Genetically modified chondrocytes expressing TGF-β1: a revolutionary treatment for articular cartilage damage?

Abstract

Introduction: Currently, joint arthroplasty remains the only definitive management of osteoarthritis, while other treatment modalities only provide temporary and symptomatic relief. The use of genetically engineered chondrocytes is currently undergoing clinical trials. Specifically, it has been designed to induce cartilage growth and differentiation in patients with degenerative arthritis, with the aim to play a curative role in the disease process.

Areas covered: This treatment involves the incorporation of TGF-β1, which has been determined to play an influential role in chondrogenesis and extracellular matrix synthesis. Using genetic manipulation and viral transduction, TGF-β1 is incorporated into human chondrocytes and administered in a minimally invasive fashion directly to the affected joint. Following a database literature search, we evaluated the current evidence on this product and its outcomes. Furthermore, we also briefly reviewed other treatments developed for chondrogenesis and cartilage regeneration for comparison.

Expert opinion: This treatment method has sustained positive effects on functional outcomes and cartilage growth in initial trials. It allows administration in a minimally invasive manner that does not require extended recovery time. Although several treatment modalities are currently under investigation and appear promising, we hope that these effects can be sustained in further studies. Ultimately, we anticipate that the results may be reproducible in many clinical settings and allow us to effectively treat cartilage damage in patients with degenerative arthritis.

Keywords:

• cartilage regeneration
• chondrogenesis
• osteoarthritis
• TGF-β

Declaration of interest

MA Mont receives loyalties, research support or is paid by Stryker, Wright Medical Technology, Inc., Biocomposites, DJ Orthopaedics, Janssen, Joint Active Systems, Medtronic, Sage Products, Inc., TissueGene and the NIH NIAMS & NICHD. WB Beaver receives funding from Stryker, DJ Orthopeadics, Orthosensor, Pacira Pharm, DePuy, Johnson & Johnson and DonJoy, and is a member of the ICJR OrthoCarolina Research Institute. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.