Peer-reviewed papers
Alpha2EQ downregulates proinflammatory cytokine and chemokine gene expression in cultured synovial fibroblasts
Equine synovial fibroblasts (n = 16) treated with Alpha2EQ® in two culture models. Compared with baseline, Alpha2EQ® significantly reduced expression of IL-6, IL-15 and CCL2/MCP1 in high IL-6 fibroblasts, and of IL-1β, CCL5/RANTES and PPBP/CXCL7 in the IL-1β-stimulated model; CXCL6/GCP-2 and TNFα were downregulated in both. The authors conclude that Alpha2EQ® reduces inflammation by modulating cytokine and chemokine expression by synovial cells.
Pugliese BR, Ruiz Rosario FK, Schnabel LV. Am J Vet Res. 2025. doi.org/10.2460/ajvr.25.09.0319. Open access, CC BY-NC.
Download PDFEvidence for alpha-2-macroglobulin as an orthobiologic osteoarthritis therapy: a narrative review
Review of the most pertinent work on α2M supporting its clinical use as an osteoarthritis treatment, across preclinical models, in vivo studies and clinical patients. Three mechanisms contribute to α2M’s modulation of joint inflammation and OA progression across species: the bait-and-trap mechanism, direct binding interactions, and regulation of gene expression. This review is the first to include the commercially available kit for equine orthobiologic preparation, Alpha2EQ®.
Pugliese BR, Schnabel LV. Am J Vet Res. 2025. doi.org/10.2460/ajvr.25.09.0318. Open access, CC BY-NC.
Download PDFIdentification of alpha-2-macroglobulin as a master inhibitor of cartilage-degrading factors that attenuates the progression of post-traumatic osteoarthritis
In vitro and in vivo (ACLT model) evidence that supplemental intra-articular α2M reduces catabolic enzymes and cytokines and favors anabolic gene expression.
Wang S, Wei X, Zhou J, et al. Arthritis Rheumatol. 2014;66(7):1843-1853.
Download PDFAlpha-2-macroglobulin: a physiological guardian
Review of α2M structure and function: the bait-region trapping mechanism, receptor-mediated clearance, and modulation of cytokines, hormones and growth factors.
Rehman AA, Ahsan H, Khan FH. J Cell Physiol. 2013;228(8):1665-1675.
Download PDFAlpha-2-macroglobulin, a native and powerful proteinase inhibitor, prevents cartilage degeneration disease by inhibiting the majority of catabolic enzymes and cytokines
Review of α2M injection as a non-operative strategy that may delay the progression of osteoarthritis by inhibiting the catabolic enzymes and cytokines that degrade cartilage.
Zhu M, Zhao B, Wei L, Wang S. Curr Mol Biol Rep. 2021;7:1-7.
Download PDFThe effectiveness of alpha-2-macroglobulin injections for osteoarthritis of the knee (human study)
Human study in which α2M showed effectiveness comparable to corticosteroids in knee osteoarthritis, with both appearing more effective than traditional PRP injection.
Thompson K, Klein D, Campbell K, et al. AANA e-poster abstracts, 2021; Arthroscopy 2022 supplement.
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Technical bulletins and white papers
Alpha-2-macroglobulin: a novel orthobiologic (technical bulletin)
The multi-modal mechanism of action: non-specific protease inhibition, cytokine and growth factor modulation, and gene regulation, with the primary literature.
Download PDFAlpha2EQ® for the management of equine recurrent uveitis
Based on the anti-inflammatory activity of α2M and its ability to inhibit proteases including collagenases, the molecule was considered as a potential addition to the management of equine recurrent uveitis.
Download PDFAlpha-2-macroglobulin for the management of equine asthma (white paper)
Full pilot study on nebulized α2M for airway inflammation.
Download PDFAlpha2EQ® nebulizing pilot study summary
Two-page summary of the equine asthma pilot study.
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Processing guides
Alpha2EQ® QuickStart guide
Easy reference for processing. Full instruction sheets are inside each kit.
Download PDFAlpha2EQ® best practices
Suggested dosing by site, handling, freezing and the nebulizing protocol.
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