The VLA-4–VCAM1 interaction also induces the production of BMSCs-derived receptor activator of NFκB ligand (RANKL), a membrane-bound or soluble (sRANKL) cytokine essential for osteoclast differentiation, which further increases osteoclast activation and bone lysis in MM. The gene discussed is TNFSF11; the disease is Miyoshi myopathy.