| Recombinant human bone morphogenetic protein-2-induced craniosynostosis and growth restriction in the immature skeleton. | |
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MedLine Citation:
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PMID: 21364420 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: : Recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered on an absorbable collagen sponge is a U.S. Food and Drug Administration-approved therapy effective at generating bone formation. In pediatric patients for whom other therapeutic options have been exhausted, rhBMP-2 is used off-label to address problematic bony defects. In the skeletally immature patient, the safety of rhBMP-2 therapy remains uncertain. Experiments are needed that investigate the effect of rhBMP-2 on growth and development in clinically relevant models. METHODS: : Ten juvenile rabbits underwent creation of a parietal skull defect that was treated with either 0.2 mg/cc rhBMP-2/absorbable collagen sponge or a neutral buffer solution/absorbable collagen sponge. Amalgam markers were placed at suture confluences to track suture separation and skull growth. Cranial growth was assessed radiographically at 10, 25, 42, and 84 days of age. Means and standard deviations for the various craniofacial growth variables were calculated and compared. Mean differences were considered significant for values of p < 0.05. At 84 days, sutures were analyzed by means of micro-computed tomographic scanning and histologic staining. RESULTS: : Treatment with rhBMP-2 resulted in fusion of the coronal sutures bilaterally, with variable fusion of the sagittal suture by cephalometric, radiographic, and histologic analysis. There were statistically significant changes to coronal suture growth, sagittal suture growth, skull height, craniofacial length, and intracranial volume (p < 0.05). CONCLUSIONS: : The use of rhBMP-2 in this juvenile animal model resulted in skeletal changes that may be undesirable in a clinical setting. The appearance of these fused sutures suggested a direct effect of rhBMP-2. Further work is required to limit the effect of rhBMP-2 to the target defect when used in the immature skeleton. |
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Authors:
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Christopher R Kinsella; James J Cray; Emily L Durham; Anne M Burrows; Lisa Vecchione; Darren M Smith; Mark P Mooney; Gregory M Cooper; Joseph E Losee |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: 127 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1173-81 Citation Subset: AIM; IM |
Affiliation:
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Pittsburgh, Pa. From the Division of Plastic Surgery and the Departments of Anthropology, Oral Biology, Orthodontics, and Bioengineering, University of Pittsburgh, and the Department of Physical Therapy, Duquesne University. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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