Recent progress in drug development for fibrodysplasia ossificans progressiva

Mol Cell Biochem. 2022 Oct;477(10):2327-2334. doi: 10.1007/s11010-022-04446-9. Epub 2022 May 10.

Abstract

Fibrodysplasia Ossificans Progressiva (FOP) is a rare genetic disease caused by heterozygous missense mutations in Activin A receptor type I which is also known as Activin-like kinase 2 (ALK2), a type I receptor of Bone Morphogenetic Proteins(BMP). Patients with FOP usually undergo episodic flare-ups and the heterotopic ossification in soft and connective tissues. Molecular mechanism study indicates that Activin A, the ligand which normally transduces Transforming Growth Factor Beta signaling, abnormally activates BMP signaling through ALK2 mutants in FOP, leading to heterotopic bone formation. To date, effective therapies to FOP are unavailable. However, significant advances have recently been made in the development of FOP drugs. In this article, we review the recent advances in understanding the FOP mechanism and drug development, with a focus on the small-molecular and antibody drugs currently in the clinical trials for FOP treatment.

Keywords: ACVR1; ALK2; BMP; Fibrodysplasia ossificans progressiva; Heterotopic ossification; TGF-β.

Publication types

  • Review

MeSH terms

  • Activins / genetics
  • Activins / metabolism
  • Bone Morphogenetic Proteins / metabolism
  • Drug Development
  • Humans
  • Ligands
  • Mutation
  • Myositis Ossificans* / drug therapy
  • Myositis Ossificans* / genetics
  • Myositis Ossificans* / metabolism
  • Ossification, Heterotopic* / genetics
  • Ossification, Heterotopic* / metabolism
  • Transforming Growth Factor beta / genetics

Substances

  • Bone Morphogenetic Proteins
  • Ligands
  • Transforming Growth Factor beta
  • Activins