Department of Pathology, Amgen Inc., Seattle, WA, USA.
Therapeutic Innovation Unit, Amgen Inc., Seattle, WA, USA.
J Bone Oncol. 2015 Jul 29;4(3):59-68. doi: 10.1016/j.jbo.2015.06.002. eCollection 2015 Sep.
Receptor activator of nuclear factor kappa-B ligand (RANKL) is an essential mediator of osteoclast formation, function and survival. In patients with solid tumor metastasis to the bone, targeting the bone microenvironment by inhibition of RANKL using denosumab, a fully human monoclonal antibody (mAb) specific to RANKL, has been demonstrated to prevent tumor-induced osteolysis and subsequent skeletal complications. Recently, a prominent functional role for the RANKL pathway has emerged in the primary bone tumor giant cell tumor of bone (GCTB). Expression of both RANKL and RANK is extremely high in GCTB tumors and denosumab treatment was associated with tumor regression and reduced tumor-associated bone lysis in GCTB patients. In order to address the potential role of the RANKL pathway in another primary bone tumor, this study assessed human RANKL and RANK expression in human primary osteosarcoma (OS) using specific mAbs, validated and optimized for immunohistochemistry (IHC) or flow cytometry. Our results demonstrate RANKL expression was observed in the tumor element in 68% of human OS using IHC. However, the staining intensity was relatively low and only 37% (29/79) of samples exhibited≥10% RANKL positive tumor cells. RANK expression was not observed in OS tumor cells. In contrast, RANK expression was clearly observed in other cells within OS samples, including the myeloid osteoclast precursor compartment, osteoclasts and in giant osteoclast cells. The intensity and frequency of RANKL and RANK staining in OS samples were substantially less than that observed in GCTB samples. The observation that RANKL is expressed in OS cells themselves suggests that these tumors may mediate an osteoclastic response, and anti-RANKL therapy may potentially be protective against bone pathologies in OS. However, the absence of RANK expression in primary human OS cells suggests that any autocrine RANKL/RANK signaling in human OS tumor cells is not operative, and anti-RANKL therapy would not directly affect the tumor.
核因子-κB 受体激活物配体(RANKL)是破骨细胞形成、功能和存活的重要介质。在实体瘤转移至骨骼的患者中,通过使用 denosumab(一种针对 RANKL 的完全人源单克隆抗体[ mAb ])抑制 RANKL 来靶向骨骼微环境,已被证明可预防肿瘤诱导的溶骨性骨破坏和随后的骨骼并发症。最近,RANKL 途径在原发性骨肿瘤——骨巨细胞瘤(GCTB)中具有突出的功能作用。GCTB 肿瘤中 RANKL 和 RANK 的表达都极高,denosumab 治疗与 GCTB 患者的肿瘤消退和肿瘤相关骨溶解减少相关。为了研究 RANKL 途径在另一种原发性骨肿瘤中的潜在作用,本研究使用专门的 mAb 评估了人类 RANKL 和 RANK 在人类原发性骨肉瘤(OS)中的表达,这些 mAb 已针对免疫组织化学(IHC)或流式细胞术进行了验证和优化。我们的结果表明,在 68%的人类 OS 中,通过 IHC 观察到 RANKL 在肿瘤成分中的表达。然而,染色强度相对较低,只有 37%(29/79)的样本显示≥10%的 RANKL 阳性肿瘤细胞。在 OS 肿瘤细胞中未观察到 RANK 的表达。相比之下,在 OS 样本中的其他细胞中清楚地观察到 RANK 的表达,包括髓样破骨细胞前体区室、破骨细胞和巨核破骨细胞。OS 样本中 RANKL 和 RANK 的染色强度和频率明显低于 GCTB 样本。在 OS 细胞本身中表达 RANKL 的观察结果表明,这些肿瘤可能介导破骨细胞反应,抗 RANKL 治疗可能对 OS 中的骨骼病理具有保护作用。然而,在原发性人类 OS 细胞中不存在 RANK 的表达表明,任何在人类 OS 肿瘤细胞中的自分泌 RANKL/RANK 信号都不起作用,抗 RANKL 治疗不会直接影响肿瘤。