Methods for gene transfer to synovium.
Development of methods for gene transfer to synoviocytes was borne from the idea that gene therapy could be used to more effectively treat rheumatoid arthritis (EU) and other joint disorders (1). Current pharmaceutical modalities in use against RA have limited effectiveness because of problems related to inefficient targeting of drugs to the joint, as well as inefficacies of the drugs themselves. Drug delivery to the joint by traditional oral, iv, and intramuscular routes, depends on passive diffusion of the drug from the synovial vasculature into the joint space (2). Thus, high systemic concentrations of the drug are necessary to achieve therapeutic intra-articular drug levels; in chronic RA, perfusion of the synovium may be compromised (3), driving required systemic drug levels even higher. This is of major concern, as the pharmaceuticals used to treat this disease are associated with serious side effects. Further compounding these problems is the chronic nature of RA, which requires lifelong treatment with high dosages of these drugs.
Orthopedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
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Kang
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Robbins
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Evans