Initiation and promotion of bone differentiation by bone morphogenetic proteins.

The presence of growth and differentiation factors in bone has been demonstrated by subcutaneous implantation of demineralized bone matrix that initiates new cartilage and bone morphogenesis. The genes for bone morphogenetic proteins (BMPs) have been cloned and expressed. Recombinant BMPs induce endochondral bone formation in vivo. The multistep sequential developmental cascade consists of chemotaxis, mitosis, and differentiation of cartilage and bone. The pleiotropic response has been well characterized. BMPs stimulate osteogenic and chondrogenic phenotypes. Natural bovine osteogenin (BMP-3) and recombinant BMP-4 are equipotent in chemotaxis, limb bud chondrogenesis, cartilage maintenance, and in vivo bone induction. There are multiple isoforms of BMPs, raising the biologic relevance of the redundancy. The mode of action and second messengers are not clear. BMPs appear to have cognate receptors as demonstrated by iodinated BMP-2B (BMP-4). Other novel members of the BMP family include osteogenic protein 1 (BMP-7) and osteogenic protein 2 (BMP-8). Bone morphogenetic proteins are members of the transforming growth factor-beta superfamily and include three distinct subfamilies: BMP-2, BMP-3, and BMP-7. Native BMP-3 and recombinant BMP-4 bind type IV collagen of the basement membrane. This novel connection may be the long elusive mechanistic explanation for the requirement of angiogenesis and vascular invasion for bone morphogenesis. BMPs may have a role in fracture repair, periodontal regeneration, and alveolar ridge augmentation.