JBJS | Clinical Applications of Recombinant Human BMPs: Early Experience and Future Development

The Journal of Bone & Joint Surgery, Volume 85, Issue suppl 3

Orthopaedic Applications | August 01, 2003

Clinical Applications of Recombinant Human BMPs: Early Experience and Future Development

Thomas A. Einhorn, MD

The Journal of Bone & Joint Surgery. 2003; 85:82-88

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In 1965, Marshall R. Urist made the seminal discovery that the extracellular matrix of bone contains a substance that has the capacity to induce new bone formation when implanted into extraskeletal sites in a host ¹ . This substance, later named bone morphogenetic protein (BMP), has become the subject of extensive research aimed at developing therapeutic strategies for the restoration and treatment of skeletal conditions resulting from trauma, degenerative disease, or ablative surgery. By 1998, a team of investigators at Genetics Institute (now Wyeth Research, Cambridge, Massachusetts) characterized the molecular clones and activities associated with this protein and derived the amino acid sequence from a highly purified preparation obtained from bovine bone ² . This led to the isolation and expression of human complementary DNAs (cDNAs), recognized as members of the transforming growth factor-ß supergene family. Over the course of the next fifteen years, investigators elucidated the molecular genetics of BMP biology, leading to the identification of fifteen individual human BMPs possessing varying degrees of cartilage and/or bone inductive activities and to the development of three therapeutic preparations, each for a specific clinical application. This article reviews the evidence upon which presently available therapeutic preparations of BMPs are based and suggests future applications likely to evolve from current investigations.

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Topics

bone morphogenetic proteins ; fracture ; bone transplantation ; osteogenesis ; collagen ; gene therapy ; genetic engineering ; bone matrix ; bone graft, autologous ; tissue transplants

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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