Analysis of the gene expression of inflammatory mediator in derived cells from synovial fluid from patients with internal derangement.

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The purpose of this study was to investigate the gene expression of inflammatory mediator in derived cells from synovial fluids, and the immunohistochemical expression and localization of inducible nitric oxide synthase (iNOS), cyclooxygenase-1, -2 (COX-1, COX-2) in synovial tissues from patients with internal derangement (ID) of the temporomandibular joint (TMJ) and patients with condylar fracture of the mandible (FR) as controls. Synovial tissues from patients with ID and from patients with FR were examined for iNOS, COX-1, COX-2 and nuclear factor kappa B (NF-κB) expressions by immunohistochemical staning. Correlation between grade for COX-2 expression and score for synovitis, and clinical findings were also analyzed, iNOS expressed synovial lining layer and blood vessels in the synovium from patients with ID. COX-2 expressed synovial lining layer, infiltrating mononuclear cells, fibroblast-like cells, and blood vessels including CD31 positive endothelial cells in the synovium from patients with ID. However, the expression of COX-1 in synovial lining cells and endothelial cells showed the similar levels both in the diseased specimens and control specimens. There were positive correlations between the expression of the COX-2 and the arthroscopic findings of synovitis (ρ=0.543, p=0.025), and joint pain (ρ=0.566, p=0.02). NF-κB also expressed in the diseased tissues, especially the synovial lining and blood vessels. The results of this study suggested that up-regulation of COX-2 in synovium may play a part in the pathogenesis of synovitis in patients with ID of the TMJ. The gene expression of inflammatory mediator in derived cells from synovial fluid is now investigating.