TNFRSF11A and Fabry disease: Based on these findings, our current understanding of FD pathophysiology is that of a positive feedback loop between altered BMSCs and osteoclasts, through which FD BMSCs release pro-osteoclastic factors inducing osteoclastogenesis, and osteoclasts respond increasing BMSC proliferation and contributing to their altered differentiation through intercellular signals like RANK-containing extracellular vesicles(8,9).