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Molecular correlates of temporomandibular joint disease
Atilla Arinci1, Evin Ademoglu, Alp Aslan
1Department of Plastic and Reconstructive Surgery, Istanbul Faculty of Medicine, Istanbul University, Turkey.
Objective:
The relation between disease severity and the known mediators of pain, inflammation, and tissue damage-prostaglandin E 2 (PGE 2 ), leukotriene B 4 (LTB 4 ), malondialdehyde (MDA), nitric oxide (NO), and myeloperoxidase (MPO)-was examined in the synovial fluid of patients with internal derangement (ID) of the temporomandibular joint (TMJ).
Study Design:
Thirty-two patients with ID were classified according to Wilkes by clinical and radiological examinations, and TMJ synovial fluid samples were obtained by arthrocentesis. PGE 2 and LTB 4 levels were measured by ELISA kits, MDA levels were determined by a fluorometric method, myeloperoxidase activity was determined by an end-point method, and NO levels were measured by Griess reaction.
Results:
The earliest significant increase was observed in NO levels (stage II) and this elevation persisted in the subsequent stages. The first significant elevation in PGE 2 and LTB 4 levels and MPO activity were observed in stage III. Both PGE 2 and LTB 4 levels were increased in stage III and were correlated with each at this stage and in the subsequent stage. Significant increases in MDA levels were observed only in stage IV. At stage IV there was correlation between MDA and PGE 2 , MDA and LTB 4 , and MDA and MPO. The relation between PGE 2 and MDA was the most powerful one.
Conclusion:
Results of this cross-sectional study point out the relation between disease severity and levels of some molecular mediators in synovial fluid of TMJ. Longitudinal studies are needed to explore the role of these molecular mediators in the progression of ID.
Insights
Levels of nitric oxide (NO), prostaglandin E 2 (PGE 2 ), leukotriene B 4 (LTB 4 ), malondialdehyde (MDA), and myeloperoxidase (MPO) increase with temporomandibular joint internal derangement (ID) severity. These molecular mediators correlate with disease progression.
Area of Science:
- Biochemistry
- Molecular Biology
- Orthodontics
Background:
- Internal derangement (ID) of the temporomandibular joint (TMJ) involves complex pathological processes.
- Understanding the molecular mediators of pain, inflammation, and tissue damage is crucial for TMJ ID.
- Key mediators include prostaglandin E 2 (PGE 2 ), leukotriene B 4 (LTB 4 ), malondialdehyde (MDA), nitric oxide (NO), and myeloperoxidase (MPO).
Purpose of the Study:
- To examine the relationship between TMJ ID disease severity and levels of specific molecular mediators in synovial fluid.
- To investigate the temporal progression of these mediators in relation to disease stages.
- To identify correlations between different molecular mediators and disease severity.
Main Methods:
- Cross-sectional study involving 32 patients with TMJ ID, classified by Wilkes criteria.
- Synovial fluid samples collected via arthrocentesis.
- Quantification of PGE 2 and LTB 4 (ELISA), MDA (fluorometric assay), MPO activity (end-point assay), and NO (Griess reaction).
Main Results:
- Nitric oxide (NO) levels showed the earliest significant increase at stage II.
- Prostaglandin E 2 (PGE 2 ), leukotriene B 4 (LTB 4 ) levels, and myeloperoxidase (MPO) activity significantly elevated at stage III.
- Malondialdehyde (MDA) levels increased significantly only at stage IV, showing correlations with PGE 2 , LTB 4 , and MPO.
Conclusions:
- Disease severity in TMJ ID is associated with increased levels of specific molecular mediators in synovial fluid.
- The findings highlight a sequential increase of these mediators with disease progression.
- Longitudinal studies are recommended to elucidate the precise role of these mediators in TMJ ID progression.
