title: The adjunctive effect of a binding peptide on bone morphogenetic protein enhanced bone healing in a rodent model of spinal fusion.
abstract: METHODS
  A prospective 8-week interventional trial employing a rat model of spinal fusion to test the effect on bone morphogenetic protein binding peptide (BBP) on rhBMP-2 induced bone healing.
  
  
  OBJECTIVE
  To determine if the addition of BBP to the collagen sponges used as a carrier for rhBMP-2 reduces the amount of rhBMP-2 required to achieve a satisfactory clinical outcome.
  
  
  BACKGROUND
  Bone morphogenetic proteins (BMPs) although effective in promoting osseous growth and spinal fusion have limitations in their extensive use because of higher costs and possible adverse effects including ectopic bone formation and local inflammatory reaction, particularly in the cervical spine.
  
  
  METHODS
  Posterolateral intertransverse process spinal fusion at L4-L5 was performed in Lewis rats. Two doses of BBP (500 microg, and 1000 microg) were tested with or without "low dose" (1 microg) rhBMP-2 and the results were compared with the low dose (1 microg) rhBMP-2. Fusion was evaluated by radiology, histology, and manual palpation tests.
  
  
  RESULTS
  Radiology revealed significant earlier fusion with 1000 microg BBP + 1 microg BMP-2 combination when compared with low dose BMP-2 (1 microg) only (P < 0.05). Manual palpation and histology at eighth week revealed higher rate of fusion with the same combination with a nearly significant difference (P = 0.057).
  
  
  CONCLUSIONS
  Specific growth factor binding agents, such as BBP, can be compounded into carriers used in fusion procedures to decrease the dosage of BMP and possibly decrease the side effects which are most likely dose-related. This may also decrease costs and improve clinical outcomes.
authors.affiliation: Department of Orthopaedics and Traumatology; Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alanay
authors.forename: Chihui
authors.initials: C
authors.lastname: Chen
authors.forename: Sang
authors.initials: S
authors.lastname: Lee
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Murray
authors.forename: Elsa J
authors.initials: EJ
authors.lastname: Brochmann
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Antonia
authors.initials: A
authors.lastname: Napoli
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
mesh_terms: D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage*; D018786:Bone Substitutes / Q000008:administration & dosage; D016503:Drug Delivery Systems / Q000379:methods; D004357:Drug Synergism; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000601:surgery; D023421:Models, Animal; D010012:Osteogenesis / Q000187:drug effects* / Q000502:physiology; D011485:Protein Binding / Q000187:drug effects / Q000502:physiology; D051381:Rats; D011917:Rats, Inbred Lew; D011994:Recombinant Proteins / Q000008:administration & dosage*; D013123:Spinal Fusion / Q000379:methods*; D016212:Transforming Growth Factor beta / Q000008:administration & dosage*
chemical_list: D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2