Bone Morphogenetic Protein

Bone Morphogenetic Proteins1

Bone morphogenetic proteins (BMPs) are a growth signaling protein found in the human body. There are many of these proteins; however, specific ones code for the growth and development of bone when in contact with pluripotent cells that can differentiate into bone forming tissue.

Over the past decade, recombitant (rh) technology has allowed for the reproduction of these proteins in the laboratory, thus the name rhBMP.

Of all the BMP’s that have been isolated in the laboratory, only BMPs 2, 4, 6, 7 and 9 have been proven to play significant roles in bone formation.1 BMP differs from bone graft materials in that BMP has true osteoinductive properties to form bone whereas graft materials essentially are fillers that allow for replacement resorption of bone by the host. BMPs with their highly osteoinductive properties have been under intense research since the early 1990’s and have undergone rigorous testing and approval by the FDA (Food and Drug Administration).

BMP-2

BMP-2 is one of the most potent growth factors that induces mesenchymal stem cell (MSC) and osteoprogenitor cell differentiation into osteoblasts.1,2 rhBMP-2 to date is the only osteoinductive protein that has been approved by the FDA and proven in multiple studies to induce viable bone formation in animal and human subjects.

rhBMP-2 has achieved safety and effectiveness results equivalent to the standard of care in certain maxillofacial reconstructive procedures.3-6 In addition, rhBMP-2 has more Level 1 clinical evidence than any other bone grafting material.2

Although rhBMP is not a solution to every situation, it considerably increases the success of bone grafting in areas where bone did not exist or areas where bone has been lost as a result of disease, trauma or surgery.

If you are a candidate for rhBMP, your surgeon will discuss this revolutionary product with you. Our practice has been involved with rhBMP since its discovery with nearly 20 years of surgical experience using rhBMP including the initial multicenter studies performed at LSU and other institutions in combination with Genetics Institute to isolate and demonstrate the efficacy of rhBMP in reconstructive surgery.

REFERENCES

  1. Gollehon, et al. Preprosthetic and Reconstructive Surgery; Peterson’s Principles or Oral and Maxillofacial Surgery; 2004, BC Decker, Inc, pp. 165-167.
  1. Cheng H, Jiang W, Phillips FM, Haydon RC, et al. Osteogenic activity of the fourteen types of human bone morphogenetic proteins (BMPs). J Bone Joint Surg Am. 2003;85:1544-1552.
  2. Resnick DK et al. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: bone graft extenders and substitutes. J Neurosurg: Spine, Vol. 2, June 2005.
  3. Burkus, et al. Anterior Lumbar Interbody Fusion Using rhBMP-2 With Tapered Interbody Cages. J Spinal Disorders. 2002; 15(5): 337-349.
  4. Boyne PJ, Lilly LC, et al. De Novo Bone Induction by Recombinant Human Morphogenetic Protein-2 (rhBMP-2) in Maxillary Sinus Floor Augmentation. J Oral Maxillofac Surg. 2005;63:1693-1707.
  5. Fiorellini JP, Howell TH, et al. Randomized Study Evaluating Recombinant Human Bone Morphogenetic Protein-2 for Extraction Socket Augmentation. J Periodontol. 2005; 76(4): 605-613.
  6. Friedlaender, et al. Osteogenic Protein-1 (Bone Morphogenetic Protein-7) in the Treatment of Tibial Nonunions: A Prospective, Randomized Clinical Trial Comparing rhOP-1 with Fresh Bone Autograft. J Bone Joint Surg Am. 2001; 83-A Suppl 1(Pt 2): S151-S158.
  7. Boden et al. Laparoscopic Anterior Spinal Arthrosesis with rhBMP-2 in a Titanium Interbody Threaded Cage. J of Spinal Disord. 1998; 11(2):95-101.