Potential applications and delivery strategies for bone morphogenetic proteins.

Bone morphogenetic proteins (BMPs) are multifunctional cytokines which are members of the Transforming Growth Factor-beta superfamily. They are the only signaling molecules which can singly induce de novo bone formation at orthotopic and heterotopic sites and their osteoinductive potency makes them clinically valuable as alternatives to bone graft. Several means of delivering BMPs to patients are undergoing evaluation including systemic administration, gene transfer and local matrix delivery vehicle implantation. The latter methodology is in advanced stages of development for application in humans in the treatment of selected spinal fusions, fracture repairs, craniomaxillofacial surgery and periodontal injury and disease. The BMPs are also widely distributed in non-skeletal tissues such as nerve, gastrointestinal tract, kidney, heart and lungs and they have a central role in vertebrate and non-vertebrate organogenesis. Initial studies indicate that the BMPs have neuro, cardio and reno-protective actions and it is likely that therapeutic indications for their use will extend well beyond skeletal disease and injury.