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Recent animal and clinical studies have suggested that Dkk-1, a secreted inhibitor of the canonical Wnt signalling pathway, could play an important role in mediating the alterations of joint tissue turnover associated with rheumatoid arthritis (RA) and osteoarthritis. Diarra et al1 showed that blockage of Dkk-1 abolished bone erosion in an inflammatory mouse model and that circulating Dkk-1 was increased in patients with active RA. More recently, we reported that increased Dkk-1 was associated with a higher risk of radiological bone erosion in patients with early RA receiving anti-tumour necrosis factor therapy.2 On the other hand, elevated circulating levels of Dkk-1 were reported to be moderately associated with reduced radiological progression of hip osteoarthritis in one study …
Competing interests None.
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