期刊
JOURNAL OF BONE AND MINERAL METABOLISM
卷 39, 期 1, 页码 2-11出版社
SPRINGER JAPAN KK
DOI: 10.1007/s00774-020-01175-1
关键词
Receptor activator of NF-kB ligand (RANKL); Osteoclasts; Osteoblasts; Reverse signaling; Denosumab; Immuno-oncology
Discovery of RANKL has led to significant advancements in osteoimmunology, development of denosumab as a clinically available treatment for osteoporosis and cancer-induced bone diseases. The RANKL/RANK/OPG system plays a pivotal role in osteoclast differentiation and function, with potential applications in cancer treatment discussed.
Almost a quarter century has passed since discovery of receptor activator of NF-kappa B ligand (RANKL). This discovery had a major impact on identification of mechanisms regulating osteoclast differentiation and function, establishment of a research field bridging bone and the immune system (osteoimmunology), and development of a fully human anti-RANKL neutralizing antibody (denosumab). Denosumab is now clinically available for treatment of osteoporosis and cancer-induced bone diseases in the US, Europe and many other countries, including Japan. Denosumab is a so-called blockbuster drug, with sales of 5.0 billion US dollars in 2019. This is a real success story from bench to bedside. In this review, the pivotal roles of the RANKL/RANK/OPG system in osteoclast differentiation and function are shown. RANKL is a ligand required for osteoclast generation, RANK is the receptor for RANKL, and osteoprotegerin (OPG) is a decoy receptor for RANKL. The review covers recent results showing the importance of RANKL on osteoblasts in regulation of osteogenesis and the role of RANKL-RANK dual signaling in coupling of bone resorption and formation, including demonstration of RANKL reverse signaling that we had previously hypothesized. Possible applications of anti-RANKL antibody in treatment of cancer are also discussed.
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