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Autologous alpha-2 macroglobulin rich plasma (A2MRP) is an investigational autologous biologic therapy developed by the Mayo Clinic for the treatment of symptomatic moderate knee osteoarthritis. The therapy is derived from the patient's own blood, which is processed to concentrate alpha-2-macroglobulin (A2M) to approximately six times its normal physiological level. A2M is a large, naturally occurring plasma protein that functions as a broad-spectrum proteinase inhibitor. It works by physically trapping and neutralizing catabolic enzymes, such as matrix metalloproteinases (MMPs) and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS), as well as inflammatory cytokines that drive cartilage degradation. By inhibiting these factors within the joint space, A2MRP aims to slow the progression of osteoarthritis and alleviate symptoms. The therapy is administered via ultrasound-guided intra-articular injection.
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