Park Shin-Young, Kim Kyoung-Hwa, Kim Sungtae, Lee Yong-Moo, Seol Yang-Jo
Program of Clinical Dental Education and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea.
Predoctoral Treatment Center, Seoul National University Dental Hospital, Seoul 03080, Korea.
Pharmaceutics. 2019 Aug 5;11(8):393. doi: 10.3390/pharmaceutics11080393.
Bone morphogenetic protein-2 (BMP-2) is a potent growth factor affecting bone formation. While recombinant human BMP-2 (rhBMP-2) has been commercially available in cases of non-union fracture and spinal fusion in orthopaedics, it has also been applied to improve bone regeneration in challenging cases requiring dental implant treatment. However, complications related to an initially high dosage for maintaining an effective physiological concentration at the defect site have been reported, although an effective and safe rhBMP-2 dosage for bone regeneration has not yet been determined. In contrast to protein delivery, BMP-2 gene transfer into the defect site induces BMP-2 synthesis in vivo and leads to secretion for weeks to months, depending on the vector, at a concentration of nanograms per milliliter. BMP-2 gene delivery is advantageous for bone wound healing process in terms of dosage and duration. However, safety concerns related to viral vectors are one of the hurdles that need to be overcome for gene delivery to be used in clinical practice. Recently, commercially available gene therapy has been introduced in orthopedics, and clinical trials in dentistry have been ongoing. This review examines the application of BMP-2 gene therapy for bone regeneration in the oral and maxillofacial regions and discusses future perspectives of BMP-2 gene therapy in dentistry.
骨形态发生蛋白-2（BMP-2）是一种影响骨形成的强效生长因子。虽然重组人BMP-2（rhBMP-2）已在骨科用于治疗骨折不愈合和脊柱融合等病例，但它也被应用于改善需要种植牙治疗的复杂病例中的骨再生。然而，尽管尚未确定用于骨再生的有效且安全的rhBMP-2剂量，但已有报道称与在缺损部位维持有效生理浓度的初始高剂量相关的并发症。与蛋白质递送不同，将BMP-2基因转移到缺损部位可在体内诱导BMP-2合成，并根据载体的不同，以每毫升纳克的浓度持续分泌数周甚至数月。就剂量和持续时间而言，BMP-2基因递送对骨伤口愈合过程具有优势。然而，与病毒载体相关的安全问题是基因递送应用于临床实践需要克服的障碍之一。最近，市售的基因疗法已被引入骨科，并且牙科领域的临床试验也在进行中。本综述探讨了BMP-2基因疗法在口腔颌面部骨再生中的应用，并讨论了BMP-2基因疗法在牙科领域的未来前景。
