Abstract

Receptor activator of NF-κB ligand (RANKL), a critical mediator of osteoclastogenesis, is upregulated in multiple myeloma (MM). The xanthine oxidase inhibitor febuxostat, clinically used for prevention of tumor lysis syndrome, has been demonstrated to effectively inhibit not only the generation of uric acid but also the formation of reactive oxygen species (ROS). ROS has been demonstrated to mediate RANKL-mediated osteoclastogenesis. In the present study, we therefore explored the role of cancer-treatment-induced ROS in RANKL-mediated osteoclastogenesis and the suppressive effects of febuxostat on ROS generation and osteoclastogenesis. RANKL dose-dependently induced ROS production in RAW264.7 preosteoclastic cells; however, febuxostat inhibited the RANKL-induced ROS production and osteoclast (OC) formation. Interestingly, doxorubicin (Dox) further enhanced RANKL-induced osteoclastogenesis through upregulation of ROS production, which was mostly abolished by addition of febuxostat. Febuxostat also inhibited osteoclastogenesis enhanced in cocultures of bone marrow cells with MM cells. Importantly, febuxostat rather suppressed MM cell viability and did not compromise Dox’s anti-MM activity. In addition, febuxostat was able to alleviate pathological osteoclastic activity and bone loss in ovariectomized mice. Collectively, these results suggest that excessive ROS production by aberrant RANKL overexpression and/or anticancer treatment disadvantageously impacts bone, and that febuxostat can prevent the ROS-mediated osteoclastic bone damage.

Highlights

  • Multiple myeloma (MM) has a unique propensity to almost exclusively develop in the bone marrow and generates devastating bone destruction

  • XO-mediated intracellular reactive oxygen species (ROS) production [19], we looked at the effects of febuxostat on ROS

  • Because ROS has been recognized as an intracellular signal mediator for RANKL-induced OC differentiation [11,21,22], these results suggest that febuxostat can act as an inhibitor for RANKL-induced osteoclastogenesis through the suppression of ROS production

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Summary

Introduction

Multiple myeloma (MM) has a unique propensity to almost exclusively develop in the bone marrow and generates devastating bone destruction. MM cells enhance osteoclast (OC) formation and activity and suppress osteoblastic differentiation from bone marrow stromal cells, leading to extensive bone destruction with rapid loss of bone [1,2,3]. ROS has been demonstrated to be produced during RANKL-induced osteoclastogenesis from bone marrow monocyte–macrophage lineage cells (BMMs), and antioxidants, including N-acetylcysteine (NAC), have been proven to prevent the RANKL-induced OC differentiation by decreasing ROS [10,11,12]. These results indicate that ROS plays a critical role in OC differentiation and activity [12,13,14]. The roles of ROS induced by anticancer agents in osteoclastogenesis have not been studied

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