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Die Unfallchirurgie

Erschienen in:

01.07.2006 | Leitthema

Stellenwert der Gentherapie in Unfallchirurgie und Orthopädie

verfasst von: Dr. A. Oberholzer, P. Stahel, S. K. Tschöke, W. Ertel

Erschienen in: Die Unfallchirurgie | Ausgabe 7/2006

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Zusammenfassung

Mit Hilfe molekularbiologischer und gentechnologischer Methoden kann durch den Transfer von spezifischen Genen das Erbgut einer Zelle verändert werden. Hierdurch werden die Zellfunktionen so moduliert, dass die Zelle, die durch das implantierte Gen verschlüsselte Funktionen erhält, Proteine synthetisiert, die sie normalerweise nicht oder nur in geringen Mengen produziert.

Wie erste tierexperimentelle Studien zeigen, kann die Gentherapie die Heilungs- und Regenerationsfähigkeit der Haut, von Sehnen, Knorpel und Knochen unterstützen und beschleunigen. In jüngster Zeit werden in Tierversuchen neue Vektoren mit einer geringeren Immunogenität und verbesserten Steuerbarkeit sowie einer erhöhten Transfersicherheit getestet. Es ist zu erwarten, dass die Gentherapie in den nächsten Jahrzehnten bei der Frakturheilung, der Sanierung von Knorpelschäden und für die Behandlung von Infektionen einen bedeutenden Stellenwert einnehmen wird.

Anonymus (2003) French gene therapy group reports on the adverse event in a clinical trial of gene therapy for X-linked severe combined immune deficiency (X-SCID). Position statement from the European Society of Gene Therapy. J Gene Med 5(1): 82–84CrossRefPubMed

Alba R, Bosch A and Chillon M (2005) Gutless adenovirus: last-generation adenovirus for gene therapy. Gene Ther 12(Suppl 1): 18–27CrossRef

Baker AH (2003) Adenoviral vectors for gene therapy. Mol Biotechnol 25(1): 101–102CrossRef

Baltzer AW, Lattermann C, Whalen JD et al. (2000) Genetic enhancement of fracture repair: healing of an experimental segmental defect by adenoviral transfer of the BMP-2 gene. Gene Ther 7(9): 734–739CrossRefPubMed

Bandara G, Mueller GM, Galea-Lauri J et al. (1993) Intraarticular expression of biologically active interleukin 1-receptor-antagonist protein by ex vivo gene transfer. Proc Natl Acad Sci U S A 90(22): 10764–10768CrossRefPubMed

Bandara G, Robbins PD, Georgescu HI et al. (1992) Gene transfer to synoviocytes: prospects for gene treatment of arthritis. DNA Cell Biol 11(3): 227–231PubMed

Bello YM, Falabella AF, Eaglstein WH (2001) Tissue-engineered skin. Current status in wound healing. Am J Clin Dermatol 2(5): 305–313CrossRefPubMed

Blesch A, Lu P, Tuszynski MH (2002) Neurotrophic factors, gene therapy, and neural stem cells for spinal cord repair. Brain Res Bull 57(6): 833–838CrossRefPubMed

Blesch A, Tuszynski MH (2004) Gene therapy and cell transplantation for Alzheimer’s disease and spinal cord injury. Yonsei Med J 45(Suppl): 28–31PubMed

10.

Bohrer H, Qiu F, Zimmermann T et al. (1997) Role of NFkappaB in the mortality of sepsis. J Clin Invest 100(5): 972–985PubMed

11.

Boissier MC, Bessis N (2004) Therapeutic gene transfer for rheumatoid arthritis. Reumatismo 56(1 Suppl 1): 51–61

12.

Buchholz CJ, Stitz J, Cichutek K (1999) Retroviral cell targeting vectors. Curr Opin Mol Ther 1(5): 613–624PubMed

13.

Bullock MR, Lyeth BG, Muizelaar JP (1999) Current status of neuroprotection trials for traumatic brain injury: lessons from animal models and clinical studies. Neurosurgery 45(2): 207–220CrossRefPubMed

14.

Cao L, Liu L, Chen ZY et al. (2004) Olfactory ensheathing cells genetically modified to secrete GDNF to promote spinal cord repair. Brain 127(3): 535–549CrossRefPubMed

15.

