Journal
TISSUE ENGINEERING PART B-REVIEWS
Volume 22, Issue 4, Pages 284-297Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/ten.teb.2015.0357
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Funding
- NIH/NIAMS [R01 AR061399, R01 AR066782, K08 AR068316]
- UCLA Department of Pathology and Laboratory Medicine
- Translational Research Fund
- UCLA Daljit S. and Elaine Sarkaria Fellowship award
- Orthopaedic Research and Education Foundation
- Musculoskeletal Transplant Foundation
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Bone morphogenetic protein-2 (BMP-2) is currently the only Food and Drug Administration (FDA)-approved osteoinductive growth factor used as a bone graft substitute. However, with increasing clinical use of BMP-2, a growing and well-documented side effect profile has emerged. This includes postoperative inflammation and associated adverse effects, ectopic bone formation, osteoclast-mediated bone resorption, and inappropriate adipogenesis. Several large-scale studies have confirmed the relative frequency of adverse events associated with the clinical use of BMP-2, including life-threatening cervical spine swelling. In fact, the FDA has issued a warning of the potential life-threatening complications of BMP-2. This review summarizes the known adverse effects of BMP-2, including controversial areas such as tumorigenesis. Next, select animal models that replicate BMP-2's adverse clinical effects are discussed. Finally, potential molecules to mitigate the adverse effects of BMP-2 are reviewed. In summary, BMP-2 is a potent osteoinductive cytokine that has indeed revolutionized the bone graft substitute market; however, it simultaneously has accrued a worrisome side effect profile. Better understanding of these adverse effects among both translational scientists and clinicians will help determine the most appropriate and safe use of BMP-2 in the clinical setting.
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