Dumic-Cule Ivo, Peric Mihaela, Kucko Lucija, Grgurevic Lovorka, Pecina Marko, Vukicevic Slobodan
Center for Translational and Clinical Research, Laboratory for Mineralized Tissues, University of Zagreb School of Medicine, Salata 11, Zagreb, Croatia.
Center for Translational and Clinical Research, Department for Intercellular communication, University of Zagreb School of Medicine, Salata 2, Zagreb, Croatia.
Int Orthop. 2018 Nov;42(11):2619-2626. doi: 10.1007/s00264-018-4153-y. Epub 2018 Sep 15.
Bone fractures represent a significant medical morbidity among aged population with osteoporosis. Bone morphogenetic proteins (BMPs) are suggested to have therapeutic potential to enhance fracture healing in such patients. Though BMP-mediated fracture healing has been well-documented in preclinical models, there has been no clinical study that demonstrated unequivocally that indeed a BMP when presented with an appropriate scaffold could provide basis for robust outcome for delayed or non-union diaphyseal bone fractures. This review presents a comprehensive insight towards the existing knowledge on the role of BMP signaling in bone formation and maintenance. Also therapeutic options based on BMP biology are discussed.A novel osteoinductive autologous bone graft substitute (ABGS) aimed to accelerate bone regeneration was developed and is currently being tested in the clinical setting. It comprises of a biologically compatible autologous carrier made from the patient's peripheral blood (autologous blood coagulum, ABC) and of rhBMP6 as an active ingredient. Such formulation circumvents the use of animal-derived materials, significantly limits inflammatory processes common in commercial bone devices and renders the carrier flexible, malleable, and injectable ensuring the ease of use. The ongoing clinical trials result will provide more detailed insights into the safety, tolerability, pharmacokinetics, and bone healing effects in humans and potentially provide novel and safe therapeutic options for bone repair.
在患有骨质疏松症的老年人群中，骨折是一种严重的医学病症。骨形态发生蛋白（BMPs）被认为具有治疗潜力，可促进此类患者的骨折愈合。尽管在临床前模型中，BMP介导的骨折愈合已有充分记录，但尚无临床研究明确表明，当BMP与合适的支架结合时，确实能为延迟或不愈合的骨干骨折带来良好的治疗效果。本综述全面深入地介绍了关于BMP信号在骨形成和维持中的作用的现有知识。此外，还讨论了基于BMP生物学的治疗选择。一种旨在加速骨再生的新型骨诱导自体骨移植替代物（ABGS）已被开发出来，目前正在临床环境中进行测试。它由患者外周血制成的生物相容性自体载体（自体血凝块，ABC）和rhBMP6作为活性成分组成。这种配方避免了使用动物源性材料，显著限制了商业骨装置中常见的炎症过程，并使载体具有柔韧性、可延展性和可注射性，确保了使用的便利性。正在进行的临床试验结果将为人类的安全性、耐受性、药代动力学和骨愈合效果提供更详细的见解，并可能为骨修复提供新的安全治疗选择。