Chen ZQ, Tang YQ, Zhang Y et al. (2004) Adenoviral transfer of human interleukin-10 gene in lethal pancreatitis. World J Gastroenterol 10(20): 3021–3025PubMed

16.

Chesnoy S, Lee PY, Huang L (2003) Intradermal injection of transforming growth factor-beta1 gene enhances wound healing in genetically diabetic mice. Pharm Res 20(3): 345–350CrossRefPubMed

17.

Conary JT, Parker RE, Christman BW et al. (1994) Protection of rabbit lungs from endotoxin injury by in vivo hyperexpression of the prostaglandin G/H synthase gene. J Clin Invest 93(4): 1834–1840PubMed

18.

Crombleholme TM (2000) Adenoviral-mediated gene transfer in wound healing. Wound Repair Regen 8(6): 460–472CrossRefPubMed

19.

Crystal RG (1995) Transfer of genes to humans: early lessons and obstacles to success. Science 270(5235): 404–410PubMed

20.

Csimma C, Swiontkowski MF (2005) Large clinical trials in musculoskeletal trauma: are they possible? Lessons learned from the international study of the use of rhBMP-2 in open tibial fractures. J Bone Joint Surg Am 87(1): 218–222CrossRefPubMed

21.

Dai Q, Manfield L, Wang Y, Murrell GA (2003) Adenovirus-mediated gene transfer to healing tendon – enhanced efficiency using a gelatin sponge. J Orthop Res 21(4): 604–609CrossRefPubMed

22.

Davidson JM, Eming SA, Dasgupta J (2003) Particle-mediated gene therapy of wounds. Methods Mol Med 78: 433–452PubMed

23.

DeGraba TJ, Pettigrew LC (2000) Why do neuroprotective drugs work in animals but not humans? Neurol Clin 18(2): 475–493CrossRefPubMed

24.

Domm C, Fay J, Schunke M, Kurz B (2000) Redifferentiation of dedifferentiated joint cartilage cells in alginate culture. Effect of intermittent hydrostatic pressure and low oxygen partial pressure. Orthopade 29(2): 91–99PubMed

25.

Doukas J, Chandler LA, Gonzalez AM et al. (2001) Matrix immobilization enhances the tissue repair activity of growth factor gene therapy vectors. Hum Gene Ther 12(7): 783–798CrossRefPubMed

26.

Eming SA, Medalie DA, Tompkins RG et al. (1998) Genetically modified human keratinocytes overexpressing PDGF-A enhance the performance of a composite skin graft. Hum Gene Ther 9(4): 529–539PubMed

27.

Evans CH and Robbins PD (1995) Possible orthopaedic applications of gene therapy. J Bone Joint Surg Am 77(7): 1103–1114PubMed

28.

Evans CH, Robbins PD, Ghivizzani SC et al. (2005) Gene transfer to human joints: progress toward a gene therapy of arthritis. Proc Natl Acad Sci USA 102(24): 8698–8703CrossRefPubMed

29.

Firsching R, Woischneck D (2001) Present status of neurosurgical trauma in Germany. World J Surg 25(9): 1221–1223CrossRefPubMed

30.

Gao GP, Yang Y, Wilson JM (1996) Biology of adenovirus vectors with E1 and E4 deletions for liver–directed gene therapy. J Virol 70(12): 8934–8943PubMed

31.

Gao X, Huang L (1991) A novel cationic liposome reagent for efficient transfection of mammalian cells. Biochem Biophys Res Commun 179(1): 280–285CrossRefPubMed

32.

Gerich TG, Lobenhoffer P, Fu FH et al. (1997) Possibilities of gene therapy in traumatic and degenerative articular lesions. Current status of experimental and initial clinical applications. Orthopade 26(5): 450–458PubMed

33.

Girod A, Ried M, Wobus C et al. (1999) Genetic capsid modifications allow efficient re-targeting of adeno-associated virus type 2. Nat Med 5(12): 1438CrossRef

34.

Govender S, Csimma C, Genant HK et al. (2002) Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am 84(12): 2123–2134CrossRefPubMed

35.

Greenberg JE, Falabella AF, Bello YM, Schachner LA (2003) Tissue-engineered skin in the healing of wound stumps from limb amputations secondary to purpura fulminans. Pediatr Dermatol 20(2): 169–172CrossRefPubMed

36.

