Pain and radiographic changes of the arthritic temporomandibular joint : relation to cytokines in synovial fluid and plasma
Author: Nordahl, Silvi
Date: 2000-12-15
Location: Sal 1, Odontologiska institutionen, Huddinge
Time: 9.00
Department: Institutionen för odontologi / Department of Odontology
Abstract
In patients with rheumatoid arthritis and other inflammatory joint
diseases, radiographic changes of the TMJ are frequently observed. Common
symptoms of TMJ involvement are pain at rest and on movement of the jaw.
This thesis investigated the relationship between pain, radiographic
changes and IL-1[beta] and TNF[alpha] levels in plasma and TMJ synovial
fluid. The progression of radiographic changes was also investigated in a
longitudinal study. A methodological study refined the use of vitamin B12
as an external marker to determine the concentration of TMJ synovial
fluid in samples obtained by saline washing.
The subjects of the clinical investigation comprised patients with
general arthritides and TMJ pain. TMJ examination included tenderness to
palpation and measurement of the pressure pain threshold by an algometer.
Pain associated with jaw movements was recorded. Venous blood samples
were collected and samples of synovial fluid were obtained using a saline
washing technique, with vitamin B12 as an external marker. The cytokine
levels in plasma and synovial fluid were analyzed by immunoassays. The
subjects underwent tomographic examination of the TMJ; in 21 subjects
this was repeated, at a mean interval of 33 months. The extension of
erosions (ER), the overall grade of radiographic changes (GR) and
progression of bone loss (PROG) were assessed and correlated with
IL-1[beta] and CRP.
Pain and tenderness of the TMJ occured independently of ER or GR, with
the exception of pain upon maximum voluntary mouth opening (MVM). In
joints with pain on MVM or tenderness to posterior palpation, levels of
synovial fluid TNF[alpha] were higher than in symptomless joints.
Multiple painful jaw movements were associated with elevated plasma
TNF[alpha] levels. In the crosssectional part of the study, ER was higher
for joints with detectable levels of synovial fluid IL- 1 [beta] than for
those without. Both ER and GR were greater in subjects with detectable
levels of plasma IL-1[beta] than those without. In the longitudinal
study, GR was higher at the second examination than at the first, whereas
there was no significant difference between ER at the two examinations.
Bone loss, assessed by PROG, progressed between the examinations. There
was a positive correlation between the level of CRP and PROG.A positive
correlation between plasma IL-1[beta] and PROG was also found for
patients with a duration of TMJ disease of < 7 years, or a diagnosis of
RA.
In the methodological part, the absorbance peak of the B12-solution with
the greatest difference to the plasma peak was at 350 nm. The dilution
factors calculated for the capillary tubes (3 [mu]L) and the standard
cuvettes [(2.5 mL) had a linear correlation coefficient of r = 0.99. The
addition of B12 as a marker did not interfere with the analysis of IL-1
[beta] and TNF[alpha].
List of papers:
I. Nordahl S, Alstergren P, Appelgren A, Appelgren B, Eliasson S, Kopp S (1997). "Pain, tenderness, mandibular mobility, and anterior open bite in relation to radiographic erosions in temporomandibular joint disease. " Acta Odontol Scand 55(1): 18-22
Pubmed
II. Nordahl S, Alstergren P, Eliasson S, Kopp S (1998). "Interleukin-1beta in plasma and synovial fluid in relation to radiographic changes in arthritic temporomandibular joints. " Eur J Oral Sci 106(1): 559-63
Pubmed
III. Nordahl S, Alstergren P, Kopp S (2000). "Tumor necrosis factor-alpha in synovial fluid and plasma from patients with chronic connective tissue disease and its relation to temporomandibular joint pain. " J Oral Maxillofac Surg 58(5): 525-30
Pubmed
IV. Nordahl S, Alstergren P, Eliasson S, Kopp S (2000). "Progression of radiographic signs of bone destruction in the temporomandibular joint in relation to markers of disease activity. A longitudal study of patients with inflammatory joints disease." Rheumatology (Submitted)
V. Alstergren P, Appelgren A, Appelgren B, Kopp S, Nordahl S, Theodorsson E (1996). "Measurement of joint aspirate dilution by a spectrophotometer capillary tube system." Scand J Clin Lab Invest 56(5): 415-20
Pubmed
I. Nordahl S, Alstergren P, Appelgren A, Appelgren B, Eliasson S, Kopp S (1997). "Pain, tenderness, mandibular mobility, and anterior open bite in relation to radiographic erosions in temporomandibular joint disease. " Acta Odontol Scand 55(1): 18-22
Pubmed
II. Nordahl S, Alstergren P, Eliasson S, Kopp S (1998). "Interleukin-1beta in plasma and synovial fluid in relation to radiographic changes in arthritic temporomandibular joints. " Eur J Oral Sci 106(1): 559-63
Pubmed
III. Nordahl S, Alstergren P, Kopp S (2000). "Tumor necrosis factor-alpha in synovial fluid and plasma from patients with chronic connective tissue disease and its relation to temporomandibular joint pain. " J Oral Maxillofac Surg 58(5): 525-30
Pubmed
IV. Nordahl S, Alstergren P, Eliasson S, Kopp S (2000). "Progression of radiographic signs of bone destruction in the temporomandibular joint in relation to markers of disease activity. A longitudal study of patients with inflammatory joints disease." Rheumatology (Submitted)
V. Alstergren P, Appelgren A, Appelgren B, Kopp S, Nordahl S, Theodorsson E (1996). "Measurement of joint aspirate dilution by a spectrophotometer capillary tube system." Scand J Clin Lab Invest 56(5): 415-20
Pubmed
Issue date: 2000-11-24
Publication year: 2000
ISBN: 91-628-4400-8
Statistics
Total Visits
Views | |
---|---|
Pain ...(legacy) | 295 |
Pain ... | 54 |
Total Visits Per Month
August 2020 | September 2020 | October 2020 | November 2020 | December 2020 | January 2021 | February 2021 | |
---|---|---|---|---|---|---|---|
Pain ... | 2 | 1 | 5 | 0 | 4 | 2 | 1 |
Top country views
Views | |
---|---|
United States | 52 |
Germany | 39 |
China | 34 |
South Korea | 23 |
Sweden | 15 |
France | 5 |
Finland | 4 |
Greece | 4 |
Canada | 3 |
Denmark | 3 |
Top cities views
Views | |
---|---|
Provo | 17 |
Kiez | 15 |
Seoul | 14 |
Sunnyvale | 9 |
Beijing | 8 |
Athens | 4 |
Shenzhen | 4 |
Woodbridge | 4 |
Ballerup | 3 |
Cairo | 3 |