Bone morphogenetic protein gene therapy.
STUDY DESIGN: A retrospective analysis of previous BMP gene therapy and general gene therapy publications. OBJECTIVE: To present the potential role of BMP gene therapy for the induction of osteogenesis and spinal fusion. SUMMARY OF BACKGROUND DATA: A variety of viral and non-viral techniques have been utilized to insert foreign transgenes into cells, both in vivo and in vitro. These techniques are now being used to transduce cells with a BMP gene to express significant amounts of BMP. This secreted BMP can subsequently stimulate osteogenesis in a variety of locations, including in the paraspinal regions. METHODS: A retrospective analysis of the literature. RESULTS: Direct and ex vivo BMP gene therapy has been shown to successfully promote bone healing and regeneration in a variety of animal models. Long-term and regulated transgene expression are clear advantages of BMP gene delivery, compared to direct BMP application. To date, BMP gene delivery with adenoviral vectors have been the most effective approach for stimulating bone induction in vivo. CONCLUSIONS: Although BMP gene therapy techniques have significant potential for the treatment of spine pathology, further preclinical and clinical research and development are required before this technology will have direct clinical applications.