Gresch O, Engel FB, Nesic D et al. (2004) New non-viral method for gene transfer into primary cells. Methods 33(2): 151–163CrossRefPubMed

37.

Grill R, Murai K, Blesch A et al. (1997) Cellular delivery of neurotrophin-3 promotes corticospinal axonal growth and partial functional recovery after spinal cord injury. J Neurosci 17(14): 5560–5572PubMed

38.

Hannallah D, Peng H, Young B et al. (2004) Retroviral delivery of Noggin inhibits the formation of heterotopic ossification induced by BMP-4, demineralized bone matrix, and trauma in an animal model. J Bone Joint Surg Am 86(1): 80–91PubMed

39.

Hannallah D, Peterson B, Lieberman JR et al. (2003) Gene therapy in orthopaedic surgery. Instr Course Lect 52: 753–768PubMed

40.

Huard J, Lochmuller H, Acsadi G et al. (1995) The route of administration is a major determinant of the transduction efficiency of rat tissues by adenoviral recombinants. Gene Ther 2(2): 107–115PubMed

41.

Ido A, Numata M, Kodama M, Tsubouchi H (2005) Mucosal repair and growth factors: recombinant human hepatocyte growth factor as an innovative therapy for inflammatory bowel disease. J Gastroenterol 40(10): 925–931CrossRefPubMed

42.

Janat-Amsbury MM, Yockman JW, Lee M et al. (2005) Local, non-viral IL-12 gene therapy using a water soluble lipopolymer as carrier system combined with systemic paclitaxel for cancer treatment. J Control Release 101(1–3): 273–285

43.

Jeschke MG, Schubert T, Klein D (2004) Exogenous liposomal IGF-I cDNA gene transfer leads to endogenous cellular and physiological responses in an acute wound. Am J Physiol Regul Integr Comp Physiol 286(5): 958–966

44.

Johnstone B, Hering TM, Caplan AI et al. (1998) In vitro chondrogenesis of bone marrow-derived mesenchymal progenitor cells. Exp Cell Res 238(1): 265–272CrossRefPubMed

45.

Keswani SG, Katz AB, Lim FY et al. (2004) Adenoviral mediated gene transfer of PDGF-B enhances wound healing in type I and type II diabetic wounds. Wound Repair Regen 12(5): 497–504CrossRefPubMed

46.

Kim SH, Lechman ER, Kim S et al. (2002) Ex vivo gene delivery of IL-1Ra and soluble TNF receptor confers a distal synergistic therapeutic effect in antigen-induced arthritis. Mol Ther 6(5): 591–600CrossRefPubMed

47.

Klein RM, Wolf ED, Wu R, Sanford JC (1992) High-velocity microprojectiles for delivering nucleic acids into living cells, 1987. Biotechnology 24: 384–386PubMed

48.

Knowles MR, Noone PG, Hohneker K et al. (1998) A double-blind, placebo controlled, dose ranging study to evaluate the safety and biological efficacy of the lipid-DNA complex GR213487B in the nasal epithelium of adult patients with cystic fibrosis. Hum Gene Ther 9(2): 249–269PubMed

49.

Lattermann C, Zelle BA, Whalen JD et al. (2004) Gene transfer to the tendon-bone insertion site. Knee Surg Sports Traumatol Arthrosc 12(5): 510–515CrossRefPubMed

50.

Lee CW, Martinek V, Usas A et al. (2002) Muscle-based gene therapy and tissue engineering for treatment of growth plate injuries. J Pediatr Orthop 22(5): 565–572CrossRefPubMed

51.

Lemarchand P, Jaffe HA, Danel C et al. (1992) Adenovirus-mediated transfer of a recombinant human alpha 1-antitrypsin cDNA to human endothelial cells. Proc Natl Acad Sci USA 89(14): 6482–6486CrossRefPubMed

52.

Lieberman JR, Le LQ, Wu L et al.(1998) Regional gene therapy with a BMP-2-producing murine stromal cell line induces heterotopic and orthotopic bone formation in rodents. J Orthop Res 16(3): 330–339CrossRefPubMed

53.

Liechty KW, Nesbit M, Herlyn M et al. (1999) Adenoviral-mediated overexpression of platelet-derived growth factor-B corrects ischemic impaired wound healing. J Invest Dermatol 113(3): 375–383CrossRefPubMed

54.

