Heterotopic ossification: Mechanistic insights and clinical challenges

Abstract

Bone formation is exquisitely controlled both spatially and temporally. Heterotopic ossification (HO) is pathological bone formation in soft tissues that often leads to deleterious outcomes. Inherited genetic forms of HO can be life-threatening and can happen as early as in infancy. However, there is currently no effective treatment for HO as the underlying cellular and molecular mechanisms have not been completely elucidated. Trauma-induced non-genetic forms of HO often occur as a common complication after surgeries or accidents, and the location of HO occurrence largely determines the symptom and outcome. While it has been difficult to determine the complicated factors causing HO, recent advancement in identifying cellular and molecular mechanism causing the genetic forms of HO may provide important insights in all HO. Here in this review, we summarize recent studies on HO to provide a current status of both clinical options of HO treatments and mechanical understanding of HO.

Keywords: ACVR1; AHO; ALK; BMP; FOP; GNAS; Gli; Gs(α); Hedgehog; Imprint; Malignancies; NESP55; Neurogenic; Osseous metaplasia; Osteoblast; POH; PTHrP; TGF-β; Trauma-induced; XLαs.