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Pulsed low-dose RANKL as a potential therapeutic for postmenopausal osteoporosis
Anna Cline-Smith, Jesse Gibbs, Elena Shashkova, Zachary S. Buchwald, Rajeev Aurora
Anna Cline-Smith, Jesse Gibbs, Elena Shashkova, Zachary S. Buchwald, Rajeev Aurora
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Research Article Bone biology Inflammation

Pulsed low-dose RANKL as a potential therapeutic for postmenopausal osteoporosis

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Abstract

A number of studies in model animal systems and in the clinic have established that RANKL promotes bone resorption. Paradoxically, we found that pulsing ovariectomized mice with low-dose RANKL suppressed bone resorption, decreased the levels of proinflammatory effector T cells and led to increased bone mass. This effect of RANKL is mediated through the induction of FoxP3+CD25+ regulatory CD8+ T cells (TcREG) by osteoclasts. Here, we show that pulses of low-dose RANKL are needed to induce TcREG, as continuous infusion of identical doses of RANKL by pump did not induce TcREG. We also show that low-dose RANKL can induce TcREG at 2, 3, 6, and 10 weeks after ovariectomy. Our results show that low-dose RANKL treatment in ovariectomized mice is optimal at once-per-month doses to maintain the bone mass. Finally, we found that treatment of ovariectomized mice with the Cathepsin K inhibitor odanacatib also blocked TcREG induction by low-dose RANKL. We interpret this result to indicate that antigens presented to CD8+ T cells by osteoclasts are derived from the bone protein matrix because Cathepsin K degrades collagen in the bone. Taken together, our studies provide a basis for using low-dose RANKL as a potential therapeutic for postmenopausal osteoporosis.

Authors

Anna Cline-Smith, Jesse Gibbs, Elena Shashkova, Zachary S. Buchwald, Rajeev Aurora

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Figure 4

Active antigen processing by osteoclasts is required for TcREG induction.

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Active antigen processing by osteoclasts is required for TcREG induction...
(A) FoxP3eGFP reporter mice were treated with odanacatib (Odn), and then low-dose RANKL was administered. In the presence of Odn, TcREG (GFP+CD8+ cells) induction was not observed (right panel). (B) The results are quantified from 6 animals/group. (C) In culture, BM cell–derived osteoclasts are able to induce FoxP3 in OVA-specific OT-I CD8+ T cells when pulsed with peptide antigen (SIINFEKL).

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