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Title: The study of RANK mutations associated with the diseases of osteoclast dysfunction
Author: Mellis, David
ISNI:       0000 0004 2707 3912
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2010
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Osteoclasts are the cells that resorb bone to maintain a healthy skeleton. Receptor activator of NFkB (RANK) is a receptor that is critical for the formation, activity and survival of osteoclasts. A number of mutations have been identified within RANK that cause bone diseases with opposite osteoclast phenotypes. The aim of this thesis was to study the downstream consequences of these disease-associated mutations for RANK protein processing and activation of the RANK signalling pathway. Early onset Paget’s disease of bone (ePDB), Familial Expansile Osteolysis (FEO) and Expansile Skeletal Hyperphosphatasia (ESH) are conditions featuring focal areas of increased bone resorption driven by overactive osteoclasts. These conditions are caused by heterozygous insertion mutations in the signal peptide region of the RANK gene, but the mechanisms underlying the development of overactive osteoclasts are not known. In this thesis, in vitro study of the mutant RANK proteins demonstrated that homozygous overexpression caused inactivation of RANK signalling due to intracellular accumulation of RANK within an extended form of the endoplasmic reticulum. By contrast, when expressed in a heterozygous manner, the mutant proteins were found at the plasma membrane and caused prolonged ligand-dependent signalling. Taken together and as predicted by the clinical situation, these data strongly suggest that heterozygous expression of the mutant RANK proteins hold the key to the hyperactive osteoclast phenotype associated with these diseases. Osteoclast-poor osteopetrosis is a disease in which osteoclasts do not form leading to a high bone mass phenotype. Single base pair mutations within RANK have been identified in some patients with this condition. These mutant RANK proteins were studied and the findings related to regions within RANK in which the mutations occur that have been shown to be critical for its function. In addition, osteoclast formation was assessed in cultures of peripheral blood mononuclear cells isolated from patients with osteopetrosis with unidentified genetic background in order to further characterise the osteoclast phenotype for each patient. In summary, the findings presented in this thesis begin to elucidate the molecular mechanisms leading to diseases of bone with opposite osteoclast phenotypes that, paradoxically, are all caused by inactivating mutations in the RANK gene.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Osteoclasts ; Bone