Lindsay JO, Sandison A, Cohen P et al. (2004) IL-10 gene therapy is therapeutic for dextran sodium sulfate-induced murine colitis. Dig Dis Sci 49(7–8): 1327–1334

55.

Litzinger DC, Huang L (1992) Phosphatidylethanolamine liposomes: drug delivery, gene transfer and immunodiagnostic applications. Biochim Biophys Acta 1113(2): 201–227PubMed

56.

Liu PY, Tong W, Liu K et al. (2004) Liposome-mediated transfer of vascular endothelial growth factor cDNA augments survival of random-pattern skin flaps in the rat. Wound Repair Regen 12(1): 80–85CrossRefPubMed

57.

Liu PY, Wang XT, Badiavas E et al. (2005) Enhancement of ischemic flap survival by prefabrication with transfer of exogenous PDGF gene. J Reconstr Microsurg 21(4): 273–279CrossRefPubMed

58.

Liu W, Wang DR, Cao YL (2004) TGF-beta: a fibrotic factor in wound scarring and a potential target for anti-scarring gene therapy. Curr Gene Ther 4(1): 123–136CrossRefPubMed

59.

Lou J, Tu Y, Burns M et al. (2001) BMP-12 gene transfer augmentation of lacerated tendon repair. J Orthop Res 19(6): 1199–202CrossRefPubMed

60.

Lu P, Blesch A, Tuszynski MH (2001) Neurotrophism without neurotropism: BDNF promotes survival but not growth of lesioned corticospinal neurons. J Comp Neurol 436(4): 456–470CrossRefPubMed

61.

Lu P, Jones LL, Snyder EY, Tuszynski MH (2003) Neural stem cells constitutively secrete neurotrophic factors and promote extensive host axonal growth after spinal cord injury. Exp Neurol 181(2): 115–129CrossRefPubMed

62.

Marcel T, Grausz JD (1996) The TMC Worldwide Gene Therapy Enrollment Report (June 1996). Hum Gene Ther 7(16): 2025–2046PubMed

63.

Marshall E (2003) Gene therapy. Second child in French trial is found to have leukemia. Science 299(5605): 320CrossRefPubMed

64.

Martinek V, Latterman C, Usas A et al. (2002) Enhancement of tendon-bone integration of anterior cruciate ligament grafts with bone morphogenetic protein-2 gene transfer: a histological and biomechanical study. J Bone Joint Surg Am 84(7): 1123–1131PubMed

65.

Mehta V, Kang Q, Luo J et al. (2005) Characterization of adenovirus-mediated gene transfer in rabbit flexor tendons. J Hand Surg Am 30(1): 136–141CrossRefPubMed

66.

Minter RM, Ferry MA, Rectenwald JE et al. (2001) Extended lung expression and increased tissue localization of viral IL-10 with adenoviral gene therapy. Proc Natl Acad Sci USA 98(1): 277–282CrossRefPubMed

67.

Moldawer LL, Edwards PD, Josephs M et al. (1999) Application of gene therapy to acute inflammatory diseases. Shock 12(2): 83–101PubMed

68.

Muller-Ladner U, Roberts CR, Franklin BN et al. (1997) Human IL-1Ra gene transfer into human synovial fibroblasts is chondroprotective. J Immunol 158(7): 3492–3498PubMed

69.

Mulligan RC (1993) The basic science of gene therapy. Science 260(5110): 926–932PubMed

70.

Musgrave DS, Bosch P, Ghivizzani S et al. (1999) Adenovirus-mediated direct gene therapy with bone morphogenetic protein-2 produces bone. Bone 24(6): 541–547CrossRefPubMed

71.

Nakamura N, Shino K, Natsuume T et al. (1998) Early biological effect of in vivo gene transfer of platelet-derived growth factor (PDGF)-B into healing patellar ligament. Gene Ther 5(9): 1165–1170CrossRefPubMed

72.

Nanney LB, Paulsen S, Davidson MK et al. (2000) Boosting epidermal growth factor receptor expression by gene gun transfection stimulates epidermal growth in vivo. Wound Repair Regen 8(2): 117–127CrossRefPubMed

73.

Neumann E, Judex M, Kullmann F et al. (2002) Inhibition of cartilage destruction by double gene transfer of IL-1Ra and IL-10 involves the activin pathway. Gene Ther 9(22): 1508–1519CrossRefPubMed

74.

