Potential applications and delivery strategies for bone morphogenetic proteins

Bone morphogenetic proteins (BMPs) are multifunctional cytokines which are members of the Transforming Growth Factor-beta superfamily. They are the on ly signaling molecules which can singly induce de novo bone formation at or thotopic and heterotopic sites and their osteoinductive potency makes them clinically valuable as alternatives to bone graft. Several means of deliver ing BMPs to patients are undergoing evaluation including systemic administr ation, gene transfer and local matrix delivery vehicle implantation. The la tter methodology is in advanced stages of development for application in hu mans in the treatment of selected spinal fusions, fracture repairs, craniom axillofacial surgery and periodontal injury and disease. The BMPs are also widely distributed in non-skeletal tissues such as nerve, gastrointestinal tract, kidney, heart and lungs and they have a central role in vertebrate a nd non-vertebrate organogenesis. Initial studies indicate that the BMPs hav e neuro, cardio and reno-protective actions and it is likely that therapeut ic indications for their use will extend well beyond skeletal disease and i njury. (C) 2000 Elsevier Science B.V. All rights reserved.