title: Plasma levels of receptor activator of nuclear factor-kappaB ligand and osteoprotegerin in patients with neuroblastoma.
abstract: Earlier reports showed that the balance between receptor activator of nuclear factor-kappaB ligand (RANKL) and its decoy-receptor osteoprotegerin (OPG) plays an important role in the pathogenesis of metastatic osteolysis induced by neuroblastoma cells. In this study, we investigated whether circulating levels of OPG, RANKL and their ratio were associated to the presence of osteolytic lesions in advanced neuroblastoma, as well as whether they provided additional information on the severity and prognosis of the disease. Plasma levels of RANKL and OPG were measured in 54 newly diagnosed neuroblastomas; 27 of them showed metastatic disease (stage IV), including 19 bone dissemination. Thirty-five children who were admitted to the pediatric department for minor surgical problems served as control group. OPG was significantly lower in all patients compared with controls, while RANKL levels were significantly increased in advanced neuroblastoma. OPG-to-RANKL ratio decreased in stage-IV patients, and particularly in those who had bone metastases. The diagnostic accuracy of the OPG-to-RANKL ratio in discriminating the presence of osteolytic lesions was not confirmed statistically. OPG correlated significantly with other prognostic factors, namely, ferritin and neurone-specific enolase. In addition, an inverse relationship was found between OPG and event-free survival, and it was more significant in patients who had bone metastasis. This pilot study confirms that the production of OPG and RANKL is disregulated in neuroblastoma. Although the OPG-to-RANKL ratio does not have a predictive value in detecting bone metastasis, the measurement of the previously mentioned markers could be useful in decisions regarding the use of adjuvant therapies.
authors.affiliation: Laboratory for Pathophysiology, Istituti Ortopedici Rizzoli, Bologna, Italy. donatella.granchi@ior.it
authors.forename: Donatella
authors.initials: D
authors.lastname: Granchi
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.forename: Ilaria
authors.initials: I
authors.lastname: Amato
authors.forename: Paolo
authors.initials: P
authors.lastname: Paolucci
authors.forename: Nicola
authors.initials: N
authors.lastname: Baldini
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood* / Q000378:metabolism / Q000556:secondary*; D001842:Bone and Bones / Q000378:metabolism; D002352:Carrier Proteins / Q000097:blood* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006023:Glycoproteins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood* / Q000378:metabolism; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000097:blood* / Q000378:metabolism / Q000556:secondary*; D010014:Osteolysis; D053244:Osteoprotegerin; D011237:Predictive Value of Tests; D011379:Prognosis; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood* / Q000378:metabolism; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood* / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D006023:Glycoproteins; D008562:Membrane Glycoproteins; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C505686:TNFRSF11A protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human