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Identification of Chlamydia trachomatis in the human temporomandibular joint
C H Henry1, A P Hudson, H C Gérard
1Boston University Goldman School of Dental Medicine, MA, USA. chenry@pol.net
Purpose:
Reactive arthritis (ReA) as a consequence of triggering Chlamydia trachomatis infections has been extensively studied to better understand inflammatory arthritis. This study investigated whether the presence of C trachomatis can be shown in the TMJ of patients with internal derangement.
Patients And Methods:
Posterior bilaminar tissue removed from 31 patients (29 F, 2 M) during TMJ articular disc repositioning and posterior ligament repair was tested for the presence of C trachomatis. Cryosections were stained using a monoclonal antibody that identifies all chlamydial serovars. Highly specific polymerase chain reaction (PCR) assays independently targeting two genes of C trachomatis also were performed; these assays also identify all serovars of this organism.
Results:
TMJ tissue from 6 of 30 patients (20%) showed the presence of C trachomatis in the posterior bilaminar tissue on immunostaining. PCR screening identified 12 of 31 patients (39%) as having C trachomatis DNA in tissue, including four of six positive by immunostaining. All chlamydia-positive patients were female, with an average age of 36.7 years (15 to 48 years).
Conclusions:
The presence of C trachomatis in the human TMJ has not been previously shown. The presence of this organism may serve as the pathogenetic mechanism for TMJ dysfunction, as demonstrated in other joints. Nonapparent chlamydial infection in females may also explain the marked prevalence of TMJ symptoms in women.
Insights
Chlamydia trachomatis DNA was detected in temporomandibular joint (TMJ) tissues of patients with internal derangement. This finding suggests a potential link between chlamydial infection and TMJ dysfunction, particularly in women.
Area of Science:
- Microbiology
- Immunology
- Rheumatology
Background:
- Reactive arthritis (ReA) is an inflammatory arthritis triggered by Chlamydia trachomatis infections.
- Understanding the pathogenesis of ReA is crucial for developing effective treatments.
- The role of C. trachomatis in temporomandibular joint (TMJ) dysfunction is not well-established.
Purpose of the Study:
- To investigate the presence of C. trachomatis in the TMJ of patients experiencing internal derangement.
- To explore the potential role of C. trachomatis in TMJ dysfunction.
Main Methods:
- Posterior bilaminar tissue samples were collected from 31 patients undergoing TMJ surgery.
- Tissue sections were analyzed using immunostaining with a monoclonal antibody against C. trachomatis.
- Polymerase chain reaction (PCR) assays targeting two specific genes of C. trachomatis were performed.
Main Results:
- C. trachomatis was identified in the TMJ tissue of 6 out of 30 patients (20%) via immunostaining.
- PCR detected C. trachomatis DNA in 12 out of 31 patients (39%), with four positive by both methods.
- All positive patients were female, with an average age of 36.7 years.
Conclusions:
- This study provides the first evidence of C. trachomatis presence in the human TMJ.
- C. trachomatis infection may be a pathogenic factor in TMJ dysfunction, similar to its role in other joints.
- Undiagnosed chlamydial infections in women could contribute to the higher prevalence of TMJ symptoms in this demographic.