Realizing the potential of gene-based molecular therapies in bone repair

Authors

  • Laura Rose,

    1. Department of Biomedical Engineering, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
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  • Hasan Uludağ

    Corresponding author
    1. Department of Biomedical Engineering, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
    2. Department of Chemical & Materials Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
    3. Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Canada
    • Address correspondence to: Hasan Uludağ, PhD, #2-020 RTF, Chemical & Materials Engineering Department, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2G6. E-mail: huludag@ualberta.ca

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ABSTRACT

A better understanding of osteogenesis at genetic and biochemical levels is yielding new molecular entities that can modulate bone regeneration and potentially act as novel therapies in a clinical setting. These new entities are motivating alternative approaches for bone repair by utilizing DNA-derived expression systems, as well as RNA-based regulatory molecules controlling the fate of cells involved in osteogenesis. These sophisticated mediators of osteogenesis, however, pose unique delivery challenges that are not obvious in deployment of conventional therapeutic agents. Viral and nonviral delivery systems are actively pursued in preclinical animal models to realize the potential of the gene-based medicines. This article will summarize promising bone-inducing molecular agents on the horizon as well as provide a critical review of delivery systems employed for their administration. Special attention was paid to synthetic (nonviral) delivery systems because they are more likely to be adopted for clinical testing because of safety considerations. We present a comparative analysis of dose-response relationships, as well as pharmacokinetic and pharmacodynamic features of various approaches, with the purpose of clearly defining the current frontier in the field. We conclude with the authors' perspective on the future of gene-based therapy of bone defects, articulating promising research avenues to advance the field of clinical bone repair. © 2013 American Society for Bone and Mineral Research

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