10-15 mlhigher volume – 10-15 ml

Cost?Cost?

1.1. IRAP syringe, sample acquisition, IRAP syringe, sample acquisition, incubation, centrifugation & filtration incubation, centrifugation & filtration into multiple syringes for immediate into multiple syringes for immediate and future injection.and future injection.

2.2. Injection fee: sterile scrub, filtering Injection fee: sterile scrub, filtering IRAP, sterile joint injection +/-antibiotic, IRAP, sterile joint injection +/-antibiotic, sedation, bandagingsedation, bandaging