title: Neoplasia following use of BMPs: is there an increased risk?
abstract: BACKGROUND
  Bone morphogenetic proteins are multi-functional growth factors, which play an important role in embryonic development and cellular functions. Among several molecules in this family, BMP-2 and BMP-7 are currently being used in the clinical setting. Main clinical targets include the treatment of non-union, open fractures and spinal fusion. Their use has not been without complications, one of which might be a carcinogenic effect.
  
  
  METHODS
  The authors offer a comprehensive review of the existing literature on the clinical studies analysing the role of bone morphogenetic proteins (BMPs) on carcinogenesis. The authors analyse the available literature and describe potential signalling pathways that can be affected as per available experimental in vitro and in vivo models.
  
  
  CONCLUSIONS
  The available experimental data and clinical evidence are rather inadequate to allow any safe scientific conclusions. Clinical studies provide incomplete evidence to support the hypothesis that BMPs are carcinogenic. The available literature has several limitations including incomplete documentation, unreported data and inhered bias as a large number of trials have been funded by the industry. The need of well-structured studies is essential to address these safety concerns.
authors.affiliation: University of Leeds, School of Medicine, Academic Department of Trauma and Orthopaedics , Leeds, LS1 3EX , UK pountos@doctors.org.uk.
authors.forename: Ippokratis
authors.initials: I
authors.lastname: Pountos
authors.forename: Michalis
authors.initials: M
authors.lastname: Panteli
authors.forename: Theodora
authors.initials: T
authors.lastname: Georgouli
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000818:Animals; D019485:Bone Morphogenetic Proteins / Q000009:adverse effects*; D001861:Bone Regeneration / Q000187:drug effects; D002471:Cell Transformation, Neoplastic / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology; D017102:Fracture Healing / Q000187:drug effects; D006801:Humans; D009369:Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D061214:Patient Safety; D018570:Risk Assessment; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D019485:Bone Morphogenetic Proteins
keywords: bone healing; bone morphogenetic proteins; carcinogenesis; mesenchymal stem cells; neoplasia