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骨形态发生蛋白2临床应用的不良反应
袁佳滨,缪雄,栗景峰,石志才*
0
(海军军医大学(第二军医大学)长海医院脊柱外科, 上海 200433
*通信作者)
摘要:
骨形态发生蛋白2(BMP2)是一种能够诱导骨形成的活性蛋白质,参与并调控诱导间充质干细胞向成骨细胞分化过程,于2002年被美国食品药品管理局批准用于单节段腰椎前路椎体融合术。然而在临床使用BMP2过程中,逐渐发现其可导致异位骨化、骨溶解及移植物下沉、骨囊肿形成、炎症反应相关并发症、神经根炎、逆行性射精和肿瘤形成等不良反应的发生。这些不良反应可能与BMP2的超适应证使用、超生理剂量使用存在一定相关性。本文主要对BMP2临床应用的不良反应进行综述,以为临床更加安全、有效地应用BMP2提供参考。
关键词:  骨形态发生蛋白2  骨生成  信号转导  不良反应
DOI:10.16781/j.0258-879x.2019.09.1010
投稿时间:2019-04-20修订日期:2019-06-26
基金项目:
Clinical application of bone morphogenetic protein 2: adverse reaction
YUAN Jia-bin,MIAO Xiong,LI Jing-feng,SHI Zhi-cai*
(Department of Spine Surgery, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Bone morphogenetic protein 2 (BMP2) is an active protein inducing bone formation, and it can regulate the proliferation of mesenchymal stem cells into osteoblasts. In 2002 BMP2 was approved by the US Food and Drug Administration for single-segment anterior lumbar intervertebral fusion surgery. However, during the clinical application, BMP2 was found to have the following adverse reactions:heterotopic ossification, osteolysis and graft sinking, formation of bone cysts, inflammation-related complications, radiculitis, retrograde ejaculation and carcinogenesis. These adverse reactions may be due to the off-label use of BMP2 and use of off-physiological dose. This review mainly sums up the adverse reactions in the clinical application of BMP2, hoping to provide reference for safer and more effective clinical medication.
Key words:  bone morphogenetic protein 2  osteogenesis  signal transmission  adverse reaction