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This article reviews the role of metabolic factors, including metalloproteinases and cytokines, in the occurrence of degenerative disk disease and disk herniation. Given that mechanical factors alone cannot cause disk degeneration, studies must explore metabolic, genetic, nutritional, and age-related factors. Zinc metalloproteinases exert particularly important effects, not only directly, but also...
Current treatments for spinal disease are unsatisfactory, and gene therapy holds promise as a means of ensuring prolonged and consistent delivery of therapeutic proteins into the spine. Direct injection of vectors into spinal structures is limited by the current lack of vectors with a satisfactory efficacy and safety profile. Conversely, ex vivo gene transfer into cells from the spine or other tissues...
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