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

临床研究本研究的目的是将月经周期与颞下颌关节疼痛、关节盘的MR证据和颞下颌关节紊乱病患者的后盘附着相关联。42名女性接受MRI检查，使用常规T1加权和T2加权以及钆增强脂肪抑制SE成像序列，在增殖期和分泌期组之间，TMJ疼痛程度存在显著的统计学差异（p<0.005）。颞下颌关节疼痛在分泌期有增加的趋势。增殖期椎间盘后附着区的增强程度明显低于分泌期（p<0.001）或分泌期（p<0.01）。这些结果表明，颞下颌关节盘的位置变化和月经周期可能在颞下颌关节疼痛的程度和后盘附着的炎症病理中发挥作用。基础研究本研究采用滑膜组织研究雌激素对炎症细胞因子产生和核因子κB（NF-κB）活性的影响。从3例RA膝关节置换术患者的新鲜手术标本中收集人滑膜组织。17 β-雌二醇显著抑制滑膜成纤维细胞培养液中IL-6、IL-8和GM-CSF的分泌（p<0.05）。凝胶迁移分析显示，加入170β-雌二醇可抑制滑膜成纤维细胞NF-κB的DNA结合活性。

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.