DR. RICHARD GAYLES: A2M Halts Progressive Joint Damage Of Osteoarthritis
By Richard Gayles, MD // September 1, 2016
A2M Neutralizes Inflammatory Substances
CENTRAL FLORIDA, USA – One of the most important proteins found in the blood is called alpha-2-macroglobulin (A2M), and is among the largest and heaviest proteins that the body makes.
A2M’s principal activity is to counteract the enzymes called proteases that breakdown various chemicals and molecules no longer needed in your body, which is part of a well-balanced chain of events that keeps you healthy.
A2M Halts Progressive Damage Of Osteoarthritic Joint
This large protein can capture and neutralize the enzymes created in an arthritic joint that cause the destruction of the cartilage.
By inactivating these enzymes, A2M effectively halts the progressive damage seen and felt in the osteoarthritic joint.
Unfortunately, common treatments such as NSAIDS, aspirin, Tylenol®, cortisone injections, and visco supplementation (Synvisc®) only address the disease symptoms.
None of these treatments actually stops the slowly progressive joint destruction seen in osteoarthritis. Weight loss, exercise and activity modifications can also address the arthritic pain that occurs in effected joints, but cannot alter the course of the disease.
A2M Neutralizes Inflammatory Substances That Collect In Joints
The degenerative process of osteoarthritis involves a process of increased activity and production of destructive and inflammatory proteases. The increased levels of these highly destructive proteases progressively damage the joint cartilage.
How and why this destructive process is triggered remains unknown. The collection of these proteases, which include cytokines, disintegrins and matrix metalloproteinases, are intensely destructive.
Over time if protease activity remains unchecked, there will be loss of the protective joint cartilage, and the development of significant pain with decreased mobility.
A2M has unique properties, which include a powerful inhibition of cartilage inflammatory proteases effectively neutralizing the process that leads to osteoarthritic cartilage degradation and joint destruction.
Liver Naturally Produces The A2M Protein
It seems logical that supplemental joint injections of A2M should diminish joint cartilage degeneration, and may be a potential therapy for osteoarthritis. If it was possible to get more of this protein into an arthritic joint early in the arthritic destructive process, it is quite possible to at least slow, if not halt, the progression of joint deterioration.
The liver actually makes a significant quantity of A2M and it circulates in your blood stream in reasonably high quantity.
Unfortunately, the A2M molecule is too large to pass through the surrounding joint capsule tissues into the inner joint space. A2M is therefore not present in sufficient quantities to effectively neutralize those destructive proteases destroying the joint.
Just recently, a method has been developed utilizing your own blood, which is collected and processed (spun at high speed) with a centrifuge.
A special filter isolates and concentrates the A2M along with some platelets, which then can be directly injected back into the knee or any other osteoarthritic joint.
‘APIC PRP’ System Delivers Concentrated A2M Directly Into Joint
A proprietary process from Cytonics has been named the “Autologous Platelet Integrated Concentration System” or “APIC PRP” system. It is the only PRP system currently available that concentrates A2M while minimizing platelets, white blood cells and other proteins.
All of the other PRP collection systems have high concentrations of platelets and white blood cells in their preparations. These white cells are intensely inflammatory in nature and are destructive to the joint cartilage.
The “APIC PRP” system reduces the white cell count in the preparation to negligible levels, thereby, allowing the concentrated alpha-2-macroglobulin to more efficiently neutralize the cytokines, disintegrins and metalloproteinases destroying the joint. This method concentrates the A2M to a level 9 to 10 times the concentration found in the blood stream.
A few words of caution….
- A2M injections work best in joints where the destruction has not reached the point of total destruction, or where the joint is “bone on bone.” This is referred to as “end stage arthritis.” A2M treatment is designed to help “slow” or “prevent” further destruction, and will have little effect when the destruction of the articular cartilage has become extreme. This would be analogous to calling the fire department after your house has burned down. This treatment is FDA approved for the treatment of mild to moderate osteoarthritis.
- This new treatment is not the “platelet rich plasma” or “PRP” concept that has been available through many companies for over a decade and is typically used in the sports field. In fact, a high concentration of platelets is quite inflammatory to a joint and will not be beneficial. Several studies and the Academy of Orthopaedic Surgeons have recommended against the use of “PRP” in osteoarthritic joints, describing it as not helpful or useless. The “APIC PRP” system referred to here minimizes platelet and white cell concentrations while maximizing the concentration of the desired chondroprotective protein—A2M. This is wholly unique in the populated field of PRP systems currently available.
To make an appointment with Dr. Richard Gayles, call 407-412-5030, and for more information, log on to LakeNonaMedicalArts.com
ABOUT THE AUTHOR
Dr. Richard Gayles is the founder and director of Lake Nona Medical Arts and brings a wealth of training and experience to pain management. He received a Bachelor of Science in Psychobiology from the University of Michigan in 1987 and his Doctor of Medicine in 1991 at the University of Michigan’s School of Medicine. After graduation, he completed a residency and Pediatric Anesthesia Fellowship in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins Hospital in Maryland.
Dr. Gayles obtained further clinical experience in anesthesiology at St. Bartholomew’s Hospital in London, England. He completed a Chronic Pain Fellowship at the Cleveland Clinic Foundation in Ohio, where he was awarded the “Fellow of the Year Award” in June of 1997.
In addition to his clinical experience, Dr. Gayles has participated in research over the past 14 years, both here at home and abroad. Dr. Gayles is Board Certified by the American Board of Anesthesiology and a Diplomat of the American Academy of Pain Management. He is also certified by the American Board of Pain Medicine, National Board of Medical Examiners and by the American Heart Association in Basic and Advanced Cardiac Life Support. Dr. Gayles holds the Following Special Affiliations: Member of Coast Guard Auxiliary and FAA (an Aero Medical Examiner) ANGEL Flight.
To make an appointment with Dr. Gayles, call 407-412-5030, and for more information, log on to LakeNonaMedicalArts.com