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Review Question - QID 897

QID 897 (Type "897" in App Search)
Ultra-high-molecular-weight polyethylene (UHMWPE) particles have been associated with osteoclastogenesis, a key component of osteolysis in total joint replacement. Which of the following accurately describes the expression of vascular endothelial growth factor (VEGF) and receptor activator of nuclear factor kappa-B ligand (RANKL) during UHWMPE induced osteolysis?

RANKL expression is increased and VEGF is unchanged or mildly decreased

16%

428/2666

VEGF expression is increased and RANKL is decreased

4%

113/2666

VEGF expression is increased and RANKL expression is unchanged

3%

92/2666

Expression of both VEGF and RANKL is increased

75%

1987/2666

Expression of both VEGF and RANKL is decreased

1%

35/2666

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RANKL, RANK, and VEGF are upregulated in any process that involves increased osteoclast activity.

Ren et al. found in a mouse model study that UHMWPE stimulation significantly increased VEGF, RANK, and RANKL gene expression. VEGF inhibitor was shown to reduce the UHMWPE-stimulated VEGF production. VEGF inhibitor also resulted in reduced RANK and RANKL gene transcripts. Thus, this study suggests that VEGF has a role in the regulation of RANK/RANKL-mediated osteoclastogenesis.

VEGF is also an important factor in angiogenesis in multiple tissues, including normal tissue (e.g. tendons) and several cancers.

Illustration A depicts the interaction of osteoblasts and osteoclasts (E=estrogen, P-C-P=bisphosphonates, CT=calcitonin). Illustration V is a video tutorial of RANK, RANK-L, and OPG and their role in postmenopausal osteoporosis.

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