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Gene therapy offers a radical different approach to the treatment of arthritis. Here we have demonstrated that two marker genes (lacZ and neo) and cDNA coding for a potentially therapeutic protein (human interleukin 1-receptor-antagonist protein; IRAP or IL-1ra) can be delivered, by ex vivo techniques, to the synovial lining of joints; intraarticular expression of IRAP inhibited intraarticular responses to interleukin 1. To achieve this, lapine synoviocytes were first transduced in culture by retroviral infection. The genetically modified synovial cells were then transplanted by intraarticular injection into the knee joints of rabbits, where they efficiently colonized the synovium. Assay of joint lavages confirmed the in vivo expression of biologically active human IRAP. With allografted cells, IRAP expression was lost by 12 days after transfer. In contrast, autografted synoviocytes continued to express IRAP for approximately 5 weeks. Knee joints expressing human IRAP were protected from the leukocytosis that otherwise follows the intraarticular injection of recombinant human interleukin 1 beta. Thus, we report the intraarticular expression and activity of a potentially therapeutic protein by gene-transfer technology; these experiments demonstrate the feasibility of treating arthritis and other joint disorders with gene therapy.

Original publication

DOI

10.1073/pnas.90.22.10764

Type

Journal article

Journal

Proceedings of the National Academy of Sciences of the United States of America

Publication Date

11/1993

Volume

90

Pages

10764 - 10768

Addresses

Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, PA 15261.

Keywords

Synovial Membrane, Animals, Rabbits, Humans, Arthritis, Sialoglycoproteins, RNA, Messenger, Interleukin-1, Injections, Intra-Articular, Cloning, Molecular, Gene Transfer Techniques, Transfection, Gene Expression, Interleukin 1 Receptor Antagonist Protein, Genetic Therapy