Osteoarthritis in horses - Part 2: a review of the intra-articular use of corticosteroids as a method of treatment

Abstract

The problem considered in this review is related to the frequent use of corticosteroids (COs) (i.e. steroids)

Inflamed synovial fluid induces a homeostatic response in bone marrow mononuclear cells in vitro: Implications for joint therapy

“…In addition, BMNC therapy sustains the production of cytokines, oxylipds, and growth factors required for tissue repair, such as IL-10, PGE 2 , and IGF-1, dampened by the frequently used intra-articular corticosteroids. 32,33 Optimizing the functions of synovial macrophages by intra-articular injection of BMNC has the potential to reestablish an anabolic synovial environment, which could substantially benefit equine and human patients affected by inflammatory joint diseases.…”

“…Modern biologicals, such as mesenchymal stem cells (MSC), platelet‐rich plasma, and autologous conditioned serum, provide only modest benefits . Notably, intra‐articular corticosteroids block the inflammatory reaction and are known to have detrimental effects on cartilage metabolism more damaging than simply chondrocyte quiescence, antagonizing common cellular pathways innately required for efficient tissue homeostasis and repair (eg, IL‐10, prostaglandin, and NF‐kB) . Two goals are important in achieving progress toward the treatment of OA: promotion of an inflammatory response that efficiently clears pro‐inflammatory triggers; preservation of cellular and tissue mechanisms involved in joint physiology.…”

Role of Innate Immunity in Initiation and Progression of Osteoarthritis, with Emphasis on Horses

“…The local use of corticosteroids in equine joints, which is a common intra-articular therapy, might have the detrimental capacity to reduce the activity of the innate immune system, thereby shifting away from M2 macrophage polarization and the production of IL-10, prostaglandins (PGE 2 ), and other anti-inflammatory cytokines. These biomarkers play a very important role in the resolution of inflammation, further impairing the capacity of the joint to achieve homeostasis and prolonging the duration of OA [ 40 , 94 ].…”

Rol del ligando del factor nuclear kappa Beta (RANKL) en osteoartritis y osteoclastogénesis de equinos fina sangre de carrera. Uso de antiinflamatorios

“…En la práctica, el manejo clínico y terapéutico de la OA es diverso, donde la mayoría de los tratamientos convencionales consideran el uso de antiinflamatorios no esteroidales conducentes a disminuir la inflamación y las claudicaciones (Barton, 2016; Orsini et al, 2012), y corticoides con el objetivo de mitigar el dolor, las alteraciones tisulares en el hueso subcondral, cartílago articular y membrana sinovial (Lacourt et al, 2012;de Souza, 2016; McIlwraith y Lattermann, 2019) inducidos por la acción de IL-1, MMPs, agrecanasas, PG E2 y radicales libres. Un seguimiento clínico comparativo en 80 equinos con claudicación, tres semanas pos-administración de triamcinolona intra-articular fue exitoso en un 87.8%, mientras que a los que se les administró triamcinolona con ácido hialurónico fue de 64.1% (de Grauw et al, 2014).…”