Autologous Serum Therapy Offers New Option for Osteoarthritis


A new injection-based modality that uses the body’s own cytokines to reduce joint inflammation was recently introduced in the US, and it has great promise for relieving joint pain, back pain, tendonitis and other symptoms of osteoarthritis (OA).

Called Regenokine, the treatment involves isolating and amplifying Interleukin-1 receptor antagonist –a naturally occurring blocker of pro-inflammatory Interleukin-1—from a patient’s own blood, and then injecting it into the affected joints. When the injections are combined with a comprehensive lifestyle program aimed at reducing inflammation, the outcomes are excellent.

Regenokine traces its origins to the German city of Dusseldorf, where orthopedic specialist Peter Wehling, MD, PhD, initially introduced the procedure, known in Europe as Orthokine. It is also called ACS or autologous conditioned serum therapy in some circles.

Dr. Wehling’s company, Orthogen AG, patented the treatment as Regenokine in 2000.

Because OA affects nearly 1 in 5 older adults, word of this effective, low-risk treatment spread quickly across the globe and soon attracted a number of high-profile patients, from Pope John Paul II to sports icons like the LA Lakers’ Kobe Bryant, and more recently the NY Yankee’s headline-grabbing third baseman, Alex “A-Rod” Rodriguez.

Within a short time, Orthokine took on a life of its own, and Dr. Wehling soon found his waiting room filled with patients from across the world seeking a drug-free, non-surgical solution to their joint pain.

The popularity of the treatment was further bolstered by a 2009 study of 310 OA patients at the Heinrich Heine University, Dusseldorf, showing markedly better two-year outcomes among those treated with Orthokine, compared with those getting hyaluronic acid or saline injections (Baltzer AW, et al. Osteoarthritis Cartilage. 2009;17(2):152-60).

In 2010, Dr. Christian Renna, DO, a physician with whom I am a naturopathic consultant, introduced this therapy—called Regenokine in the US–to his Lifespan Medicine clinic in Santa Monica, CA. Lifespan is one of two US centers providing Regenokine therapy, and the only one in the Western states.

Disarming the Cascade

Regenokine’s main mode of action is in reducing site-specific inflammation through the use of the body’s own anti-inflammatory cytokines, particularly the IL-1 receptor antagonist.

The procedure involves removing 2 ounces of the patient’s blood, which is then slightly warmed, to simulate a fever. The heat naturally increases expression of IL-1Ra. The sample is then spun in a centrifuge to separate the constituent parts. The IL-1Ra-rich fluid layer is then injected back into the joint in a series of 4-6 sessions over a time frame of 4 days to 3 weeks.

Interleukin-1 (IL-1) is an important mediator of tissue destruction in OA. Amplification of the autologous IL-1Ra blocks the inflammatory receptor on the surface of the joint, thus disarming a major driver of the pain process.

Many patients experience an immediate sense of relief. Others find improvement in the weeks to months after the injection series is completed.

“I just want to be pain-free. A friend swore by this treatment two years ago, and I refused. I wish I would have done it then. It’s nice to wake up and not have back pain,” says professional golfer, Vijay Singh. In a 2012 interview with the New York Times, Singh is quoted as saying, “the results were incredible.”

Safe & Well-Tolerated

This process not only improves quality of life, it also helps protect and preserve healthy cartilage, and works to stop the progression of the disease; all with virtually no risk of side effects.

The Regenokine injections are well tolerated by most patients; this is a non-surgical procedure and consists simply of anti-inflammatory compounds found naturally in a patient’s own blood. It can be used to treat issues in the ankles, knees, hips, shoulders, elbows, wrists, fingers, toes and spine.

The procedure has been safely used by over 60,000 OA and back pain patients worldwide, and has helped thousands of patients avoid joint surgery or surgical interventions. Though it has not yet been approved by the FDA, it has been approved by German regulators since 2003.

A Comprehensive Program

After treating hundreds of patients, it soon became apparent to both Dr. Wehling and Dr. Renna that outcomes are greatly influenced by a patient’s underlying health status. Regenokine works best in people who are living lifestyles that lower inflammation. It doesn’t work as well in people with typical Western inflammation-promoting lifestyles.

This realization prompted Dr. Renna to develop a comprehensive 12- week lifestyle program focusing on nutrition, exercise, sleep and stress.

The Regenokine Program aims to reduce inflammation, optimize blood sugar control, and obtain an optimal Body Mass Index through modifying individual lifestyle patterns.

Though the obvious goal may be reducing joint pain, the program positively impacts many other disease processes. Many patients see a reduction in risk factors associated with metabolic syndrome, diabetes and cardiovascular disease. They also experience improved energy and mental wellbeing, better sleep, and improved ability to handle stress.

In my role as a naturopath at Dr. Renna’s clinic, I follow up with patients 4-6 times over the course of the 12-week program, depending on each patient’s needs. Patients receive individualized diet plans, supplementation recommendations, sleep and stress optimization programs and exercise suggestions.

During this time frame, patients will also have sessions with a physical therapist and follow-up visits with the doctor who gave the injections.

The result of the Regenokine Treatment Program is an overall improvement in joint health, reduced pain, improved mobility, healthier lifestyle and reduced risk factors for future chronic illnesses. Through the combined use of the high-tech Regenokine injection series and the time-tested, research-backed lifestyle medicine approach patients are gaining a new lease and a fresh perspective on a pain-free life.


Bianca Garilli is a former US Marine turned Naturopathic Doctor. She is an expert in comprehensive preventive care and treating chronic illnesses with natural medicine and lifestyle changes. Dr. Garilli has worked with various clinics and groups to develop foundational health programs for their clinics and patients including co-creating the Live Longer, Live Better program at the University of California, Irvine and the Regenokine Lifestyle Medicine Program at Lifespan Medicine in Santa Monica, CA. Dr. Garilli can be reached at

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