Background: :
Intervertebral Disc (IVD) degeneration is a major public health concern, and
gene therapy seems a promising approach to delay or even reverse IVD degeneration. However, the
delivery system used to transfer exogenous genes into intervertebral disc cells remains a challenge.
Methods::
The MEDLINE, Web of Science, and Scopus databases were searched for English-language
articles related to gene therapy for IVD degeneration articles from 1999 to May 2019. The keywords
included “gene therapy” AND “intervertebral disc”. The history of the development of different delivery
systems was analysed, and the latest developments in viral and non-viral vectors for IVD degeneration
treatment were reviewed.
Results: :
Gene therapy delivery systems for IVD degeneration are divided into two broad categories:
viral and non-viral vectors. The most commonly used viral vectors are adenovirus, adeno-associated
virus (AAV), and lentivirus. Enthusiasm for the use of adenovirus vectors has gradually declined and
has been replaced by a preference for lentivirus and AAV vectors. New technologies, such as RNAi
and CRISPR, have further enhanced the advantage of viral vectors. Liposomes are the classic non-viral
vector, and their successors, polyplex micelles and exosomes, have more potential for use in gene therapy
for IVD degeneration.
Conclusion::
Lentivirus and AAV are the conventional viral vectors used in gene therapy for IVD degeneration,
and the new technologies RNAi and CRISPR have further enhanced their advantages. Nonviral
vectors, such as polyplex micelles and exosomes, are promising gene therapy vectors for IVD degeneration.
Baseline audit of manipulation and management of intravenous therapy delivery systems
