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

本研究旨在探讨炎症介质在滑液衍生细胞中的基因表达，以及诱导型一氧化氮合酶（iNOS）、环氧化酶-1，-2 （COX-1, COX-2）在颞下颌关节（TMJ）和下颌骨髁突骨折（FR）患者滑液组织中的免疫组织化学表达和定位。采用免疫组化染色法检测ID患者和FR患者滑膜组织iNOS、COX-1、COX-2和核因子κB （NF-κB）表达。分析COX-2表达等级与滑膜炎评分及临床表现的相关性，iNOS表达滑膜内膜层及滑膜血管。COX-2表达于ID患者滑膜内层，浸润于单个核细胞、成纤维细胞样细胞和血管，包括CD31阳性内皮细胞。然而，COX-1在滑膜衬里细胞和内皮细胞中的表达在病变标本和对照标本中均表现出相似的水平。COX-2的表达与关节镜下滑膜炎（ρ=0.543, p=0.025）和关节疼痛（ρ=0.566, p=0.02）呈正相关。NF-κB在病变组织中也有表达，尤其是滑膜内膜和血管。本研究结果提示，滑膜COX-2的上调可能参与了颞下颌关节ID患者滑膜炎的发病机制。目前正在研究滑膜液衍生细胞中炎症介质的基因表达。

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.