Astudy of arthritic mechanism of the temporomandibular joint disorders

1. 兔颞下颌关节关节炎的实验研究用兔颞下颌关节疾病模型研究了颞下颌关节关节炎的蛋白水解活性。对人工关节盘脱位引起的关节炎进行了组织病理学检查。在整个检查期间，组织免疫化学染色显示蛋白水解酶如基质金属蛋白酶（MMPs）和聚集酶（ADAMTS）的表达。尤其在关键破坏期，酶表达的发生率较高。髁突软骨层也可见I型和H型胶原染色的表达。这些成分的分布随破坏时间的不同而不同。临床收获材料的分析在知情同意的情况下，使用人体滑液材料和颞下颌关节上部关节室的活检组织进行了组织学和生化检查。在有明显关节炎改变的患者中，Milk显示MMP5和ADAMTS的发生率较高。在软骨基质破坏过程中，ADAMTS首先作用于蛋白聚糖分解，然后MMPs作用于蛋白聚糖和胶原蛋白分解。这些酶表达已经在骨科领域的RA患者中被注意到。相反，在本研究中，这两种酶活性在颞下颌关节的发生率很高。从结果来看，关节炎在颞下颌关节可能是轻微的。通过关节镜手术获得的粘连组织显示出大量的纤维母细胞。晚期关节炎标本表现为骨化或软骨变性。这些病变经常出现在术前MRI图像中。

1. Experimental study of temporomandibular joint arthritis in the rabbitsProteolytic activities of the temporomandibular arthritis have been investigated using a rabbit model of temporomandibular disorders. Histopathologic examination has been achieved on the arthritis caused by an artificial dislocation of the articular disc. Throughout the examination period, histoimmunochemical staining showed expression of proteolytic enzymes such as matrix metalloproteinases (MMPs) and aggrecanase(ADAMTS). Especially in the critical destructive period, specimens showed higher incidence of enzymatic expression. Expression of type I and H collagen stain were also noticed in the cartilage layer of the mandibular condyle. Distribution of these components differed according to the destruction periods.2. Analyses of the clinically harvested materialsHistopatholigic and biochemistric examination have been carried out using human materials of synovial fluid and biopsy tissue from the upper joint compartment of the temporomandibular joints, under informed consent. In patients with prominent arthritic changes on Milk showed higher incidence of MMP5 and ADAMTS. During cartilage matrix destruction, ADAMTS first acts on proteoglycan breakdown, then MMPs act on proteoglycan and collagen breakdown. These enzymatic expressions have been noticed in RA patients in the field of Orthopedic Surgery. Conversely in the present study, high incidence of both enzymatic activities has been noticed in the temporomandibular joints. From the results, arthritis may be mild in the temporomandibular joints. Harvested adhesion tissue via arthroscopic surgery showed a number of fibro-blastic cells. Specimens from advanced stage of arthritis showed ossification or cartilaginous degeneration. These lesions are frequently showed in preoperative MRI images.