RANKL (receptor activator of nuclear factor kappaB ligand)

Stimulates osteoclastogenesis and induces osteoclast activation and also activates osteoblasts.

A protein expressed by osteoblastic stromal cells which binds to the receptor activator of nuclear factor κB and mediates osteoclastic differentiation, activation and survival.

Osteoblast production of receptor activator of nuclear factor kappa B ligand (RANKL), which leads to activation of osteoclasts and disturbance of normal coupling of bone formation and bone resorption. 

Mediates the interaction between osteoblasts and osteoclasts.

Low serum levels associated with a significant risk for nontraumatic fractures in the general population.

In myeloma it is hypersecreted by stromal cells, osteocytes, an myeloma cells, resulting in increased osteoclast activity.

Osteoclasts can then directly recruit myeloma cells and promote their proliferation, survival and increase resistance to apoptosis.

Excessive RANKL associated with increased bone resorption and decreased patient survival in myeloma.

Denosumab binds to and neutralizes RANKL, inhibiting osteoclast and reduces the frequency of skeletal related events in patients with advanced solid tumors and myeloma.

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