BACKGROUNDInitially identified for their capability to induce heterotopic bone formation,
bone morphogenetic proteins (BMPs) are multifunctional growth factors that belong
to the transforming growth factor β superfamily. Using cellular and
molecular genetic approaches, recent studies have implicated intra-ovarian BMPs as
potent regulators of ovarian follicular function. The bi-directional communication
of oocytes and the surrounding somatic cells is mandatory for normal follicle
development and oocyte maturation. This review summarizes the current knowledge on
the physiological role and molecular determinants of these ovarian regulatory
factors within the human germline-somatic regulatory loop.OBJECTIVE AND RATIONALEThe regulation of ovarian function remains poorly characterized in humans because,
while the fundamental process of follicular development and oocyte maturation is
highly similar across species, most information on the regulation of ovarian
function is obtained from studies using rodent models. Thus, this review focuses
on the studies that used human biological materials to gain knowledge about human
ovarian biology and disorders and to develop strategies for preventing, diagnosing
and treating these abnormalities.SEARCH METHODSRelevant English-language publications describing the roles of BMPs or growth
differentiation factors (GDFs) in human ovarian biology and phenotypes were
comprehensively searched using PubMed and the Google Scholar database. The
publications included those published since the initial identification of BMPs in
the mammalian ovary in 1999 through July 2016.OUTCOMESStudies using human biological materials have revealed the expression of BMPs,
GDFs and their putative receptors as well as their molecular signaling in the
fundamental cells (oocyte, cumulus/granulosa cells (GCs) and theca/stroma cells)
of the ovarian follicles throughout follicle development. With the availability of
recombinant human BMPs/GDFs and the development of immortalized human cell lines,
functional studies have demonstrated the physiological role of intra-ovarian
BMPs/GDFs in all aspects of ovarian functions, from follicle development to
steroidogenesis, cell–cell communication, oocyte maturation, ovulation and
luteal function. Furthermore, there is crosstalk between these potent ovarian
regulators and the endocrine signaling system. Dysregulation or naturally
occurring mutations within the BMP system may lead to several female reproductive
diseases. The latest development of recombinant BMPs, synthetic BMP inhibitors,
gene therapy and tools for BMP-ligand sequestration has made the BMP pathway a
potential therapeutic target in certain human fertility disorders; however,
further clinical trials are needed. Recent studies have indicated that GDF8 is an
intra-ovarian factor that may play a novel role in regulating ovarian functions in
the human ovary.WIDER IMPLICATIONSIntra-ovarian BMPs/GDFs are critical regulators of folliculogenesis and human
ovarian functions. Any dysregulation or variations in these ligand...