Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. Jul 26, 2026; 14(21): 121907
Published online Jul 26, 2026. doi: 10.12998/wjcc.121907
Published online Jul 26, 2026. doi: 10.12998/wjcc.121907
Dickkopf-1 in rheumatoid arthritis: Mechanistic insights, imaging associations, and emerging therapeutic strategies
Adithya Vikram Rajesh, Department of Orthopaedics, Government Tirunelveli Medical College and Hospital, Tirunelveli 627011, Tamil Nadu, India
Arunagiri Gunasekar, Department of Orthopaedics, Government Medical College and Hospital, Thiruvallur 602001, Tamil Nadu, India
Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Naveen Jeyaraman, Arulkumar Nallakumarasamy, Sathish Muthu, Madhan Jeyaraman, De
Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman, Department of Orthopaedics, Or
Sanjeevi Bharadwaj, Department of Trauma and Orthopaedics, Wye Valley NHS Trust, Here
Arulkumar Nallakumarasamy, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Author contributions: Rajesh VA, Gunasekar A, Jeyaraman N, Bharadwaj S, Nallakumarasamy A, and Muthu S analyzed the articles for the review and wrote the manuscript; Jeyaraman N, Bharadwaj S, and Jeyaraman M designed the research; Jeyaraman M finalized the manuscript.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Conflict-of-interest statement: The authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Madhan Jeyaraman, MD, PhD, Associate Professor, Researcher, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India.
Received: April 17, 2026
Revised: May 6, 2026
Accepted: June 9, 2026
Published online: July 26, 2026
Processing time: 108 Days and 18.2 Hours
Revised: May 6, 2026
Accepted: June 9, 2026
Published online: July 26, 2026
Processing time: 108 Days and 18.2 Hours
Core Tip
Core Tip: Dickkopf-1 (DKK-1) is a key regulator of bone remodeling in rheumatoid arthritis, driving erosion by inhibiting Wnt signaling, suppressing osteoblasts, and enhancing RANKL-mediated osteoclastogenesis. Elevated DKK-1 correlates with inflammation, autoantibodies, disease activity, and imaging indices, while genetic variants modulate risk. Though blockade shows therapeutic promise, safety concerns and assay variability remain. DKK-1 offers a multidimensional biomarker for prognosis, monitoring, and precision-targeted therapy in rheumatoid arthritis.