title: rAAV-mediated overexpression of TGF-β stably restructures human osteoarthritic articular cartilage in situ.
abstract: BACKGROUND
  Therapeutic gene transfer is of significant value to elaborate efficient, durable treatments against human osteoarthritis (OA), a slow, progressive, and irreversible disorder for which there is no cure to date.
  
  
  METHODS
  Here, we directly applied a recombinant adeno-associated virus (rAAV) vector carrying a human transforming growth factor beta (TGF-β) gene sequence to primary human normal and OA chondrocytes in vitro and cartilage explants in situ to monitor the stability of transgene expression and the effects of the candidate pleiotropic factor upon the regenerative cellular activities over time.
  
  
  RESULTS
  Efficient, prolonged expression of TGF-β achieved via rAAV gene transfer enhanced both the proliferative, survival, and anabolic activities of cells over extended periods of time in all the systems evaluated (at least for 21 days in vitro and for up to 90 days in situ) compared with control (reporter) vector delivery, especially in situ where rAAV-hTGF-β allowed for a durable remodeling of OA cartilage. Notably, sustained rAAV production of TGF-β in OA cartilage advantageously reduced the expression of key OA-associated markers of chondrocyte hypertrophic and terminal differentiation (type-X collagen, MMP-13, PTHrP, β-catenin) while increasing that of protective TIMPs and of the TGF-β receptor I in a manner that restored a favorable ALK1/ALK5 balance. Of note, the levels of activities in TGF-β-treated OA cartilage were higher than those of normal cartilage, suggesting that further optimization of the candidate treatment (dose, duration, localization, presence of modulating co-factors) will most likely be necessary to reproduce an original cartilage surface in relevant models of experimental OA in vivo without triggering potentially adverse effects.
  
  
  CONCLUSIONS
  The present findings show the ability of rAAV-mediated TGF-β gene transfer to directly remodel human OA cartilage by activating the biological, reparative activities and by regulating hypertrophy and terminal differentiation in damaged chondrocytes as a potential treatment for OA or for other disorders of the cartilage that may require transplantation of engineered cells.
authors.affiliation: Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrbergerstr, Bldg 37, Homburg/Saar 66421, Germany. mmcucchiarini@hotmail.com.
authors.forename: Jagadeesh K
authors.initials: JK
authors.lastname: Venkatesan
authors.forename: Ana
authors.initials: A
authors.lastname: Rey-Rico
authors.forename: Gertrud
authors.initials: G
authors.lastname: Schmitt
authors.forename: Anna
authors.initials: A
authors.lastname: Wezel
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
authors.forename: Magali
authors.initials: M
authors.lastname: Cucchiarini
mesh_terms: D000368:Aged; D017209:Apoptosis / Q000187:drug effects; D002358:Cartilage, Articular / Q000473:pathology*; D049109:Cell Proliferation / Q000187:drug effects; D019902:Chondrocytes / Q000187:drug effects / Q000473:pathology; D000229:Dependovirus / Q000378:metabolism*; D006801:Humans; D010003:Osteoarthritis / Q000628:therapy*; D020011:Protective Agents / Q000494:pharmacology; D011995:Recombination, Genetic / Q000235:genetics; D015398:Signal Transduction / Q000187:drug effects; D014161:Transduction, Genetic; D016212:Transforming Growth Factor beta / Q000235:genetics* / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D020011:Protective Agents; D016212:Transforming Growth Factor beta
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