Macrophysiologic roles of a delivery system for vulnerary factors needed for bone regeneration.

Traditional histology identifies three components of bone: cells, an extracellular mineralized organic matrix, and a lymphatic-vascular component. Specialized bone cells known as osteoblasts promote bone regeneration. Clinically, this property has been exploited by surgeons with autografts and bank bone preparations to restore deficient form and function to almost every aspect of the skeleton. Unfortunately, these therapies can be inadequate for patients with panskeletal trauma. Therefore, a suitable alternative may be a laboratory-derived product consisting of a vulnerary factor and delivery system. The integration of a laboratory-engineered product in an osseous wound environment is a formidable challenge demanding a keen appreciation of the product's macrophysiologic roles in wound healing biology. Consequently, the purposes for this paper are 1) to define briefly macrophysiology relevant to a delivery system for vulnerary molecules and bone regeneration; 2) to review a key family of bone regenerating molecules, the bone morphogenetic proteins (BMPs); and 3) to relate delivery system engineering with bone regeneration.