Ahmed Neveen, Petersson Arne, Catrina Anca Irinel, Mustafa Hamid, Alstergren Per
Department of Dental Medicine, Section for Orofacial Pain and Jaw Function, Karolinska Institutet , Huddinge , Sweden.
Acta Odontol Scand. 2015 Apr;73(3):232-40. doi: 10.3109/00016357.2014.994561. Epub 2014 Dec 17.
To investigate if TNF, IL-1 or their endogenous controls, in relation to ACPA, are associated with radiological signs of ongoing temporomandibular joint (TMJ) bone tissue resorption and disc displacement in RA patients.
Twenty-two consecutive outpatients with TMJ of RA were included. Systemic inflammatory activity was assessed by DAS28. The number of painful regions in the body and ESR, CRP, RF and ACPA were analyzed. TMJ synovial fluid and blood samples were obtained and analyzed for TNF, TNFsRII, IL-1ra, IL-1sRII and ACPA. The ratios between the mediators and their endogenous control receptors were used in the statistical analysis. Magnetic resonance imaging was performed in closed- and open-mouth positions and evaluated regarding disc position and presence of condylar and temporal erosions of the TMJ.
A high TNF level in relation to TNFsRII in TMJ synovial fluid correlated to the degree of TMJ condylar erosion. A high IL-1ra level in relation to TNF in TMJ synovial fluid was also correlated to the degree of TMJ condylar erosion. The total degree of TMJ condylar erosion was correlated with the number of painful regions.
This study indicates that TNF in TMJ synovial fluid mediates TMJ cartilage and bone tissue resorption in RA. The study also suggests that the degree of endogenous cytokine control is of importance for development of bone tissue destruction.
研究肿瘤坏死因子（TNF）、白细胞介素-1（IL-1）或其内源性对照物与抗环瓜氨酸肽抗体（ACPA）相关时，是否与类风湿关节炎（RA）患者颞下颌关节（TMJ）骨组织持续吸收及盘移位的放射学征象相关。
纳入22例连续的患有颞下颌关节类风湿关节炎的门诊患者。通过疾病活动度评分28（DAS28）评估全身炎症活动。分析身体疼痛部位数量、红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）和抗环瓜氨酸肽抗体（ACPA）。获取颞下颌关节滑液和血液样本，分析其中的肿瘤坏死因子（TNF）、肿瘤坏死因子受体II（TNFsRII）、白细胞介素-1受体拮抗剂（IL-1ra）、白细胞介素-1受体II（IL-1sRII）和抗环瓜氨酸肽抗体（ACPA）。在统计分析中使用介质与其内源性对照受体之间的比率。在闭口和开口位进行磁共振成像，并评估颞下颌关节盘的位置以及髁突和颞骨侵蚀情况。
颞下颌关节滑液中肿瘤坏死因子水平与肿瘤坏死因子受体II的比率较高与颞下颌关节髁突侵蚀程度相关。颞下颌关节滑液中白细胞介素-1受体拮抗剂水平与肿瘤坏死因子的比率较高也与颞下颌关节髁突侵蚀程度相关。颞下颌关节髁突侵蚀的总程度与疼痛部位数量相关。
本研究表明，颞下颌关节滑液中的肿瘤坏死因子介导类风湿关节炎患者颞下颌关节软骨和骨组织吸收。该研究还提示内源性细胞因子控制程度对骨组织破坏的发展具有重要意义。
