Study for the diagnosis of early cartilage degradation in the patient with TMJ internal derangement

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In this research project, biochemical markers in the synovial fluid (SF) for detecting intra-articular inflammation and early cartilage degradation of the temporomandibular joint (TMJ) disease were examined. SF was obtained from 25 TMJs in 22 patients with internal derangement (ID) or osteoarthritis (TMJ-OA), 15 asymptomatic TMJs in 11 normal volunteers. Cytokine levels were measured by ELISA,and the proteinase activities were detected by enzymography. SF from TMJs with ID and OA showed higher (p<0.05) levels (330.1(]SY.+-。[)347.7pg/100mug of SF protein) of IL-1 beta than the asymptomatic control TMJs (76.7(]SY.+-。[)95.3pg/100mug of SF protein). SF from TMJs with OA contained significantly (p<0.05) higher levels of IL-1beta (531.8(]SY.+-。[)379.6pg/100mug of SF protein) and IL-6 (979(]SY.+-。[)552pg/100mug of SF protein) than those with ID (IL-1beta : 216.7(]SY.+-。[)280.1pg, IL-6 : 293(]SY.+-。[)434pg). Two matrix metalloproteinases (MMPs) with gelatinolytic activities at 92kDa and 72kDa were constitutively detected in both the TMJ-SF (either normal or disease). Also detected were weak bands with molecular weight of 83kDa and 66kDa. Western blot analysis delineated that these were active forms of MMP-9 (83kDa) and MMP-2 (66kDa). The bands were also detected in TMJ with OA which showed high levels of IL-1beta and IL-6.These findings suggest that concomitant increases, in the levels of cytokines (IL-1 and IL-6) and active forms of MMPs, would be potential catabolic markers for cartilage degradation of the TMJ.