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Blood, 15 December 2001, Vol. 98, No. 13, pp. 3534-3540
PLENARY PAPER
Osteoprotegerin inhibits the development of osteolytic bone
disease in multiple myeloma
Peter I. Croucher,
Claire
M. Shipman,
Jennifer Lippitt,
Mark Perry,
Kewal Asosingh,
Anja Hijzen,
Alex C. Brabbs,
Edwin J. R. van Beek,
Ingunn Holen,
Timothy M. Skerry,
Colin R. Dunstan,
Graham R. Russell,
Ben Van Camp, and
Karin Vanderkerken
From the Nuffield Department of Orthopaedic Surgery,
University of Oxford, Nuffield Orthopaedic Centre, United Kingdom;
Division of Genomic Medicine, University of Sheffield Medical School,
United Kingdom; Department of Medicine, University of Bristol, United
Kingdom; Department of Hematology and Immunology, Free University
Brussels, Belgium; Department of Biology, University of York, United
Kingdom; Department of Academic Radiology, Royal Hallamshire Hospital,
Sheffield, United Kingdom; and Department of Pathology, Amgen, Thousand
Oaks, CA.
Multiple myeloma is a B-cell malignancy characterized by the
accumulation of plasma cells in the bone marrow and the development of
osteolytic bone disease. The present study demonstrates that myeloma
cells express the critical osteoclastogenic factor RANKL (the ligand
for receptor activator of NF- B). Injection of 5T2MM myeloma cells
into C57BL/KaLwRij mice resulted in the development of bone disease
characterized by a significant decrease in cancellous bone volume in
the tibial and femoral metaphyses, an increase in osteoclast formation,
and radiologic evidence of osteolytic bone lesions. Dual-energy x-ray
absorptiometry demonstrated a decrease in bone mineral density (BMD) at
each of these sites. Treatment of mice with established myeloma with
recombinant osteoprotegerin (OPG) protein, the soluble decoy receptor
for RANKL, prevented the development of lytic bone lesions. OPG
treatment was associated with preservation of cancellous bone volume
and inhibition of osteoclast formation. OPG also promoted an
increase in femoral, tibial, and vertebral BMD. These data suggest that
the RANKL/RANK/OPG system may play a critical role in the development
of osteolytic bone disease in multiple myeloma and that targeting this
system may have therapeutic potential.

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