Astudy of arthritic mechanism of the temporomandibular joint disorders

1.兔颞下颌关节关节炎的实验研究本实验采用兔颞下颌关节紊乱病模型，观察了关节蛋白的降解活性。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，组织免疫组织化学染色显示蛋白水解酶，如基质金属蛋白酶(MMPs)和蛋白水解酶(ADAMTS)的表达。尤其是在破坏的关键时期，标本表现出较高的酶表达发生率。在下颌骨的软骨层也有I型和H型胶原的表达。这些成分的分布因销毁时间的不同而不同。对临床采集的材料进行分析在知情同意的情况下，使用滑液和来自颞下颌关节上关节间隙的活检组织的人体材料进行组织病理学和生化检查。在有明显关节炎改变的患者中，MMP5和ADAMTS的发生率较高。在软骨基质破坏过程中，ADAMTS首先作用于蛋白多糖的破坏，然后MMPs作用于蛋白多糖和胶原的破坏。这些酶的表达在骨科领域的类风湿关节炎患者中已经被注意到。相反，在目前的研究中，这两种酶活性在颞颌关节中的发生率都很高。从结果来看，关节炎在颞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有大量的成纤维细胞。晚期关节炎标本显示骨化或软骨变性。这些病变经常出现在术前的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.