Expression of adenovirally delivered gene products in healing osseous tissues

Gene therapy has moved from the promise of laboratory investigation to the reality of clinical practice in just the last decade, Various methods for d elivery of genes to host cells have been developed and utilized both in vit ro and in vivo. From the perspective of the plastic surgeon, gene therapy h olds the promise to augment healing in clinical situations that remain diff icult to treat, such as chronic wounds, osteoradionecrosis, or possibly to expedite current clinical practices, such as distraction osteogenesis. The authors chose to investigate the potential for gene therapy in osseous tiss ues using a replication-deficient adenovirus vector to deliver the marker t ransgene beta-galactosidase. An adenovirus vector is ideal for use in situa tions in which transgene expression is desired for only a relatively short period of time, such as wound and fracture healing. Utilizing a rat mandibu lar osteotomy model, they demonstrated that, using an adenoviral vector, fo reign genes can be delivered in a simple fashion and can be expressed in a reliable manner within and around the osteotomy site for at least 10 days. Furthermore, there was no evidence of transfection of distant tissues assoc iated with local application of the adenovirus vector. With this informatio n, clinicians may now attempt to deliver osteogenic and angiogenic genes in a site-specific fashion to improve and expedite osseous healing.