Bone Morphogenetic Proteins in Fracture Healing

Summary

Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-β superfamily with potent osteoinductive properties. They orchestrate the repair process by recruiting mesenchymal progenitor cells, promoting chondrogenic and osteoblastic differentiation and regulating angiogenesis within the fracture callus. Endogenous BMP expression rises at sites of injury, driving the phases of inflammation, soft callus formation, hard callus mineralisation and eventual remodelling. Recombinant human BMPs, notably BMP-2 and BMP-7, have been incorporated into biomaterial carriers to augment healing in cases of delayed union and non-union, providing alternatives to autologous bone grafts. Key challenges include optimising carrier design for sustained release, balancing dose efficacy with safety and minimising ectopic bone formation. Emerging strategies integrating controlled‐release scaffolds, combinatorial signalling and cell-based delivery aim to refine clinical outcomes and broaden applications in complex fractures.

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Bone Morphogenetic Proteins in Fracture Healing publication trend

The graph below shows the total number of articles in bone morphogenetic proteins in fracture healing across all publications each year (not limited to Nature Index journals).

Technical terms

Bone morphogenetic protein (BMP): Osteoinductive growth factor that directs progenitor cells to form bone tissue.

Non-union: A fracture that fails to heal within the expected time frame, necessitating further intervention.

Osteoinduction: The process by which growth factors stimulate undifferentiated cells to develop into bone-forming cells.

Carrier (scaffold): A biomaterial matrix used to deliver BMPs and support cell infiltration, vascularisation and tissue regeneration.

Recombinant human BMP-2 (rhBMP-2): Laboratory-produced BMP-2 employed clinically to enhance and accelerate bone repair.

References

  1. Bone morphogenetic proteins in fracture repair. International Orthopaedics (2018).
  2. Bone Morphogenetic Protein 2 Promotes Bone Formation in Bone Defects in Which Bone Remodeling Is Suppressed by Long-Term and High-Dose Zoledronic Acid. Bioengineering (2023).
  3. Application of BMP in Bone Tissue Engineering. Frontiers in Bioengineering and Biotechnology (2022).
  4. Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of Clinical Medicine (2021).
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