Localized low-dose rhBMP-2 is effective at promoting bone regeneration in mandibular segmental defects.

Autor: Carlisle P; Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234., Guda T; Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, 78249., Silliman DT; Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234., Burdette AJ; United States Naval Medical Research Unit-San Antonio, Fort Sam Houston, Texas, 78234., Talley AD; Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235., Alvarez R; United States Naval Medical Research Unit-San Antonio, Fort Sam Houston, Texas, 78234., Tucker D; Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234., Hale RG; Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234., Guelcher SA; Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235., BrownBaer PR; Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234.
Jazyk: angličtina
Zdroj: Journal of biomedical materials research. Part B, Applied biomaterials [J Biomed Mater Res B Appl Biomater] 2019 Jul; Vol. 107 (5), pp. 1491-1503. Date of Electronic Publication: 2018 Sep 28.
DOI: 10.1002/jbm.b.34241
Abstrakt: At least 26% of recent battlefield injuries are to the craniomaxillofacial (CMF) region. Recombinant human bone morphogenetic protein 2 (rhBMP-2) is used to treat CMF open fractures, but several complications have been associated with its use. This study tested the efficacy and safety of a lower (30% recommended) dose of rhBMP-2 to treat mandibular fractures. rhBMP-2 delivered via a polyurethane (PUR) and hydroxyapatite/β-tricalcium phosphate (Mastergraft®) scaffold was evaluated in a 2 cm segmental mandibular defect in minipigs. Bone regeneration was analyzed at 4, 8, and 12 weeks postsurgery using clinical computed tomography (CT) and rhBMP-2, and inflammatory marker concentrations were analyzed in serum and surgery-site drain effluent. CT scans revealed that pigs treated with PUR-Mastergraft® + rhBMP-2 had complete bone bridging, while the negative control group showed incomplete bone-bridging (n = 6). Volumetric analysis of regenerated bone showed that the PUR-Mastergraft® + rhBMP-2 treatment generated significantly more bone than control by 4 weeks, a trend that continued through 12 weeks. Variations in inflammatory analytes were detected in drain effluent samples and saliva but not in serum, suggesting a localized healing response. Importantly, the rhBMP-2 group did not exhibit an excessive increase in inflammatory analytes compared to control. Treatment with low-dose rhBMP-2 increases bone regeneration capacity in pigs with mandibular continuity defects and restores bone quality. Negative complications from rhBMP-2, such as excessive inflammatory analyte levels, were not observed. Together, these results suggest that treatment with low-dose rhBMP-2 is efficacious and may improve safety when treating CMF open fractures. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1491-1503, 2019.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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