Bone morphogenetic proteins (BMPs) are multi-functional growth factors belonging to
the Transforming Growth Factor-Beta (TGF-beta) superfamily. These proteins are essential
to many developmental processes, including cardiogenesis, neurogenesis, and osteogenesis.
Specifically, within the BMP family, Bone Morphogenetic Protein-2 (BMP-2) was the
first BMP to be characterized and has been well-studied. BMP-2 has important roles
during embryonic development, as well as bone remodeling and homeostasis in adulthood.
Some of its specific functions include digit formation and activating osteogenic genes,
such asRunt-Related Transcription Factor 2(RUNX2). Because of its diverse functions
and osteogenic potential, the Food and Drug Administration (FDA) approved usage of
recombinant human BMP-2 (rhBMP-2) during spinal fusion surgery, tibial shaft repair,
and maxillary sinus reconstructive surgery. However, shortly after initial injections
of rhBMP-2, several adverse complications were reported, and alternative therapeutics
have been developed to limit these side-effects. As the clinical application of BMP-2
is largely implicated in bone, we focus primarily on its role in bone. However, we
also describe briefly the role of BMP-2 in development. We then focus on the structure
of BMP-2, its activation and regulation signaling pathways, BMP-2 clinical applications,
and limitations of using BMP-2 as a therapeutic. Further, this review explores other
potential treatments that may be useful in treating bone disorders.