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  • Open Access

Unbalanced levels of bone resorption promoting factors in bone marrow from patients with rheumatoid arthritis in comparison to osteoarthritis

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Arthritis Res Ther20035 (Suppl 3) :73

  • Published:


  • Bone Resorption
  • Rheumatoid Arthritis Patient
  • Osteoclast Differentiation
  • Bone Marrow Sample
  • Bone Marrow Microenvironment


RANKL and IL-6 participate in osteoclast differentiation and activation, and therefore regulate bone resorption. The biological activity of RANKL is inhibited by its natural decoy receptor osteoprotegerin (OPG), while IL-6 activity is either enhanced by soluble IL-6 receptor (sIL-6R) or inhibited by soluble glycoprotein 130 (sgp130), an extracellular domain of the signaling chain of the IL-6 receptor complex.


To compare the levels of RANKL, OPG, IL-6, sIL-6R and sgp130 in bone marrow plasma isolated from rheumatoid arthritis (RA) and osteoarthritis (OA) patients.


Bone marrow samples isolated from 29 RA patients and 12 OA patients (mean age 51 ± 14.3 years and 56.3 ± 10.5 years, respectively) undergoing hip replacement surgery were diluted twice in heparinized PBS. The levels of cytokines were measured using specific ELISAs.


The levels of tested cytokines, the ratio of respective ligands to their receptors and the statistical significance of the data are presented in Table 1.
Table 1

Levels of RANKL, osteoprotegerin (OPG), IL-6, soluble IL-6 receptor (sIL-6R), and soluble glycoprotein 130 (sgp130) in the bone marrow of rheumatoid arthritis and osteoarthritis patients


RANKL (pg/ml)

OPG (ng/ml)


IL-6 (pg/ml)

sIL-6R (ng/ml)

sgp130 (ng/ml)

sgp130:sIL-6R ratio

sIL-6R:IL-6 ratio

Rheumatoid arthritis

61 ± 50

9.9 ± 3.3


284 ± 370

33.7 ± 19

195 ± 111




40 ± 34

12.4 ± 3.2


132 ± 76

16.7 ± 6.9

123 ± 55



Rheumatoid arthritis vs osteoarthritis


P < 0.05


Not significant

P < 0.0002

P < 0.009


NS, not significant.

The levels of RANKL in RA patients were elevated by 53% in comparison with those in OA patients. In contrast, the levels of OPG were diminished by 20%. Thus, the ratio of OPG/RANKL, thought to better reflect environmental signals promoting bone resorption than levels of individual cytokines, is diminished in RA patients in comparison with OA patients. Similarly, the 115% increase of IL-6 and the 102% increase of sIL-6R is not compensated for by only the 59% increase of sgp130 in RA patients in comparison with OA patients.


The present data indicate that the bone marrow microenvironment of RA patients in comparison with OA patients is enriched in factors promoting osteoclastogenesis, osteoclast activation and bone resorption. At the same time, the levels of corresponding natural decoy receptors is diminished. Thus, RA-associated osteoporosis and bone erosions may, at least partially, be related to unbalanced production of RANKL, IL-6 and sIL-6R in the bone marrow.

Authors’ Affiliations

Department of Pathophysiology and Immunology, Institute of Rheumatology, Warsaw, Poland
Clinic of Orthopaedy, Institute of Rheumatology, Warsaw, Poland
Clinic of Rheumatic Diseases, Institute of Rheumatology, Warsaw, Poland


© The Author(s) 2003