Ma Yuanjun, He Feng, Chen Xiaohua, Zhou Shuncheng, He Rui, Liu Qian, Yang Hongxu, Zhang Jing, Zhang Mian, Miao Hui, Yu Shibin
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
Department of Stomatology, Chinese PLA General Hospital of Central Theater Command, Wuhan, China.
J Oral Rehabil. 2024 Apr;51(4):666-676. doi: 10.1111/joor.13636. Epub 2023 Dec 10.
BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) is characterized by articular cartilage degeneration and progressive synovitis. How to effectively inhibit TMJOA in the early stage has been a hot topic in the biomedical field. As a non-invasive physiotherapy, pulsed electromagnetic field (PEMF) treatment has shown great potential in the treatment of osteoarthritis (OA) in extremity joints. OBJECTIVE: This study aims to investigate the biological effect of PEMF intervention on TMJ cartilage degeneration and synovium inflammation at the early stage of TMJOA. METHODS: PEMF (2.0 mT, 15 Hz, 2 h/day) treatment was given to rats in which TMJOA was induced by applying the unilateral anterior crossbite (UAC). Histological and immunohistochemical staining, TUNEL assay, real-time PCR and western blotting assay were performed to detect the changes of the morphology and the expression of pro-inflammatory and degradative factors in condylar cartilage and synovium. RESULTS: Obvious condylar cartilage degeneration, characterized by decreased cartilage thickness, degraded cartilage extracellular matrix, increased expression of pro-inflammatory and degradative factors (TNF-α, IL-1β, MMP-13, ADAMTS-5, IL-6, MMP-3, MMP-9 and COL-X) and increased chondrocytes death, was observed in UAC group, accompanied by synovium hyperplasia and up-regulation of pro-inflammatory and degradative factors in synovium. PEMF intervention reversed the decreased cartilage thickness at 3 weeks and degraded cartilage extracellular matrix at 6 weeks. Moreover, the up-regulation of pro-inflammatory, degradative and hypertrophyic factors and chondrocytes death in condylar cartilage induced by UAC were inhibited to some extent. In addition, the synovium hyperplasia and the up-regulation of pro-inflammatory and degradative factors in synovium were inhibited at 3 weeks and 6 weeks. CONCLUSIONS: Appropriate PEMF stimulation can reverse the loss of cartilage extracellular matrix, the chondrocytes death, the increased expression of pro-inflammatory and degradative factors in cartilage, the decreased cartilage thickness and synovium inflammation induced by UAC at the early stage of TMJOA to some extent. PEMF stimulation may be a promising method in clinical TMJOA treatment.
背景：颞下颌关节骨关节炎（TMJOA）的特征是关节软骨退变和进行性滑膜炎。如何在早期有效抑制TMJOA一直是生物医学领域的研究热点。作为一种非侵入性物理治疗方法，脉冲电磁场（PEMF）治疗在四肢关节骨关节炎（OA）的治疗中显示出巨大潜力。 目的：本研究旨在探讨PEMF干预对TMJOA早期颞下颌关节软骨退变和滑膜炎症的生物学效应。 方法：对通过单侧前牙反合（UAC）诱导TMJOA的大鼠进行PEMF（2.0 mT，15 Hz，每天2小时）治疗。采用组织学和免疫组化染色、TUNEL检测、实时PCR和蛋白质免疫印迹法检测髁突软骨和滑膜的形态变化以及促炎和降解因子的表达。 结果：UAC组观察到明显的髁突软骨退变，表现为软骨厚度降低、软骨细胞外基质降解、促炎和降解因子（TNF-α、IL-1β、MMP-13、ADAMTS-5、IL-6、MMP-3、MMP-9和COL-X）表达增加以及软骨细胞死亡增加，同时伴有滑膜增生和滑膜中促炎和降解因子上调。PEMF干预在3周时逆转了软骨厚度降低，在6周时逆转了软骨细胞外基质降解。此外，UAC诱导的髁突软骨中促炎、降解和肥大因子上调以及软骨细胞死亡在一定程度上受到抑制。另外，在3周和6周时，滑膜增生以及滑膜中促炎和降解因子上调受到抑制。 结论：适当的PEMF刺激可在一定程度上逆转TMJOA早期UAC诱导的软骨细胞外基质丢失、软骨细胞死亡、软骨中促炎和降解因子表达增加、软骨厚度降低以及滑膜炎症。PEMF刺激可能是临床治疗TMJOA的一种有前景的方法。
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