Gene Therapy in Bone Regeneration: A Summary of Delivery Approaches for Effective Therapies

Abstract

Injuries involving bones are a significant burden on the health care system. While biological therapies for stimulation of bone formation and repair have advanced to clinical practise, gene delivery towards the same goal is actively explored to provide more cost-effective and efficacious therapies. The viral carriers have proven to be effective for delivery of genes involved in bone tissue regeneration, but the safety concerns associated with viral carriers prevent their widespread clinical use. Instead, a better understanding of the viral mechanisms of gene delivery is guiding the design of effective non-viral gene carriers. This chapter will review the critical features of viral carriers that make them effective in gene delivery to human cells. Intracellular events in trafficking of viral vectors are linked to viral structural features and use of functional peptide motifs for mimicking viral delivery have been summarized. Non-viral approaches to gene delivery in the context of bone regeneration and repair have been reviewed, with emphasis on the challenges facing such a gene delivery. Therapeutic outcomes obtained from animal studies were critically summarized and the range of promising agents for gene delivery has been reviewed.