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Practical Chondroprotective Drug Use
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When confronted with a horse suffering from acute or chronic joint disease, your thera- peutic goals should be aimed at both the soft tissue supportive structures and cartilage within the joint. the joint should not be thought of as simply articular cartilage, but rather as an organ consisting of cartilage, joint capsule, ligaments, synovial fluid and subchondral bone. your therapeutic goals may be to decrease inflammation, alleviate pain, or restore the articular environment to slow progression of disease. your recom- mended therapy will likely include a combination of supportive care methods, as well as administration of pharmaceuticals and nutriceuticals.
Hyaluronan
Hyaluronan (Ha) is present within articular cartilage where it is synthesized by chondro- cytes and in synovial fluid where it is synthesized by type B synoviocytes. Hyaluronan can exist as hyaluronic acid, sodium hyaluronate or as hyaluronate depending on the environment in which it is found, and all terms are used interchangeably. it has been recognized for many years and in several species that in osteoarthritis (oa) the molecu- lar weight and concentration of Ha were diminished by one half to one third of their normal values, giving rise to the concept of visco-supplementation.
Hyaluronan imparts the viscoelastic nature to synovial fluid, which means it behaves as a viscous solution at low sheer rates and is elastic in nature at high sheer rates. in syno- vial fluid Ha also lubricates the synovial membrane/cartilage interface (boundary lubri- cation) and physically excludes active inflammatory components and leukocytes from the joint cavity, a mechanism known as steric exclusion. Hyaluronan has additional direct anti-inflammatory effects and has been shown to decrease and fibroblastic pan- nus formation in osteoarthritic joints. [...]
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