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© 2010 @ Southern Arizona Limb Salvage Alliance (SALSA) Authorship: Nicholas A. Giovinco Julia Bernardini David G. Armstrong The Receptor Activator for Nuclear Factor kappa B Ligand is believed to be an important molecule of bone metabolism. This is a natural and necessary surface-bound molecule on several types of cells, and serves to activate osteoclasts. Overproduction of RANKL is implicated in a variety of degenerative diseases. In patients with neuropathy, the RANKL/OPG pathway is thought to mediate the development of Neuropathic Osteoarthropathy or “Charcot Joint“ An illustrative depiction of the RANKL pathway is as follows: Cellular stress or injury may result in expression of RANK Ligand on the surface of activated ostoblasts and T cells. In this example, an activated T cell is contacting a pre-osteoclast. Because this RANKL presenting cell is in an activated
