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Leukemia. 2017 Dec;31(12):2686-2694. doi: 10.1038/leu.2017.152. Epub 2017 May 22.

Genetic deletion of Sost or pharmacological inhibition of sclerostin prevent multiple myeloma-induced bone disease without affecting tumor growth.

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Department of Anatomy and Cell Biology, Indiana University, Indianapolis, IN, USA.
Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA.
Division of Hematology/Oncology, Department of Medicine, Indiana University, Indianapolis, IN, USA.
Lilly Research Laboratories, Indianapolis, Indiana, USA.
Division of Endocrinology, Department of Medicine, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA.


Multiple myeloma (MM) causes lytic bone lesions due to increased bone resorption and concomitant marked suppression of bone formation. Sclerostin (Scl), an osteocyte-derived inhibitor of Wnt/β-catenin signaling, is elevated in MM patient sera and increased in osteocytes in MM-bearing mice. We show here that genetic deletion of Sost, the gene encoding Scl, prevented MM-induced bone disease in an immune-deficient mouse model of early MM, and that administration of anti-Scl antibody (Scl-Ab) increased bone mass and decreases osteolysis in immune-competent mice with established MM. Sost/Scl inhibition increased osteoblast numbers, stimulated new bone formation and decreased osteoclast number in MM-colonized bone. Further, Sost/Scl inhibition did not affect tumor growth in vivo or anti-myeloma drug efficacy in vitro. These results identify the osteocyte as a major contributor to the deleterious effects of MM in bone and osteocyte-derived Scl as a promising target for the treatment of established MM-induced bone disease. Further, Scl did not interfere with efficacy of chemotherapy for MM, suggesting that combined treatment with anti-myeloma drugs and Scl-Ab should effectively control MM growth and bone disease, providing new avenues to effectively control MM and bone disease in patients with active MM.

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