Gene therapy for osteoarthritis - New perspectives for the twenty-first century

Morphologic changes observed in osteoarthritis include cartilage erosion an d a variable degree of synovial inflammation, Proinflammatory cytokines suc h as interleukin-1 beta, locally produced by the inflamed synovium, also li kely contribute to these alterations. Despite an extensive armamentarium an d numerous surgical options, osteoarthritis remains incurable, and an impro ved approach in the treatment of this disease is imperative. Drug delivery is a major weakness of existing antiarthritic therapies. Local delivery of antiinflammatory cytokines or the in vivo induction of their expression usi ng gene transfer may provide a novel approach for the treatment of osteoart hritis. Evidence of the efficacy of gene therapy in osteoarthritis remains very scarce. To the authors' knowledge, there is no clinical research proto col en route for the treatment of osteoarthritis using gene therapy. The au thors present the only two studies that have proved successful in treating animal models of osteoarthritis using gene therapy, and propose an overview of several strategies far the development of gene therapy in osteoarthriti s treatment in the future.