Targeted delivery of therapeutic agents with lyophilized matrices
Embodiments of surgical grafts, and methods, for the delivery of therapeutic agents to a target tissue via acellular matrices, are described. In some embodiments, nonviable matrices are successful in preventing or lessening adhesion formation by guiding tissue repair and remodeling, while also providing the target tissue with therapeutic agents that can act as repair and remodeling factors. An exemplary method to modulate flexor tendon healing and provide elimination or reduction of fibrotic adhesions involves loading a freeze-dried flexor digitorum longus allograft with recombinant adeno-associated viral (rAAV) vectors for the targeted and transient expression of growth/differentiation factor 5 (GDF5).
1. A surgical graft, for use in promoting healing of a diseased or injured tendon, comprising:
an acellular, lyophilized, biologically derived matrix comprising a collagen; and
at least one therapeutic agent, releasably coupled to the matrix and comprising an expression system, the expression system configured to result in expression of at least one therapeutic protein;
wherein the graft is sized and shaped to be placed in a patient's body cavity in proximity to a diseased or injured tendon;
wherein, when the graft is placed in the body cavity, the at least one therapeutic agent is released into the tendon;
wherein the at least one therapeutic agent is in an amount effective to promote healing of the tendon and to reduce an amount of fibrotic adhesion of the tendon relative to a tendon that has been treated with a graft that does not include the therapeutic agent; and
wherein the expression system comprises a recombinant adeno-associated virus carrying a nucleic acid having the sequence of SEQ ID NO: 1.
2. The graft of claim 1 , wherein the healing comprises at least one of tissue remodeling, accelerating wound healing, or enhancing cell repopulation.
3. The graft of claim 1 , wherein the healing comprises at least one of improving joint flexion, improving joint range of motion, or improving tendon gliding.
4. The graft of claim 1 , wherein the collagen is derived from at least one of tendon or ligament.
5. The graft of claim 1 , wherein the at least one therapeutic agent is adsorbed to the matrix.
6. The graft of claim 1 , wherein the at least one therapeutic agent is sustained released.
7. A surgical graft, for use in promoting healing of a diseased or injured tendon, comprising:
an acellular, lyophilized, biologically derived matrix comprising a collagen; and
at least one therapeutic agent, releasably coupled to the matrix and comprising an expression system, the expression system configured to result in expression of at least one therapeutic protein;
wherein the graft is sized and shaped to be placed in a patient's body cavity in proximity to a diseased or injured tendon;
wherein, when the graft is placed in the body cavity, the at least one therapeutic agent is released into the tendon;
wherein the at least one therapeutic agent is in an amount effective to promote healing of the tendon and to reduce an amount of fibrotic adhesion of the tendon relative to a tendon that has been treated with a graft that does not include the therapeutic agent; and
wherein the expression system comprises a recombinant adeno-associated virus carrying a nucleic acid encoding a protein having the amino acid sequence of SEQ ID NO: 2.
8. The graft of claim 7 , wherein the healing comprises at least one of tissue remodeling, accelerating wound healing, or enhancing cell repopulation.
9. The graft of claim 7 , wherein the healing comprises at least one of improving joint flexion, improving joint range of motion, or improving tendon gliding.
10. The graft of claim 7 , wherein the collagen is derived from at least one of tendon or ligament.
11. The graft of claim 7 , wherein the at least one therapeutic agent is adsorbed to the matrix.
12. The graft of claim 7 , wherein the at least one therapeutic agent is sustained released.