Study on Molecular Mechanism for the Intra-Articular Lesions of Temporo-mandibular Joint Disorders by Estrogen Hormonal Changes During the Menstrual Cycle

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Clinical Study The purpose of this investigations was to correlate the menstrual cycle with TMJ pain, MR evidence of the disk, and posterior disk attachment in patients with temporomandibular joint disorders. Forty-two women underwent MRI using conventional Tl-weighted and T2- weighted and gadolinium-enhanced fat-suppressed SE imaging sequences.There was a strong statistical difference in the degree of TMJ pain between proliferated phase and secretory phase groups (p<0.005). TMJ pain showed a tendency to increase at the secretory phase. Significantly less contrast enhancement of the posterior disk attachment was observed in the proliferated phase than in the secretory phase (p<0.001) or menstrua] phase (p<0.01). Anterior disk displacement without reduction of the TMJ was closely associated with TM Jpain.These results suggest that positional changes of the disk and the menstrual cycle may play a role in the degree of TMJ pain and inflammatory pathology of the posterior disk attachment.Basic Study This study investigated the estrogen effects on inflammatory cytokine production and nuclear factor κB (NF-κB) activity using the synovial tissues. Human synovial tissues were collected from surgical specimen freshly removed from three patients with RA undergoing knee joint replacement.17β-estradiol significantly inhibited IL-6, IL-8, and GM-CSF secretions in the culture medium from synovial fibroblasts (p<0.05). From the analysis of gel shift assay, DNA-binding activity of NF-κB was prevented by added 170β-estradiol in stimulated synovial fibroblasts.