| BACKGROUNDOsteoarthritis (OA) is a common leading cause of morbidity in the aging population.It is characterised pathologically by focal areas of damage to the articular cartilage, associated with osteophytosis at the joint margins, changes in the subchondral bone, variable degrees of mild synovitis, and thickening of the joint capsule. The clinical problems associated with these pathological and radiographic changes include joint pain related to use, short-lasting inactivity stiffness of joints, pain on movement with a restricted range, and cracking of joints. Osteoarthritis is thought to be the biggest cause of the high rate of regional joint pain in older people.Cytokines and other signalling molecules released from the cartilage, synovium, and bone affect chondrocyte function. Among the known growth factors, insulin-like growth factor 1 (IGF-1), transforming growth factor beta (TGF-|3) have been shown to influence the healing of cartilage. Although the direct application of specific growth factor has a beneficial effect on the healing process of cartilage in vivo, a method for complete restoration of hyaline cartilage is still not available. The clinical use of growth factors is mainly limited by the problem of delivery. Because of the complexity of cartilage regeneration, a continuous delivery of stimulating substances is required, at least temporarily, to reach the optimum level for the treatment of osteochondral defects. At this point, the short biological half-life of growth factors represents the limiting feature for the success of such treatment.The advent of gene therapy provides new possibilities for the treatment of injuries to cartilage. Gene therapy is a technique relying on the alteration of cellular genetic information. It is applicable in the treatment of cartilage lesions by transferring genes, encoded for specific growth factors, into chondrocytes or... |
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