Gassner R J, Buckley M J, Studer R K, Evans C H, Agarwal S
Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria.
Int J Oral Maxillofac Surg. 2000 Oct;29(5):389-94.
In temporomandibular joint disorders, the release of proinflammatory cytokines such as interleukin-1 (IL-1) initiates an inflammatory process disrupting cartilage homeostasis, ultimately leading to cartilage destruction. Additionally, mechanical stimuli affect articular chondrocyte metabolism. While articular chondrocytes generate nitric oxide (NO) in the presence of IL-1 proteoglycan synthesis is consecutively suppressed. The purpose of this study was to assess the effects of proinflammatory cytokines and mechanical strain in the form of cyclic tensile stretch on proteoglycan synthesis in chondrocytes, as compared to the NO competitive inhibitor L-N-monomethyl arginine (LMA), and to assess whether this effect is secondarily related to the activity of growth factors such as transforming growth factor beta (TGF-beta). Lapine articular chondrocytes were exposed to one of four different treatment regimens: no cyclic tensile stretch, IL-1, cyclic tensile stretch, or IL-1 plus cyclic tensile stretch. NO production was determined as medium nitrite accumulation. TGF-beta-bioactivity in chondrocyte conditioned medium was measured with the mink-lung epithelial cell bioassay. Proteoglycan synthesis was measured as the incorporation of 35-[S]-sodium sulfate into macromolecules separated from unincorporated label by gel filtration on PD-10 columns. In resting chondrocyte cultures, only baseline levels of NO were measured and the application of stretch for 24 h did not affect NO production. Addition of IL-1 provoked a large increase in NO synthesis which was abrogated in the presence of LMA. Application of stretch decreased the IL-1 induced NO synthesis, but did not modify the effect of LMA (being a competitive inhibitor of the inducible NO synthase) inhibiting IL-1 induced NO production. Glucosaminoglycan production was noted as proteoglycan synthesis showing almost no effect of cyclic stretch alone in comparison to the control condition, which correlates with the missing NO production in control and stretch conditions. Addition of IL-1 strongly inhibited proteoglycan synthesis, which was partly restored in the presence of LMA. However, cyclic stretch acted as a stronger restorer of proteoglycan synthesis in IL-1 treated conditions in the absence, and even more in the presence, of LMA. It was concluded that motion in the form of cyclic tensile stretch is a remarkable anti-inflammatory stimulus reversing the IL-1 induced suppression of proteoglycan synthesis in chondrocytes. These findings have therapeutic implications for the treatment of temporomandibular joint disorders, supporting early onset of postoperative and post-traumatic continuous passive motion therapy.
在颞下颌关节紊乱症中,白细胞介素 -1(IL -1)等促炎细胞因子的释放引发炎症过程,破坏软骨内环境稳定,最终导致软骨破坏。此外,机械刺激会影响关节软骨细胞的代谢。在存在IL -1的情况下,关节软骨细胞会产生一氧化氮(NO),同时蛋白聚糖合成会受到连续抑制。本研究的目的是评估促炎细胞因子和以周期性拉伸形式存在的机械应变对软骨细胞中蛋白聚糖合成的影响,并与NO竞争性抑制剂L -N -单甲基精氨酸(LMA)进行比较,同时评估这种影响是否继发于转化生长因子β(TGF -β)等生长因子的活性。将兔关节软骨细胞暴露于四种不同的处理方案之一:无周期性拉伸、IL -1、周期性拉伸或IL -1加周期性拉伸。通过培养基中亚硝酸盐积累来测定NO的产生。用貂肺上皮细胞生物测定法测量软骨细胞条件培养基中的TGF -β生物活性。通过在PD -10柱上进行凝胶过滤,将35 -[S] -硫酸钠掺入从未掺入标记物中分离出的大分子中来测量蛋白聚糖的合成。在静止的软骨细胞培养物中,仅测量到基线水平的NO,施加24小时的拉伸不会影响NO的产生。添加IL -1会导致NO合成大幅增加,而在存在LMA的情况下这种增加会被消除。施加拉伸会降低IL -1诱导的NO合成,但不会改变LMA(作为诱导型NO合酶的竞争性抑制剂)抑制IL -1诱导的NO产生的效果。与对照条件相比,单独的周期性拉伸对蛋白聚糖合成几乎没有影响,这与对照和拉伸条件下NO产生的缺失相关,此时的蛋白聚糖合成以糖胺聚糖产生来衡量。添加IL -1会强烈抑制蛋白聚糖合成,在存在LMA的情况下这种抑制会部分恢复。然而,在不存在LMA甚至存在LMA的情况下,周期性拉伸在IL -1处理条件下对蛋白聚糖合成的恢复作用更强。得出的结论是,以周期性拉伸形式存在的运动是一种显著的抗炎刺激,可逆转IL -1诱导的软骨细胞中蛋白聚糖合成的抑制。这些发现对颞下颌关节紊乱症的治疗具有治疗意义,支持术后和创伤后早期开始持续被动运动疗法。