Antibodies may be directly influencing the development of the chronic bone fragility disease osteoporosis in patients with autoimmune diseases such as rheumatoid arthritis. The preliminary discovery may represent a major advance in the fight against osteo

PRESS DISPENSARY - Wednesday, Jun 30, 2010 - Antibodies which neutralise osteoprotegerin (OPG) may be directly influencing the development of osteoporosis in patients with autoimmune diseases such as rheumatoid arthritis, coeliac disease and even thyroid disease, according to preliminary research by the Rheumatology Department at the Institute of Genetics and Molecular Medicine in Edinburgh. Recent studies have identified detectable levels of OPG antibodies in such patients.

Osteoporosis is a chronic disease that causes bone fragility and results in 230,000 fractures annually in the UK* while OPG is a defence against osteoporosis as it inhibits bone resorption (the breaking down and therefore weakening of bones, which increases with age). Osteoporosis is recognised as a complication of certain autoimmune diseases but, until now, it has been attributed to multiple causes such as malabsorption, over production of pro-inflammatory cytokines, immobility or corticosteroid therapy. However, the new study suggests that antibodies which oppose OPG may be neutralising its benefits and therefore contributing directly to the advance of osteoporosis.

Following the observation in a patient with coeliac disease that severe osteoporosis occurred alongside the development of neutralising antibodies to OPG, a test was conducted at the Institute of Genetics and Molecular Medicine in which 46 patients with coeliac disease were screened for the presence of OPG antibodies. During the study, antibodies were detected in 33% of this group. In further pilot studies, OPG antibodies were identified in 20% of patients with inflammatory arthritis, 10% of patients with hypothyroidis and a full 80% of patients with severe osteoporosis.

Speaking at the 37th European Symposium on Calcified Tissues taking place in Glasgow on Wednesday 30 June 2010, the Institute's Dr Philip Riches says: "Although our data is preliminary, it is proof of concept that autoantibodies to OPG occur commonly in a variety of autoimmune diseases, as well as in a high percentage of unselected patients with severe osteoporosis. This raises the possibility that they may contribute more generally to the pathogenesis of osteoporosis. We're carrying out further studies to establish the clinical significance of these antibodies."

Further work is ongoing.

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Notes for editors

The European Calcified Tissue Society (ECTS) is the major organisation in Europe for researchers and clinicians working in the field of calcified tissues and related fields. ECTS acts as a forum for the dissemination of high quality research through its annual meeting, the European Symposium on Calcified Tissues, and through training courses and workshops.

Calcified tissues are central to a healthy skeleton and to bone disorders - such as osteoporosis, back pain and fractures - that make life a misery for countless people. Children can inherit some forms of bone diseases causing bone pain, shortness and deformed limbs.

The '3rd Joint Meeting of the European Calcified Tissue Society and the International Bone and Mineral Society' takes place in Athens on 7-11 May, 2011. Some 3,500 delegates are expected to attend.

* Source: National Osteoporosis Society

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