The Adelaide Centre for Spinal Research, Surgical Pathology, SA Pathology, Frome Road, Adelaide, South Australia, 5000, Australia.
J Orthop Res. 2013 Sep;31(9):1390-7. doi: 10.1002/jor.22387. Epub 2013 Jun 4.
The failure of orthopedic implants in osteoporotic patients is attributed to the lack of sufficient bone stock and regenerative capacity but most treatments for osteoporosis fail to address this issue. rhBMP-2 is known to promote bone formation under normal conditions but has not been used clinically in the osteoporotic condition. Osteoporosis was induced in 19 ewes using ovariectomy, low calcium diet, and steroid injection. After induction, the steroid was withdrawn and pellets containing inert carrier with rhBMP-2 in either slow or fast-release formulation were implanted into the lumbar vertebrae of each animal. After 2, 3, and 6 months the spines were harvested and assessed for changes in BMD and histomorphometric indices. BMD did not change after cessation of steroid treatment. After 2 months BV/TV increased in the vicinity of the pellets containing the fast-release rhBMP-2 and was sustained for the duration of the study. Focal voids surrounding all implants, particularly the slow-release formulation, were observed initially but resolved with time. Increased BV/TV adjacent to rhBMP-2 pellets suggests it could be used for localized treatment of osteoporosis. Refinement of the delivery system and supplementary treatments may be necessary to overcome the initial catabolic effects of rhBMP-2.
在骨质疏松症患者中，骨科植入物的失效归因于缺乏足够的骨量和再生能力，但大多数骨质疏松症的治疗方法都未能解决这个问题。rhBMP-2 在正常情况下已知可促进骨形成，但尚未在骨质疏松症的情况下在临床上使用。通过卵巢切除术、低钙饮食和类固醇注射在 19 只母羊中诱导骨质疏松症。诱导后，停止使用类固醇，并将含有惰性载体和缓慢或快速释放配方的 rhBMP-2 的丸剂植入每只动物的腰椎。2、3 和 6 个月后收获脊柱并评估骨密度和组织形态计量学指标的变化。停止类固醇治疗后，骨密度没有变化。2 个月后，快速释放 rhBMP-2 丸剂附近的 BV/TV 增加，并持续整个研究期间。所有植入物周围，特别是缓慢释放制剂，最初观察到的局部空洞，但随着时间的推移而解决。rhBMP-2 丸剂附近增加的 BV/TV 表明它可用于骨质疏松症的局部治疗。可能需要改进输送系统和补充治疗以克服 rhBMP-2 的初始分解代谢作用。
