Bone Morphogenetic Proteins (BMPs) are a group of growth factors known for their ability to induce the formation of bone and cartilage. They belong to the Transforming Growth Factor-Beta (TGF-β) superfamily, which includes other growth factors such as Growth Differentiation Factors (GDFs) and Glial-derived Neurotrophic Factors (GDNFs) . Among the BMPs, Bone Morphogenetic Protein-2 (BMP-2) is one of the most well-studied and was the first to be characterized .
BMP-2 plays a crucial role in various developmental processes, including cardiogenesis, neurogenesis, and osteogenesis . During embryonic development, BMP-2 is essential for digit formation and the activation of osteogenic genes such as Runt-Related Transcription Factor 2 (RUNX2) . In adulthood, BMP-2 is involved in bone remodeling and homeostasis, making it a vital component in maintaining bone health .
Recombinant human BMP-2 (rhBMP-2) is a synthetic version of the naturally occurring BMP-2. It is produced using recombinant DNA technology, which allows for the creation of a monomeric form of the protein . The FDA has approved the use of rhBMP-2 for various medical applications, including spinal fusion surgery, tibial shaft repair, and maxillary sinus reconstructive surgery . The therapeutic potential of rhBMP-2 lies in its robust capacity to induce bone formation .
BMP-2 exerts its effects by binding to specific receptors on the surface of target cells, initiating a cascade of intracellular signaling pathways . One of the primary pathways activated by BMP-2 is the Smad1/5/8 signaling pathway, which leads to the transcription of osteogenic genes . This signaling cascade ultimately results in the differentiation of mesenchymal stem cells into osteoblasts, the cells responsible for bone formation .
The clinical application of rhBMP-2 has shown promising results in promoting bone regeneration and repair . However, its use is not without complications. Some patients have reported adverse effects, such as inflammation and ectopic bone formation, following rhBMP-2 treatment . As a result, alternative therapeutic strategies are being explored to mitigate these side effects while harnessing the osteogenic potential of BMP-2 .