title: BMPs in bone regeneration: Less is more effective, a paradigm-shift.
abstract: Worldwide, the clinical application of BMP2 (bone morphogenetic protein 2) has helped an increasing number of patients achieve bone regeneration in a clinical area lacking simple solutions for difficult bone healing situations. In this review, the historical aspects and current critical clinical issues are summarized and positioned against new research findings on efficacy and function of BMP2. Knowledge concerning how the dose of this growth factor as well as its interaction with mechanical loading influences the efficacy of bone regeneration, might open possible future strategies in cases where bony bridging is unachievable so far. In conclusion, it is apparent that there is a substantial need for continued basic research to unravel the details of its function and the underlying signaling pathways involved, to make BMP2 even more relevant and safe in daily clinical use, even though this growth factor has been known for more than 125 years.
authors.affiliation: Berlin-Brandenburger Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Katharina.Schmidt-Bleek@charite.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schmidt-Bleek
authors.affiliation: Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; Research Center, Shriners Hospitals for Children-Canada, Department of Pediatric Surgery, McGill University, 1003 Decarie Blvd., Montreal, Quebec H4A 0A9, Canada. Electronic address: bwillie@shriners.mcgill.ca.
authors.forename: Bettina M
authors.initials: BM
authors.lastname: Willie
authors.affiliation: Centre for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Philipp.schwabe@charite.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schwabe
authors.affiliation: Berlin-Brandenburger Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Petra.Seemann@charite.de.
authors.forename: Petra
authors.initials: P
authors.lastname: Seemann
authors.affiliation: Berlin-Brandenburger Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: georg.duda@charite.de.
authors.forename: Georg N
authors.initials: GN
authors.lastname: Duda
mesh_terms: D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2
keywords: BMP2; Bone healing; Bone morphogenetic protein; Growth factor; Regeneration