Nixon AJ, Haupt JL, Frisbie DD et al. (2005) Gene-mediated restoration of cartilage matrix by combination insulin-like growth factor-I/interleukin-1 receptor antagonist therapy. Gene Ther 12(2): 177–186CrossRefPubMed

75.

Oberholzer C, Oberholzer A, Bahjat FR et al. (2001) Targeted adenovirus–induced expression of IL-10 decreases thymic apoptosis and improves survival in murine sepsis. Proc Natl Acad Sci USA 98(20): 11503–11508CrossRefPubMed

76.

Palmer RR, Lewis AL, Kirkwood LC et al. (2004) Biological evaluation and drug delivery application of cationically modified phospholipid polymers. Biomaterials 25(19): 4785–4796CrossRefPubMed

77.

Pascher A, Steinert AF, Palmer GD et al. (2004) Enhanced repair of the anterior cruciate ligament by in situ gene transfer: evaluation in an in vitro model. Mol Ther 10(2): 327–336CrossRefPubMed

78.

Peterson B, Iglesias R, Zhang J et al. (2005) Genetically modified human derived bone marrow cells for posterolateral lumbar spine fusion in athymic rats: beyond conventional autologous bone grafting. Spine 30(3): 283–290CrossRefPubMed

79.

Rancan M, Morganti-Kossmann MC, Barnum SR et al. (2003) Central nervous system-targeted complement inhibition mediates neuroprotection after closed head injury in transgenic mice. J Cereb Blood Flow Metab 23(9): 1070–1074CrossRefPubMed

80.

Robbins PD, Ghivizzani SC (1998) Viral vectors for gene therapy. Pharmacol Ther 80(1): 35–47CrossRefPubMed

81.

Rogy MA, Auffenberg T, Espat NJ et al. (1995) Human tumor necrosis factor receptor (p55) and interleukin 10 gene transfer in the mouse reduces mortality to lethal endotoxemia and also attenuates local inflammatory responses. J Exp Med 181(6): 2289–2293CrossRefPubMed

82.

Romano G, Pacilio C, Giordano A (1999) Gene transfer technology in therapy: current applications and future goals. Stem Cells 17(4): 191–202PubMed

83.

Schaefer DJ, Klemt C, Zhang XH, Stark GB (2000) Tissue engineering with mesenchymal stem cells for cartilage and bone regeneration. Chirurg 71(9): 1001–1018CrossRefPubMed

84.

Schmidt OI, Heyde CE, Ertel W, Stahel PF (2005) Closed head injury – an inflammatory disease? Brain Res Brain Res Rev 48(2): 388–399CrossRefPubMed

85.

Seggewiss R, Dunbar CE (2005) A new direction for gene therapy: intrathymic T cell-specific lentiviral gene transfer. J Clin Invest 115(8): 2064–2067CrossRefPubMed

86.

Shea LD, Houchin TL (2004) Modular design of non-viral vectors with bioactive components. Trends Biotechnol 22(9): 429–431CrossRefPubMed

87.

Smeets RL, van de Loo FA, Arntz OJ et al. (2003) Adenoviral delivery of IL-18 binding protein C ameliorates collagen-induced arthritis in mice. Gene Ther 10(12): 1004–1011CrossRefPubMed

88.

Smith L, Byers JF (2002) Gene therapy in the post-Gelsinger era. JONAS Healthc Law Ethics Regul 4(4): 104–110CrossRefPubMed

89.

Sun L, Xu L, Chang H, Henry FA et al. (1997) Transfection with aFGF cDNA improves wound healing. J Invest Dermatol 108(3): 313–318CrossRefPubMed

90.

Supp DM, Supp AP, Bell SM, Boyce ST (2000) Enhanced vascularization of cultured skin substitutes genetically modified to overexpress vascular endothelial growth factor. J Invest Dermatol 114(1): 5–13CrossRefPubMed

91.

Tarkka T, Sipola A, Jamsa T et al. (2003) Adenoviral VEGF-A gene transfer induces angiogenesis and promotes bone formation in healing osseous tissues. J Gene Med 5(7): 560–566CrossRefPubMed

92.

Tarner IH, Slavin AJ, McBride J et al. (2003) Treatment of autoimmune disease by adoptive cellular gene therapy. Ann NY Acad Sci 998: 512–519CrossRefPubMed

93.

