The gene TNFRSF11B encodes for osteoprotegerin (OPG) and was recently identified as the CCAL1 locus associated with familial calcium pyrophosphate deposition disease (CPDD). While the CCAL1 OPG mutation (OPG-XL) was originally believed to be a gain-of-function mutation, loss of OPG activity causes arthritis-associated osteolysis in mice, which is likely related to excess subchondral osteoclast formation and/or activity. The purpose of the present study was to further explore the effect of OPG-XL in osteoclastogenesis. The effects of recombinant OPG-XL and wild-type (WT) OPG were determined in monoculture and coculture models of RANKL-induced osteoclastogenesis. The effects of OPG-XL on osteoclast survival as well as on TRAIL-induced apoptosis were determined using standard in vitro assays and compared to WT OPG. The ability of OPG-XL and WT OPG to bind to osteoblasts was measured with enzyme-linked immunosorbent assay and flow cytometry using the osteoblastic MC3T3-E1 cell line. OPG-XL was less effective than WT OPG at blocking RANKL-induced osteoclastogenesis in monoculture and coculture models. Osteoclast survival and inhibition of TRAIL-induced apoptosis were similar in the presence of OPG-XL and WT OPG. Compared to WT OPG, considerably less OPG-XL bound to cells. These findings indicate that OPG-XL is a loss-of-function mutation as it relates to RANKL-mediated osteoclastogenesis, and thus may permit increased osteoclast numbers and heightened bone turnover. Further studies are necessary to demonstrate how this mutation contributes to arthritis in individuals carrying this mutation.

ANKH is the human homolog of a gene whose dysfunction in a mutant mouse strain results in progressive ankylosis of the spine as well as soft tissue mineralization. ANKH mutations have been reported in inherited human disorders such as familial calcium pyrophosphate deposition disease (CPPD) and cranial metaphyseal dysplasia; however, research into the function of the ANKH protein has been more challenging. Progress has recently been made to understand the role of ANKH in the regulation of physiological and pathological mineralization. ANKH expression is regulated by intracellular levels of oxygen, phosphate and calcium as well as by the growth factor TGF-β. In addition, ANKH expression affects chondrogenesis, osteoblastogenesis and osteoclastogenesis. ANKH appears to interact with several cellular proteins, including the phosphate transporter PiT-1, and with proteins involved in NF-kappa β signaling, suggesting that ANKH may play an important non-PPi transporter role. ANKH has also been shown to regulate ATP efflux from chondrocytes. ANKH expression, as well as its potential non-PPi transporter functions, plays a variety of roles in the regulation of cellular events that surround differentiation and mineralization in bone and cartilage. Additional studies are warranted to further elucidate the contributions of ANKH to human health and disease, and to determine if ANKH deserves targeting for the treatment of diseases such as CPPD.