Recombinant Human Platelet-Derived Growth Factor: Biology and Clinical Applications

The abilities of bone to remodel, fractures to repair, and bone grafts to incorporate are all fundamental reflections of the bone remodeling cycle. This process is characterized by the recruitment and differentiation of osteoblastic and osteoclastic cell populations, whose cellular activities are co...

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Published in:Journal of bone and joint surgery. American volume 2008-02, Vol.90 (Supplement_1 Suppl 1), p.48-54
Main Authors: Hollinger, Jeffrey O, Hart, Charles E, Hirsch, Steven N, Lynch, Samuel, Friedlaender, Gary E
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Bone Remodeling - drug effects
Bone Remodeling - physiology
Clinical Trials as Topic
Diseases of the osteoarticular system
Female
Fracture Healing - physiology
Guided Tissue Regeneration, Periodontal
Humans
Medical sciences
Orthopedic surgery
Platelet-Derived Growth Factor - metabolism
Platelet-Derived Growth Factor - pharmacology
Proto-Oncogene Proteins c-sis
Rats
Recombinant Proteins
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
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Summary:The abilities of bone to remodel, fractures to repair, and bone grafts to incorporate are all fundamental reflections of the bone remodeling cycle. This process is characterized by the recruitment and differentiation of osteoblastic and osteoclastic cell populations, whose cellular activities are coordinated and regulated by an elaborate system of growth factors and cytokines. One of the crucial biological factors responsible for reparative osseous activity is platelet-derived growth factor (PDGF). The potent stimulatory effects of PDGF as a chemoattractant and mitogen for mesenchymal cells (including osteogenic cells), along with its ability to promote angiogenesis, have been demonstrated in a variety of preclinical models predicting maxillofacial, spine and appendicular skeletal, and soft-tissue applications. The biological profile of PDGF, including its ability to recruit osteoprogenitor cells, makes it particularly suited to address the skeletal defects that are seen with comorbid conditions such as osteoporosis, diabetes, and the effects of smoking. The clinical success and safety that have been demonstrated with use of recombinant human PDGF (rhPDGF) in the repair of periodontal defects have led to U.S. Food and Drug Administration (FDA) approval of rhPDGF for this indication. Ongoing pilot and pivotal trials in the United States and internationally will continue to clarify the promising role of PDGF in the treatment of challenging skeletal disorders.
ISSN:0021-9355
1535-1386
DOI:10.2106/JBJS.G.01231