Battle of the Biologics for Equine Injuries

Biological therapies, widely used throughout the equine medical industry for various musculoskeletal injuries, include platelet-rich plasma (PRP) and bone marrow concentrate (BMC). Evidence supports the use of both therapies, though which product performs superiorly remains up in the air.

To briefly review, musculoskeletal injuries such as osteoarthritis occur commonly in horses. Rest and nonsteroidal anti-inflammatory drugs have been therapeutic mainstays but do not help regenerate tissue. Biologics such as PRP and BMC decrease inflammation, enhance healing, and protect cartilage after direct injection into an affected joint.

PRP is obtained by collecting a small volume of the horse’s blood and separating the platelets from the red and white blood cells and fluid portion of the blood. BMC is generated from concentrating the contents of bone marrow, which is a more invasive medical procedure than producing PRP.

“The power of PRP and BMC is believed to stem from the growth factors generated by these products. Once injected into a joint, these growth factors presumably promote healing by stimulating migration of local stem cells to the injured tissue and supporting the growth of healthy cartilage,” explained Laura Petroski, B.V.M.S., a veterinarian for Kentucky Equine Research.

While BMC contains some stem cells, the number of stem cells in an individual sample is difficult to quantify. PRP does not contain any stem cells. Whether or not there are sufficient stem cells in BMC to outperform PRP, however, remains to be determined. Ultimately, the benefits of both products likely boils down to their impact on growth factors, interleukins, and other signaling molecules.

In a recent study*, PRP and BMC were tested to determine which product could attract the most local stem cells, referred to as mesenchymal stem cells or MSCs. These cells could help regenerate musculoskeletal tissues, including cartilage.

“The data showed that both PRP and BMC equally attracted local stem cells. This finding prompted the researchers to suggest that using a combination of both PRP and BMC could have added value in terms of local stem cell recruitment,” noted Petroski.

According to the research team, additional MSC migration studies would “further our understanding of the mechanism of action for the biologics in tissue repair” and “further optimize the use of biologics in the field of regenerative medicine.”

“Oral joint health supplements also support skeletal tissues, serving as important prophylactic products,” said Petroski. Kentucky Equine Research offers several products, including the chondroitin and glucosamine product KER-Flex; a high-molecular weight hyaluronic product called Synovate HA; and EO-3, which contains the natural anti-inflammatory properties of DHA and EPA. Each of these products has proven benefits for horses with osteoarthritis.

Synovate HA and EO-3 are available in Australia. For more joint support, look for Glucos-A-Flex in Australia, too.

*Holmes, H.L., B. Wilson, J.P. Goerger, et al. 2018. Facilitated recruitment of mesenchymal stromal cells by bone marrow concentrate and platelet rich plasma. PLoS One 13(3):e0194567.