Background Myeloma cells may secrete factors that affect thefunction of osteoblasts, osteoclasts, or both.
Methods We subjected purified plasma cells from the bone marrowof patients with newly diagnosed multiple myeloma and controlsubjects to oligonucleotide microarray profiling and biochemicaland immunohistochemical analyses to identify molecular determinantsof osteolytic lesions.
Results We studied 45 control subjects, 36 patients with multiplemyeloma in whom focal lesions of bone could not be detectedby magnetic resonance imaging (MRI), and 137 patients in whomMRI detected such lesions. Different patterns of expressionof 57 of approximately 10,000 genes from purified myeloma cellscould be used to distinguish the two groups of patients (P<0.001).Permutation analysis, which adjusts the significance level toaccount for multiple comparisons in the data sets, showed that4 of these 57 genes were significantly overexpressed by plasmacells from patients with focal lesions. One of these genes,dickkopf 1 (DKK1), and its corresponding protein (DKK1) werestudied in detail because DKK1 is a secreted factor that hasbeen linked to the function of osteoblasts. Immunohistochemicalanalysis of bone marrowbiopsy specimens showed that onlymyeloma cells contained detectable DKK1. Elevated DKK1 levelsin bone marrow plasma and peripheral blood from patients withmultiple myeloma correlated with the gene-expression patternsof DKK1 and were associated with the presence of focal bonelesions. Recombinant human DKK1 or bone marrow serum containingan elevated level of DKK1 inhibited the differentiation of osteoblastprecursor cells in vitro.
Conclusions The production of DKK1, an inhibitor of osteoblastdifferentiation, by myeloma cells is associated with the presenceof lytic bone lesions in patients with multiple myeloma.
Source Information
From the Donna D. and Donald M. Lambert Laboratory of Myeloma Genetics, Myeloma Institute for Research and Therapy (E.T., F.Z., B.B., J.D.S.), and the Departments of Radiology (R.W.) and Pathology (Y.M.), College of Medicine, University of Arkansas for Medical Sciences, Little Rock; and Cancer Research and Biostatistics, Seattle (E.R.). Mr. Tian and Dr. Zhan contributed equally to the article.
Address reprint requests to Dr. Shaughnessy at the Donna D. and Donald M. Lambert Laboratory of Myeloma Genetics, University of Arkansas for Medical Sciences, 4301 W. Markham St. #776, Little Rock, AR 72205, or at jshaughnessy{at}uams.edu.
DKK1 in Multiple Myeloma
Meyer M. A., Hofbauer L. C., Neubauer A., Schoppet M., Lu C. M., Walker R. C., Barlogie B., Shaughnessy J. Jr.
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N Engl J Med 2004;
350:1464-1466, Apr 1, 2004.
Correspondence
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Ebeling, P. R.
(2005). Defective Osteoblast Function May Be Responsible for Bone Loss from the Proximal Femur Despite Pamidronate Therapy. J. Clin. Endocrinol. Metab.
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Morgan, T., Atkins, G. J., Trivett, M. K., Johnson, S. A., Kansara, M., Schlicht, S. L., Slavin, J. L., Simmons, P., Dickinson, I., Powell, G., Choong, P. F.M., Holloway, A. J., Thomas, D. M.
(2005). Molecular Profiling of Giant Cell Tumor of Bone and the Osteoclastic Localization of Ligand for Receptor Activator of Nuclear Factor {kappa}B. Am. J. Pathol.
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Bergsagel, P. L., Kuehl, W. M., Zhan, F., Sawyer, J., Barlogie, B., Shaughnessy, J. Jr
(2005). Cyclin D dysregulation: an early and unifying pathogenic event in multiple myeloma. Blood
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Ai, M., Holmen, S. L., Van Hul, W., Williams, B. O., Warman, M. L.
(2005). Reduced Affinity to and Inhibition by DKK1 Form a Common Mechanism by Which High Bone Mass-Associated Missense Mutations in LRP5 Affect Canonical Wnt Signaling. Mol. Cell. Biol.
25: 4946-4955
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Oyajobi, B. O., Shipman, C. M., Mundy, G. R.
(2005). Recent Insights into Myeloma Bone Disease. IBMS BoneKEy
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Wang, F.-S., Lin, C.-L., Chen, Y.-J., Wang, C.-J., Yang, K. D., Huang, Y.-T., Sun, Y.-C., Huang, H.-C.
(2005). Secreted Frizzled-Related Protein 1 Modulates Glucocorticoid Attenuation of Osteogenic Activities and Bone Mass. Endocrinology
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Tickenbrock, L., Schwable, J., Wiedehage, M., Steffen, B., Sargin, B., Choudhary, C., Brandts, C., Berdel, W. E., Muller-Tidow, C., Serve, H.
(2005). Flt3 tandem duplication mutations cooperate with Wnt signaling in leukemic signal transduction. Blood
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Bredella, M. A., Steinbach, L., Caputo, G., Segall, G., Hawkins, R.
(2005). Value of FDG PET in the Assessment of Patients with Multiple Myeloma. Am. J. Roentgenol.
184: 1199-1204
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Ranheim, E. A., Kwan, H. C. K., Reya, T., Wang, Y.-K., Weissman, I. L., Francke, U.
(2005). Frizzled 9 knock-out mice have abnormal B-cell development. Blood
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He, B., Lee, A. Y., Dadfarmay, S., You, L., Xu, Z., Reguart, N., Mazieres, J., Mikami, I., McCormick, F., Jablons, D. M.
(2005). Secreted Frizzled-Related Protein 4 Is Silenced by Hypermethylation and Induces Apoptosis in {beta}-Catenin-Deficient Human Mesothelioma Cells. Cancer Res.
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Gregory, C. A., Perry, A. S., Reyes, E., Conley, A., Gunn, W. G., Prockop, D. J.
(2005). Dkk-1-derived Synthetic Peptides and Lithium Chloride for the Control and Recovery of Adult Stem Cells from Bone Marrow. J. Biol. Chem.
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Abraham, R. S., Ballman, K. V., Dispenzieri, A., Grill, D. E., Manske, M. K., Price-Troska, T. L., Paz, N. G., Gertz, M. A., Fonseca, R.
(2005). Functional gene expression analysis of clonal plasma cells identifies a unique molecular profile for light chain amyloidosis. Blood
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Luo, Q., Kang, Q., Si, W., Jiang, W., Park, J. K., Peng, Y., Li, X., Luu, H. H., Luo, J., Montag, A. G., Haydon, R. C., He, T.-C.
(2004). Connective Tissue Growth Factor (CTGF) Is Regulated by Wnt and Bone Morphogenetic Proteins Signaling in Osteoblast Differentiation of Mesenchymal Stem Cells. J. Biol. Chem.
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Colucci, S., Brunetti, G., Rizzi, R., Zonno, A., Mori, G., Colaianni, G., Del Prete, D., Faccio, R., Liso, A., Capalbo, S., Liso, V., Zallone, A., Grano, M.
(2004). T cells support osteoclastogenesis in an in vitro model derived from human multiple myeloma bone disease: the role of the OPG/TRAIL interaction. Blood
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