ABSTRACT
One option to improve tissue regeneration is the use of growth factors. As a promising alternative to recombinant protein therapy, gene therapy allows local and sustained release of growth factors. This moderate and constant release is more suitable for regenerative processes compared to administration of high protein doses. Exogenous growth factors are produced by cells in situ;such highly bioactive amounts of growth factors are produced directly at the defect site, thereby highly limiting adverse off-target effects. Targeted research areas include (combinatorial) gene therapy approaches for bone/musculoskeletal tissue regeneration in vivo and ex vivo. Amongst them, new techniques such as viral and non-viral gene delivery systems, next-generation therapeutical DNA vectors for example with decreased immunogenicity, enhanced bioactivity of growth factor and enhanced gene expression. Beside DNA based gene therapy also mRNA based technologies are increasingly used and becoming popular by Covid vaccination successes. Increasing records of clinical success in the last years have constantly improved awareness of gene therapy, strengthening the enthusiasm of the community for novel and effective treatment methods providing the needed momentum for further developments.