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Osteoprotegerin (OPG) is a soluble decoy receptor, produced by osteoblastic cells and in the inflamed synovium of RA by dendritic cells, B cells, and other immunocompetent cells.1,2 It inhibits the differentiation of osteoclast precursor cells and the activation of mature osteoclasts by neutralising the receptor activator of NF-κB ligand (RANKL).3
RANKL, a member of the tumour necrosis factor family, is expressed on prae-osteoblasts and T lymphocytes. A soluble RANKL (sRANKL) can be produced by activated T lymphocytes or can be generated from the cell bound form by a protease. RANKL itself activates a receptor activator of NF-κB (RANK).4
RANKL, together with monocyte-colony stimulating factor, interleukin 1, and RANK is responsible for osteoclast formation and activation and inhibits …