Recombinant human bone morphogenetic protein-2: a novel osteoinductive alternative to autogenous bone graft?
Autogenous bone grafts from the iliac crest have long been the gold standard for repair and reconstruction of bone; however harvesting of the grafts from the iliac crest is associated with donor site morbidity, particularly chronic pain. The bone morphogenetic proteins (BMPs) are soluble bone matrix glycoproteins that induce the differentiation of osteoprogenitor cells into osteogenic cells and have the potential to act as autogenous bone graft substitutes. BMP-2, which can be produced with recombinant technology, is highly osteoinductive, inducing bone formation by stimulating the differentiation of mesenchymal cells into chrondroblasts and osteoblasts. At present, more than 1,000 patients have received rhBMP-2 in clinical trials for acute open tibial fracture and interbody fusion procedures for the treatment of degenerative disc disease. Data suggest that rhBMP-2 therapy may offer an effective alternative to autogenous bone graft for recalcitrant bone unions and spinal fusion, obviating donor site morbidity.
Szpalski
Marek
M
Department of Orthopaedics, Hôpitaux Iris Sud, Bruxelles, Belgium and Eeuwfeest Kliniek, Antwerpen, Belgium. marek.szpalski@win.be
Gunzburg
Robert
R
D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D016723:Bone Remodeling; D016025:Bone Transplantation; D002454:Cell Differentiation; D017102:Fracture Healing; D006801:Humans; D011994:Recombinant Proteins; D013123:Spinal Fusion; D013978:Tibial Fractures / Q000188:drug therapy / Q000601:surgery; D016212:Transforming Growth Factor beta / Q000494:pharmacology / Q000627:therapeutic use*
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2