Bone Morphogenetic Proteins<sbt aid="1014249">Development and Clinical Efficacy in the Treatment of Fractures and Bone Defects</sbt>

Abstract

The discovery of bone morphogenetic proteins marks a major step forward in the understanding of bone physiology and in the development of advanced methods in skeletal surgery. The cornerstones for successful growth-factor therapy in skeletal surgery remain biomechanical stability and biological vitality of the bone providing an adequate environment for new bone formation. Knowledge of the biological characteristics, mechanisms of action, and methods of delivery of growth factors will become essential for skeletal surgeons. The current clinical application of bone morphogenetic proteins is safe and efficacious as a result of a well-regulated cascade of events leading to bone formation. Clinical trials have not yet determined whether different clinical indications each require a specific bone-tissue-engineering format or if a single pathway for stimulating bone-healing with growth factors is sufficient.

Superpulsed laser irradiation increases osteoblast activity via modulation of bone morphogenetic factors

“…Of the BMPs, BMP-2, 6, and 9 have been shown to be the most potent agents in inducing osteoblast differentiation of mesenchymal stem cells. On the contrary, BMP-3 exhibits no osteogenic activity and antagonizes the osteogenic activity of BMP-2, 4, 6, 7, and 9 [16].…”

The Synergistic Effect of Autograft and BMP-7 in the Treatment of Atrophic Nonunions

“…In 1988, Wozney et al [49] identified the genetic sequences of BMPs. Since then, over 20 different BMP-homologous molecules have been described, 15 of which were identified in humans [43]. BMPs belong to the transforming growth factor-b superfamily, a large family of growth and differentiation factors, which are involved in several stages of embryonic organogenesis and in various stages of intramembranous and endochondral ossification during fracture healing [19,36].…”

Long-term safety and efficacy of human bone morphogenetic protein (HBMP) in the treatment of resistant non-unions and failed arthrodesis

“…BMP quickly gained favor due to its unique ability to induce chemotaxis of progenitor cells and induce differentiation and proliferation of mesenchymal cells into cartilage and bone-forming cells. [1][2][3][4][5] The landmark discovery of BMP by Urist marked a major turning point in the understanding of bone physiology, and has dually influenced the clinical management of resistant and delayed unions in orthopedic surgery. The current management for the majority of pseudarthrosis cases includes mechanical stabilization with various forms of internal or external fixation in addition to some form of a biological stimulation.…”