Appelgren A, Appelgren B, Kopp S, Lundeberg T, Theodorsson E
Department of Clinical Oral Physiology, Faculty of Dentistry, Karolinska Institute, Huddinge, Sweden.
J Orofac Pain. 1995 Summer;9(3):215-25.
The contribution of the nervous system to the pathophysiology of rheumatoid arthritis has been proposed to be mediated by certain neuropeptides. Neuropeptide Y, calcitonin gene-related peptide, substance P, and neurokinin A are considered modulators of inflammatory joint disease. Parameters of pain, as well as occlusal signs of tissue destruction from the arthritic TMJ and the corresponding neuropeptide concentrations in TMJ synovial fluid, were investigated in patients with various inflammatory joint diseases. The patients with rheumatoid arthritis were also examined in a separate diagnostic group. Visual analog scale, palpatory tenderness, maximal voluntary mouth opening, and anterior open bite were correlated to neuropeptide-like immunoreactivities of the above four neuropeptides. It was found that high concentrations of calcitonin gene-related peptide and neuropeptide Y in TMJ fluid are associated with pain, impairment of mandibular mobility, and occlusal signs of TMJ destruction in patients with rheumatoid arthritis. The results indicated neuropeptide involvement in rheumatoid arthritis, proposing a potentiation of the symptoms and signs by the inflammatory action of calcitonin gene-related peptide and neuropeptide Y.
神经系统对类风湿性关节炎病理生理学的作用被认为是由某些神经肽介导的。神经肽Y、降钙素基因相关肽、P物质和神经激肽A被视为炎性关节疾病的调节因子。研究了各种炎性关节疾病患者的疼痛参数，以及来自关节炎性颞下颌关节的组织破坏的咬合体征和颞下颌关节滑液中的相应神经肽浓度。类风湿性关节炎患者也在一个单独的诊断组中接受检查。视觉模拟评分、触诊压痛、最大自主开口度和前牙开合与上述四种神经肽的神经肽样免疫反应性相关。研究发现，类风湿性关节炎患者颞下颌关节液中高浓度的降钙素基因相关肽和神经肽Y与疼痛、下颌运动障碍以及颞下颌关节破坏的咬合体征有关。结果表明神经肽参与了类风湿性关节炎，提示降钙素基因相关肽和神经肽Y的炎性作用增强了症状和体征。
