Bone morphogenetic proteins and bone morphogenetic protein gene therapy inneurological surgery: A review

OBJECTIVE: To review the uses of bone morphogenetic proteins (BMPs) and BMP gene therapy for the treatment of neurosurgical disorders. METHODS: Literature review. RESULTS: BMPs are members of the transforming growth factor beta superfamil y, and they play an important role in the growth and development of numerou s tissues, including bone, brain, and spinal cord. Although the majority of previous studies have focused on the regulatory functions of BMPs in the n ormal growth and differentiation of the skeletal system, BMPs also seem to be exquisitely involved in the regulation of cellular proliferation, surviv al, differentiation, apoptosis, and lineage commitment in the central nervo us system. When specific BMPs are delivered on biological matrices, they ha ve the capacity to induce bone, cartilage, ligament, and tendon at both het erotopic and orthotopic sites, suggesting that they may play a major role i n the future treatment of spinal and craniofacial pathology. For example, r ecent studies have clearly demonstrated the usefulness of BMPs and BMP gene therapy for the induction of spinal arthrodesis in several animal models. In addition, several BMPs have been shown to have a neuroprotective effect in animal models of head injury, cerebral ischemia, and Parkinson's disease and may therefore have direct clinical applications for the treatment of c entral nervous system disorders. CONCLUSION: As the physiological activity of BMPs in the development and pa thology of the central nervous system and spine are move fully elucidated, BMP therapeutics and gene therapy will probably have numerous applications in neurological surgery.