title: Modulation of the biologic activity of the rabbit intervertebral disc by gene therapy: an in vivo study of adenovirus-mediated transfer of the human transforming growth factor beta 1 encoding gene.
abstract: METHODS
  In vivo studies using a rabbit model to determine the biologic effects of direct, adenovirus-mediated transfer of a therapeutic gene to the intervertebral disc.
  
  
  OBJECTIVE
  1) To deliver an exogenous therapeutic gene to rabbit lumbar intervertebral discs in vivo, 2) to quantify the resulting amount of gene expression, and 3) to determine the effect on the biologic activity of the discs.
  
  
  BACKGROUND
  Although growth factors such as transforming growth factor beta 1 appear to have promising therapeutic properties, there currently is no practical method for sustained delivery of exogenous growth factors to the disc for the management of certain chronic types of disease (e.g., disc degeneration). A possible solution is to modify the disc cells genetically through gene transfer such that the cells manufacture the desired growth factors endogenously on a continuous basis.
  
  
  METHODS
  Saline, with or without virus, was injected directly into lumbar discs of 22 skeletally mature female New Zealand white rabbits. Group 1 (n = 11) received the adenovirus construct Ad/CMV-hTGF beta 1 containing the therapeutic human transforming growth factor beta 1-encoding gene. Group 2 (n = 6) received adenovirus containing the luciferase marker gene. Group 3 (n = 5) received saline only. The rabbits were killed 1 week after injection. Immunohistochemical staining for human transforming growth factor beta 1 was performed on the disc tissues of one rabbit from Group 1. Nucleus pulposus tissues from the remaining rabbits were cultured in serumless medium. Bioassays were performed to determine human transforming growth factor beta 1 production and proteoglycan synthesis.
  
  
  RESULTS
  Discs injected with Ad/CMV-hTGF beta 1 exhibited extensive and intense positive immunostaining for transforming growth factor beta 1. The nucleus pulposus tissues from the discs injected with Ad/CMV-hTGF beta 1 exhibited a 30-fold increase in active transforming growth factor beta 1 production, and a 5-fold increase in total (active + latent) transforming growth factor beta 1 production over that from intact control discs (P < 0.05). Furthermore, these tissues exhibited a 100% increase in proteoglycan synthesis compared with intact control tissue, which was statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  The results of this study suggest that the intervertebral disc is an appropriate site for adenovirus-mediated transfer of exogenous genes and subsequent production of therapeutic growth factors. Gene therapy therefore may have useful applications for study of the basic science of the intervertebral disc and for clinical management of degenerative disc disease.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania, USA.
authors.forename: K
authors.initials: K
authors.lastname: Nishida
authors.forename: J D
authors.initials: JD
authors.lastname: Kang
authors.forename: L G
authors.initials: LG
authors.lastname: Gilbertson
authors.forename: S H
authors.initials: SH
authors.lastname: Moon
authors.forename: J K
authors.initials: JK
authors.lastname: Suh
authors.forename: M T
authors.initials: MT
authors.lastname: Vogt
authors.forename: P D
authors.initials: PD
authors.lastname: Robbins
authors.forename: C H
authors.initials: CH
authors.lastname: Evans
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000818:Animals; D005260:Female; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D006801:Humans; D007150:Immunohistochemistry; D007403:Intervertebral Disc / Q000378:metabolism*; D011509:Proteoglycans / Q000378:metabolism; D011817:Rabbits; D016212:Transforming Growth Factor beta / Q000235:genetics* / Q000378:metabolism*
chemical_list: D011509:Proteoglycans; D016212:Transforming Growth Factor beta