title: Osteoporosis associated with neutralizing autoantibodies against osteoprotegerin.
abstract: Autoantibodies against osteoprotegerin, which block the inhibitory effect of osteoprotegerin on signaling by the receptor activator of nuclear factor (NF)-kappaB (RANK), were identified in a man with celiac disease who presented with severe osteoporosis and high bone turnover. The osteoporosis did not respond to the treatment of his celiac disease but was completely reversed by bisphosphonate therapy. Autoantibodies against osteoprotegerin were detected in three additional patients with celiac disease. Such autoantibodies may be associated with the development of high-turnover osteoporosis, but whether autoantibodies against osteoprotegerin commonly contribute to the pathogenesis of osteoporosis in patients with celiac disease remains to be determined.
authors.affiliation: Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Riches
authors.forename: Euan
authors.initials: E
authors.lastname: McRorie
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
authors.forename: Catherine
authors.initials: C
authors.lastname: Determann
authors.forename: Rob
authors.initials: R
authors.lastname: van't Hof
authors.forename: Stuart H
authors.initials: SH
authors.lastname: Ralston
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000276:immunology; D016723:Bone Remodeling; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000276:immunology; D055050:Diet, Gluten-Free; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000276:immunology; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy / Q000276:immunology*; D053244:Osteoprotegerin / Q000276:immunology*; D053245:RANK Ligand / Q000378:metabolism; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000378:metabolism; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human; C505688:TNFSF11 protein, human; D011503:Transglutaminases