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Osteoporosis: from Peter on 2009-10-08

A new paper suggesting a possible causal mechanism for osteoporosis in coeliacs, and a method for treatment.

New England Journal of Medicine

Osteoporosis Associated with Neutralizing Autoantibodies against Osteoprotegerin
Philip L. Riches, M.R.C.P., Euan McRorie, F.R.C.P., William D. Fraser, Ph.D., F.R.C.Path., Catherine Determann, B.Med.Sci., Rob van't Hof, Ph.D., and Stuart H. Ralston, M.D.



SUMMARY

Autoantibodies against osteoprotegerin, which block the inhibitory effect of osteoprotegerin on signaling by the receptor activator of nuclear factor (NF)-B (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.