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J Oral Pathol Med. 2006 Nov;35(10):620-5.

RANKL and cathepsin K in diffuse sclerosing osteomyelitis of the mandible.

Author information

1
Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland. marjut.montonen@kolumbus.fi

Abstract

BACKGROUND:

Diffuse sclerosing osteomyelitis (DSO) of the mandible is characterized by mixed bone resorption and formation.

METHODS:

Immunohistopathology of DSO in the clinically acute and subacute phases was compared with healthy bone.

RESULTS:

Receptor activator of nuclear factor kappaB ligand (RANKL) was found in DSO lesions. When it was used in vitro to stimulate monocytes, cathepsin K expression was observed in mononuclear prefusion precursors and in multinuclear giant cells. Similarly, exacerbations of DSO were characterized by RANKL and induction of cathepsin K in mononuclear precursor cells, which subsequently seem to differentiate into osteoclasts or foreign body giant cells. The proportion of bone to soft tissue increased with the duration of disease.

CONCLUSIONS:

RANKL-driven osteoclastogenesis and acidic cysteine endoproteinase cathepsin K seem to play important roles in DSO as osteoclast-mediated bone resorption may represent the primary disease process later followed by new bone formation.

[Indexed for MEDLINE]

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