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A bio-assay for effectors of osteoclast differentiation in serum from patients with bone diseaseOsteoclast differentiation and activity, and hence bone loss, depend on two opposing cytokines. Receptor activator of NF-κB ligand (RANKL) produced by osteoblasts and T-cells stimulates, while osteoprotegerin inhibits. Both of these cytokines are found in serum. Our aim was to develop a functional assay for any factors present in human serum that can affect osteoclast differentiation and to assess whether any such factors vary in diseases in which bone loss occurs.