Application of gene therapy in osteoarthritis.

Abstract

Osteoarthritis (OA) is a leading cause of pain and disability globally,characterized by progressive cartilage degeneration, subchondralbone remodeling, and synovial inflammation. Current treatmentsprimarily offer symptomatic relief without addressing the underlyingdisease mechanisms or halting progression. Gene therapy hasemerged as a promising strategy to target the molecular drivers ofOA by modulating key pathways involved in inflammation, tissuedegeneration, and pain. This review summarizes recent advancesin OA gene therapy, including anti-inflammatory approachestargeting IL-1β and IL-10, as well as regenerative strategiesleveraging TGF-β1 and FGF-18. Preclinical and early clinicalstudies have shown encouraging results in both symptom reliefand cartilage preservation. However, significant challengesremain, including vector safety, immune responses, and thecomplex, heterogeneous nature of OA that complicates treatmentresponse. The integration of precision medicine with improved genedelivery platforms and combinatorial therapeutic strategies holdsstrong potential to overcome these limitations. Collectively, theseinnovations may accelerate the development of disease-modifyingosteoarthritis drugs (DMOADs) and provide long-term, effectivetherapeutic options for patients.