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rhNELL-1 is a recombinant human protein growth factor essential for normal bone development. It is being developed as an orthobiologic product to promote bone formation and regeneration, particularly in spinal fusion procedures. The proposed mechanism of action involves classic receptor binding and intracellular signaling transduction to the nucleus to promote osteogenic gene expression and bone formation. Preclinical studies have demonstrated that rhNELL-1 effectively promotes bone formation in advanced spine models, increases fusion rates and quantity of new bone compared to controls, and is well tolerated with no evidence of inflammation or toxicity[2][3][5]. The drug has been incorporated into the NB1 bone graft device (a combination with demineralized bone matrix), which is currently under clinical investigation for spinal fusion in patients with degenerative disc disease.
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