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OPG and RANKL in serum and synovial fluids of patients with rheumatoid arthritis, osteoarthritis and spondylarthropathy
© The Author(s) 2003
- Received: 14 January 2003
- Published: 24 February 2003
- Rheumatoid Arthritis
- Synovial Fluid
- Inflammatory Arthritis
- Sandwich ELISA
Osteoprotegerin (OPG) and receptor activator of nuclear factor κB ligand (RANKL) are the key regulators of osteoclastogenesis in inflammatory diseases, such as RA. OPG binds to RANKL, prevents its ligation to receptor activator of nuclear factor κB (RANK) and inhibits differentiation and activation of osteoclasts. The imbalance of this system results in the predominance of osteoresorption and bone erosions.
The aim of study was to compare the levels of OPG and soluble RANKL (sRANKL) in serum (S) and synovial fluid (SF) in rheumatoid arthritis (RA), osteoarthritis (OA) and spondylartropathies (SpA) and to correlate these levels with inflammatory parameters. We hypothesized that there is a higher local synthesis of both factors and positive correlation of sRANKL in synovial fluid with the disease activity in RA.
The paired S and knee SF samples were collected from 105 patients with RA (n = 45), OA (n = 46) and SpA (n = 14). The OPG and sRANKL levels were measured by sandwich ELISA (Biomedica).
The mean OPG and sRANKL levels in patient cohorts
1.9 (1.6; 2.3)
2.4 (2.2; 2.7)
1.8 (0.9; 2.7)
3.8 (3.1; 4.4)
8.4 (7.5; 9.3)
3.5 (2.1; 4.8)
3.36 (2.5; 4.2)
3.41 (2.9; 3.8)
1.9 (1.5; 2.5)
The increased local production of OPG and sRANKL in active joints reflects the production by inflammatory cells. Lower local and systemic concentrations of OPG in RA and SpA, but not in OA, are in agreement with the theory that OPG is insufficiently protective in inflammatory arthritis. The finding that there is no difference in SF sRANKL in RA and OA suggests that the local osteoresorption results from cell-bound RANKL rather than from the activity of the soluble form.
Supported by grant NK/7293-3 MH CR.