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-lra) 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 I jection 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 -5 weeks. Knee joints expressing human IRAP were protected from the leukocytosis that otherwise follows the intraarticular injection of recombinant human interleukin 1p3. Thus, we report the intraarticular expression and activity of a potentially therapeutic protein by genetransfer technology; these experiments demonstrate the feasibility of treating arthritis and other joint disorders with gene therapy.Arthritis is a chronic, debilitating condition affecting over 30 million Americans (1). Presently incurable, it remains the agent of considerable suffering and economic loss. Therapeutic intervention in arthritis is hindered by a number of factors, including difficulties in targeting drugs to joints. Proteins are particularly vulnerable to this restriction, which is of special concern, as many new agents with considerable antiarthritic potential are proteins. As an alternative to traditional methods of drug delivery, we have suggested the transfer oftherapeutic genes to the synovial lining ofjoints (2,3). Expression of these genes would overcome proteindelivery problems and lead to the intraarticular accumulation of the gene products at the site of disease, with reduced exposure of nontarget organs.Using the rabbit knee joint as a model system, we are therefore developing in vivo and ex vivo methods for delivering genes to joints. This model takes advantage of the similarity in size between the knee joint of the rabbit and the human proximal interphalangeal joint, a common site of rheumatoid arthritis. Moreover, there exists a large body of literature on the biology of the rabbit's knee, including well-established methods for synovial cell culture (e.g., refs. 4-6). Here we report the transfer to synovium of two marker genes and one potentially therapeutic gene by an ex vivo approach. Intraarticular expression of the interleukin 1-re-The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact. (rhIL-1,8). These results demonstrate the feasibility of ...
Gene therapy with insulin-like growth factor-1 (IGF-1) increases matrix production and enhances chondrocyte proliferation and survival in vitro. The purpose of this study was to determine whether arthroscopically-grafted chondrocytes genetically modified by an adenovirus vector encoding equine IGF-1 (AdIGF-1) would have a beneficial effect on cartilage healing in an equine femoropatellar joint model. A total of 16 horses underwent arthroscopic repair of a single 15 mm cartilage defect in each femoropatellar joint. One joint received 2 x 10(7) AdIGF-1 modified chondrocytes and the contralateral joint received 2 x 10(7) naive (unmodified) chondrocytes. Repairs were analysed at four weeks, nine weeks and eight months after surgery. Morphological and histological appearance, IGF-1 and collagen type II gene expression (polymerase chain reaction, in situ hybridisation and immunohistochemistry), collagen type II content (cyanogen bromide and sodium dodecyl sulphate-polyacrylamide gel electrophoresis), proteoglycan content (dimethylmethylene blue assay), and gene expression for collagen type I, matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, aggrecanase-1, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and TIMP-3 were evaluated. Genetic modification of chondrocytes significantly increased IGF-1 mRNA and ligand production in repair tissue for up to nine weeks following transplantation. The gross and histological appearance of IGF-1 modified repair tissue was improved over control defects. Gross filling of defects was significantly improved at four weeks, and a more hyaline-like tissue covered the lesions at eight months. Histological outcome at four and nine weeks post-transplantation revealed greater tissue filling of defects transplanted with genetically modified chondrocytes, whereas repair tissue in control defects was thin and irregular and more fibrous. Collagen type II expression in IGF-1 gene-transduced defects was increased 100-fold at four weeks and correlated with increased collagen type II immunoreaction up to eight months. Genetic modification of chondrocytes with AdIGF-1 prior to transplantation improved early (four to nine weeks), and to a lesser degree long-term, cartilage healing in the equine model. The equine model of cartilage healing closely resembles human clinical cartilage repair. The results of this study suggest that cartilage healing can be enhanced through genetic modification of chondrocytes prior to transplantation.
Can social media be used to enhance the process of learning by students in Higher Education? Social media have become widely adopted by students in their personal lives. However, the application of social media to teaching and learning remains to be fully explored. In this study, the use of the social media tool Twitter for teaching was considered. Undergraduate students in Business and Management (n=252) were encouraged to use Twitter for communicating with their tutor and each other during a twelve-week course. Their involvement was evaluated using a survey considering amount of Twitter usage and students' attitudes and experiences. The data were analysed using factor analyses, which revealed a single usage construct and three attitudinal factors. Three findings emerged. Firstly, a positive correlation was found between amount of Twitter usage and student engagement in University-associated activities including organising their social lives and sharing information. Secondly, course-related tweeting was not related to interpersonal relationships between students and their tutor. Thirdly, Twitter usage did not impact class attendance. The results are salient for educational practitioners wishing to introduce social media into their teaching.
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