Institute of Regenerative Sports Medicine in Fort Lauderdale

A2M

Alpha-2-Macroglobulin (A2M) is a naturally occurring molecule that exists in your blood. It is the largest non-immunoglobulin protein in blood plasma. This protein is synthesized mainly in the liver, but it can also be produced locally by macrophages (immune cells).

While it is naturally occurring and protective of the human body, its large molecular size and complex nature limits its ability to travel to a joint or to a spinal disc space. Not enough natural A2M is present in the synovial fluid of a joint in order to inactivate the high concentrations of catabolic (destructive) factors found in osteoarthritis.

Alpha-2-Macroglobulin acts as an anti-protease, meaning it stops or slows down the breakdown of proteins. It functions as an inhibitor of blood clot breakdown (fibrinolysis) by inhibiting plasmin and kallikrein. A2M may also act as a carrier protein, because it also binds to numerous growth factors and cytokines – such as platelet-derived growth factor (PDGF), basic fibroblast growth factor (FGF), transforming growth factor beta (TGF-B), insulin, and interleukin 1B (IL-1B).

Findings suggest that treatment with supplemental joint injections with A2M helps protect the existing cartilage in post-traumatic osteoarthritis and other types of arthritis. Alpha-2-Macroglobulin includes two areas that bind and capture proteases, which are destructive enzymes. After the binding process is complete, the A2M molecules are eliminated from the body via natural bodily processes.

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