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Gene therapy for rheumatoid arthritis
Author(s) -
Bessis Natacha,
Doucet Christelle,
Cottard Virginie,
Douar AnneMarie,
Firat Hüseyin,
Jorgensen Christian,
Mezzina Mauro,
Boissier MarieChristophe
Publication year - 2002
Publication title -
the journal of gene medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.689
H-Index - 91
eISSN - 1521-2254
pISSN - 1099-498X
DOI - 10.1002/jgm.325
Subject(s) - genetic enhancement , medicine , rheumatoid arthritis , ex vivo , immunology , monoclonal antibody , inflammation , interleukin 1 receptor antagonist , arthritis , tumor necrosis factor alpha , in vivo , receptor antagonist , receptor , cancer research , antibody , biology , gene , antagonist , biochemistry , microbiology and biotechnology
Rheumatoid arthritis (RA) is a severe autoimmune systemic disease. Chronic synovial inflammation results in destruction of the joints. No conventional treatment is efficient in RA. Gene therapy of RA targets mainly the players of inflammation or articular destruction: TNF‐α or IL‐1 blocking agents (such as anti‐TNF‐α monoclonal antibodies, soluble TNF‐α receptor, type II soluble receptor of IL‐1, IL‐1 receptor antagonist), antiinflammatory cytokines (such as IL‐4, IL‐10, IL‐1), and growth factors. In this polyarticular disease, the vector expressing the therapeutic protein can be administered as a local (intra‐articular injection) or a systemic treatment (extra‐articular injection). All the main vectors have been used in experimental models, including the more recent lentivirus and adeno‐associated virus. Ex vivo gene transfer was performed with synovial cells, fibroblasts, T cells, dendritic cells, and different cells from xenogeneic origin. In vivo gene therapy is simpler, although a less controlled method. Clinical trials in human RA have started with ex vivo retrovirus‐expressing IL‐1 receptor antagonists and have demonstrated the feasibility of the strategy of gene therapy. The best target remains to be determined and extensive research has to be conducted in preclinical studies. Copyright © 2002 John Wiley & Sons, Ltd.