Tinsley R, Eriksson P (2004) Use of gene therapy in central nervous system repair. Acta Neurol Scand 109(1): 1–8CrossRefPubMed

94.

Tuszynski MH, Grill R, Jones LL, McKay HM, Blesch A (2002) Spontaneous and augmented growth of axons in the primate spinal cord: effects of local injury and nerve growth factor-secreting cell grafts. J Comp Neurol 449(1): 88–101CrossRefPubMed

95.

Tyrone JW, Mogford JE, Chandler LA et al. (2000) Collagen-embedded platelet-derived growth factor DNA plasmid promotes wound healing in a dermal ulcer model. J Surg Res 93(2): 230–236CrossRefPubMed

96.

Vaccaro AR, Patel T, Fischgrund J et al. (2005) A 2-year follow-up pilot study evaluating the safety and efficacy of op-1 putty (rhbmp-7) as an adjunct to iliac crest autograft in posterolateral lumbar fusions. Eur Spine J 14(7): 623–629CrossRefPubMed

97.

Varley AW, Geiszler SM, Gaynor RB, Munford RS (1997) A two-component expression system that responds to inflammatory stimuli in vivo. Nat Biotechnol 15(10): 1002–1006CrossRefPubMed

98.

Viggeswarapu M, Boden SD, Liu Y et al. (2001) Adenoviral delivery of LIM mineralization protein-1 induces new-bone formation in vitro and in vivo. J Bone Joint Surg Am 83(3): 364–376CrossRefPubMed

99.

Wang XT, Liu PY, and Tang JB (2004) Tendon healing in vitro: genetic modification of tenocytes with exogenous PDGF gene and promotion of collagen gene expression. J Hand Surg Am 29(5): 884–890CrossRefPubMed

100.

Waterhouse JE, Harbottle RP, Keller M et al. (2005) Synthesis and application of integrin targeting lipopeptides in targeted gene delivery. Chembiochem 6(7): 1212–1223CrossRefPubMed

101.

Weiss YG, Maloyan A, Tazelaar J et al. (2002) Adenoviral transfer of HSP–70 into pulmonary epithelium ameliorates experimental acute respiratory distress syndrome. J Clin Invest 110(6): 801–806CrossRefPubMed

102.

Wickham TJ, Carrion ME, Kovesdi I (1995) Targeting of adenovirus penton base to new receptors through replacement of its RGD motif with other receptor-specific peptide motifs. Gene Ther 2(10): 750–756PubMed

103.

Xing Z, Ohkawara Y, Jordana M, Graham FL, Gauldie J (1997) Adenoviral vector-mediated interleukin-10 expression in vivo: intramuscular gene transfer inhibits cytokine responses in endotoxemia. Gene Ther 4(2): 140–149CrossRefPubMed

104.

Yamamoto A, Fukuda A, Seto H et al. (2003) Suppression of arthritic bone destruction by adenovirus-mediated dominant-negative Ras gene transfer to synoviocytes and osteoclasts. Arthritis Rheum 48(9): 2682–2692CrossRefPubMed

105.

Yang M, Ma QJ, Dang GT et al. (2005) In vitro and in vivo induction of bone formation based on ex vivo gene therapy using rat adipose-derived adult stem cells expressing BMP-7. Cytotherapy 7(3): 273–281CrossRefPubMed

106.

Yenari MA, Sapolsky RM (2005) Gene therapy in neurological disease. Methods Mol Med 104: 75–88PubMed

107.

Yoshioka T, Okada T, Maeda Y et al. (2004) Adeno-associated virus vector-mediated interleukin-10 gene transfer inhibits atherosclerosis in apolipoprotein E-deficient mice. Gene Ther 11(24): 1772–1779CrossRefPubMed

108.

Zhang HG, Zhou T, Yang P et al. (1998) Inhibition of tumor necrosis factor alpha decreases inflammation and prolongs adenovirus gene expression in lung and liver. Hum Gene Ther 9(13): 1875–1884PubMed

Titel: Stellenwert der Gentherapie in Unfallchirurgie und Orthopädie
verfasst von: Dr. A. Oberholzer
P. Stahel
S. K. Tschöke
W. Ertel
Publikationsdatum: 01.07.2006
Verlag: Springer-Verlag
Erschienen in: Die Unfallchirurgie / Ausgabe 7/2006
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI: https://doi.org/10.1007/s00113-006-1127-0

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