BMP-7 (Osteogenic Protein-1)
Overview
BMP-7, also known as osteogenic protein-1 (OP-1), is a member of the bone morphogenetic protein family with a mature homodimeric structure of approximately 139 amino acids per monomer. Like other BMPs, it signals through serine/threonine kinase receptors to activate SMAD transcription factors, promoting differentiation of mesenchymal cells into osteoblasts and chondrocytes. The recombinant form is delivered on a bovine collagen matrix to provide localized, sustained release. BMP-7 also exhibits renoprotective effects in preclinical models, though clinical development in nephrology has not advanced.
Key Research Findings
Recombinant human BMP-7 (OP-1 Putty) received FDA approval under a Humanitarian Device Exemption in 2001 for revision posterolateral lumbar spinal fusion and recalcitrant long bone nonunions where autograft is not feasible. Clinical trials demonstrated comparable efficacy to autograft in promoting bone healing in nonunion fractures. The product was voluntarily withdrawn from the U.S. market in 2014 by the manufacturer due to commercial considerations, though it remains available in select international markets.
Surgical implantation
FDA Approved
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Teriparatide (Forteo)
FDA ApprovedA recombinant form of the first 34 amino acids of human parathyroid hormone (PTH 1-34). When administered intermittently via daily subcutaneous injection, teriparatide stimulates osteoblastic bone formation more than osteoclastic resorption, producing a net anabolic effect on bone. It activates the PTH1 receptor on osteoblasts, increasing Wnt signaling, osteoblast differentiation, and survival while reducing sclerostin expression.
Abaloparatide (Tymlos)
FDA ApprovedA synthetic 34-amino acid peptide analog of parathyroid hormone-related protein (PTHrP 1-34) that selectively activates the RG conformation of the PTH1 receptor. This receptor selectivity produces a more transient signaling response compared to teriparatide, favoring anabolic bone formation with less stimulation of bone resorption and calcium mobilization. Abaloparatide increases bone mineral density at both cortical and trabecular sites.
Calcitonin
FDA ApprovedA 32-amino acid peptide hormone naturally produced by parafollicular C-cells of the thyroid gland. Calcitonin inhibits osteoclast-mediated bone resorption by binding to calcitonin receptors on osteoclasts, reducing their activity and number. Salmon calcitonin is approximately 40-50 times more potent than human calcitonin and has a longer half-life, making it the preferred therapeutic form.
Vosoritide (Voxzogo)
FDA ApprovedA C-type natriuretic peptide (CNP) analog that acts as an agonist at the natriuretic peptide receptor B (NPR-B) on growth plate chondrocytes. Vosoritide counteracts the constitutively activated FGFR3 signaling that suppresses endochondral ossification in achondroplasia. By stimulating the NPR-B/cGMP/MAPK pathway, it antagonizes the growth-inhibitory FGFR3 signal and restores more normal linear bone growth.