“…Competitive ELISA was reported to determine the bioactivity of anti-RANKL mAbs. 18 However, ELISA only involves the initial step of binding, which is far from the end point of the biological response, so it could not completely represent the MOA of anti-RANKL mAbs. As for bioactivity determination of anti-RANKL mAbs with cell based methods, calcification of porcine valvular interstitial cells was checked by Alizarin red staining, 19 and maturation of patients-derived and mice-derived osteoclast were indicated by tartrate resistant acid phosphatase (TRAP) activity, 20 while both of which are unsuitable for routine bioassay due to the employment of primary cells and the resultant high variability.…”