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低分子量和高分子量透明质酸对兔骨关节炎颞下颌关节的影响。

Effects of low and high molecular weight hyaluronic acid on the osteoarthritic temporomandibular joint in rabbit.

作者信息

Iturriaga Veronica, Vásquez Bélgica, Bornhardt Thomas, Del Sol Mariano

机构信息

Department of Integral Adult Care Dentistry, Temporomandibular Disorder and Orofacial Pain Program, Sleep & Pain Research Group, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.

Faculty of Health Sciences, Universidad de Tarapacá, Avenida 18 de Septiembre #2222, Arica, Chile.

出版信息

Clin Oral Investig. 2021 Jul;25(7):4507-4518. doi: 10.1007/s00784-020-03763-x. Epub 2021 Jan 3.

Abstract

OBJECTIVE

To compare the effect between intra-articular infiltration of low molecular weight (LMW-HA) and high molecular weight hyaluronic acid (HMW-HA) on the histopathological characteristics of the cartilage and disc of the temporomandibular joint (TMJ) osteoarthritis (OA) induced in rabbits.

MATERIAL AND METHODS

An experimental study was conducted on 38 rabbit TMJs. The effect of different hyaluronic acids was compared at 30 and 135 days. Histopathological analysis was performed. Cartilage damage was assessed with the OARSI scale.

RESULTS

The severity of the induced OA according to OARSI was 3.4 degrees in the mandibular condyle (MC) and 3.2 in the mandibular fossa (MF); the articular disc (AD) presented disorganization of the collagen fibers, with randomly arranged hypertrophic chondrocytes. At 30 days, untreated TMJs worsened. TMJ treated with LMW-HA reduced its severity to 1.5 degrees in MC and 1.6 in MF, the AD presented histological aspects within normal limits. TMJ treated with HMW-HA presented 2.4 degrees in MC and 2.2 in MF, the AD maintained characteristics similar to the group with OA. At 135 days, all groups worsened.

CONCLUSION

Exogenous HA is effective in the management of TMJ-OA induced in rabbits, showing cartilage and articular disc repair at 30 days. The LMW-HA group had better effects on joint tissue than HMW-HA 30 days after treatment. However, at 135 days, both groups presented regression of joint tissue repair.

CLINICAL RELEVANCE

HA is effective in the anti-arthritic treatment of TMJ-OA induced in rabbits; LMW-HA shows better results in cartilage and articular disc repair than HMW-HA.

摘要

目的

比较低分子量透明质酸(LMW-HA)和高分子量透明质酸(HMW-HA)关节腔内注射对兔颞下颌关节(TMJ)骨关节炎(OA)软骨和关节盘组织病理学特征的影响。

材料与方法

对38个兔颞下颌关节进行实验研究。在30天和135天时比较不同透明质酸的效果。进行组织病理学分析。用OARSI量表评估软骨损伤情况。

结果

根据OARSI量表,诱导性OA的严重程度在下颌髁突(MC)为3.4度,在下颌窝(MF)为3.2度;关节盘(AD)胶原纤维排列紊乱,肥大软骨细胞随机排列。30天时,未治疗的颞下颌关节病情加重。用LMW-HA治疗的颞下颌关节严重程度在MC降至1.5度,在MF降至1.6度,关节盘组织学表现正常。用HMW-HA治疗的颞下颌关节在MC为2.4度,在MF为2.2度,关节盘维持与OA组相似的特征。135天时,所有组病情均加重。

结论

外源性透明质酸对兔诱导性TMJ-OA有效,在30天时显示出软骨和关节盘修复。治疗30天后,LMW-HA组对关节组织的效果优于HMW-HA组。然而,在135天时,两组关节组织修复均出现倒退。

临床意义

透明质酸对兔诱导性TMJ-OA的抗关节炎治疗有效;LMW-HA在软骨和关节盘修复方面比HMW-HA效果更好。

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