Levels of fibroblast growth factor 2 in synovial fluids in human patients with internal derangement of the temporomandibular joint

Synovial fluid levels of VEGF and FGF-2 before and after intra-articular injection of hyaluronic acid in patients with temporomandibular disorders: a short-term study

Our purpose was to measure the temporomandibular joint (TMJ) synovial fluid (SF) levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) before and after intra-articular injection of hyaluronic acid (HA) and to investigate the possible mechanism involved in the therapeutic value of HA. We analysed the synovial fluid of 30 patients with unilateral internal derangement (ID) or osteoarthritis (OA) of the TMJ (confirmed by magnetic resonance imaging and cone-beam computed tomography) and recorded clinical signs and symptoms including maximal mouth opening, subjective joint pain, and joint noise at the patient's each visit. All clinical signs significantly improved after injection of HA, and there was no significant difference between ID and OA groups. In synovial fluid parameters, the concentration of VEGF was significantly higher before treatment with HA than after treatment, but there was no significant difference in the concentration of FGF-2 between before and after treatment. The study findings suggest intra-articular injection of HA may reduce the synovitis and improve the internal state of the TMJ in a short period.

Correlation between plasma and synovial fluid basic fibroblast growth factor with radiographic severity in primary knee osteoarthritis

PURPOSE

The aim of this study was to investigate plasma and synovial fluid basic fibroblast growth factor (bFGF) levels in patients with primary knee osteoarthritis (OA) and to evaluate the correlation between bFGF levels and disease severity.

METHODS

Thirty-five patients with knee OA and 15 healthy individuals were recruited into this study. Knee OA grading was performed according to the Kellgren-Lawrence classification. bFGF concentrations in both plasma and synovial fluid were determined using enzyme-linked immunosorbent assay.

RESULTS

Plasma and synovial fluid bFGF levels in knee OA patients were significantly higher than in controls (P < 0.001). Moreover, plasma and synovial fluid bFGF concentrations were positively correlated with radiographic severity (r = 0.535, P < 0.001 and r = 0.570, P < 0.001, respectively). Further analysis revealed that there was a positive correlation between plasma and synovial fluid bFGF levels (r = 0.674, P < 0.001).

CONCLUSIONS

Plasma and synovial fluid bFGF levels were significantly increased in OA patients, and these elevated levels were positively correlated with radiographic severity. These findings indicate that bFGF levels may be a monitor of disease severity and could play an essential part in the pathophysiology of degenerative process in OA.

Temporomandibular joint pain and synovial fluid analysis: a review of the literature

The pathophysiology of temporomandibular joint pain is not well understood. A significant amount of research has been conducted to evaluate synovial fluid in these patients and in healthy controls. Qualitative and quantitative analyses of the synovial fluid have shown a significant difference between these groups. A multitude of inflammatory mediators and degradation products have been identified. The concentration of these products has been shown to correlate with several clinical parameters including pain, chronicity, severity of degenerative change, and response to treatment. A common inflammatory pathway would appear to be involved in most patients. At the present time, synovial fluid analysis does not have the sensitivity or specificity to allow specific diagnoses and targeted treatment. Continued research with the specific aim of establishing more appropriate therapeutic modalities based on the biochemical pathways is warranted.

Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study

OBJECTIVES

Temporomandibular joint disorders (TMD) comprise a group of chronic painful conditions of mastication in the temporomandibular joint (TMJ). Although the association between TMD and internal derangement of the TMJ is well documented, the functional relevance is still unclear. Increased concentrations of inflammatory mediators have been identified in the synovial fluid of affected patients with TMD, suggesting an underlying degenerative or inflammatory process. The aim of this study was to generate a comprehensive cytokine expression profile in TMD.

METHODS

15 samples from patients with internal derangement of TMJ were analysed using a novel cytokine array that enables the analysis of 79 different cytokines simultaneously.

RESULTS

Cytokine levels were correlated with the presence of joint effusion (JE) determined by MRI. In the majority of synovial fluid samples, angiogenin (Ang), fibroblast growth factor (FGF)-9, insulin-like growth factor-binding protein (IGFBP)-3, interleukin (IL)-1alpha, IL-1beta, IL-8, inducible protein (IP)-10, macrophage inflammatory protein (MIP)-1beta, osteoprotegerin (OPG), transforming growth factor (TGF)-beta2, tissue inhibitor of metalloproteinase (TIMP)-1, TIMP-2, tumour necrosis factor (TNF)-beta and vascular endothelial growth factor (VEGF) were detectable. Furthermore, the expression levels of Ang, brain-derived neurotrophic factor (BDNF), FGF-4, FGF-9, IGFBP-2, IL-8, MIP-1beta, OPG, pulmonary and activation-regulated protein (PARC), TGF-beta2, TIMP-2 and VEGF were significantly associated with the presence of JE; among these, nine cytokines (Ang, BDNF, FGF-4, FGF-9, IGFBP-2, MIP-1beta, PARC, TGF-beta2 and TIMP-2) were hitherto not described in TMD.

CONCLUSIONS

This study confirmed previous reports of elevated cytokine levels in TMD. Additionally, we identified previously undescribed cytokines that were upregulated and correlated significantly with the presence of JE. We were able to identify novel cytokines that have hitherto not been described in TMD. Strategies targeting the identified cytokines may represent a novel therapy option in TMD.

Expression of capsaicin receptor TRPV-1 in synovial tissues of patients with symptomatic internal derangement of the temporomandibular joint and joint pain

OBJECTIVE

To elucidate expression of capsaicin receptor TRPV-1 in synovial tissues of the human temporomandibular joint (TMJ) with internal derangement and discuss its relationship with joint pain.

STUDY DESIGN

Fifty-four TMJs in 54 patients were examined using an immunohistochemical technique. As controls, 10 TMJs with habitual dislocation without pain were also examined.

RESULTS

TRPV-1 was expressed mainly in the blood vessels beneath the lining cells in synovial tissues from 31 of the 54 joints with internal derangement and from 8 of the 10 control joints. The extent score of TRPV-1-stained cells with internal derangement was not significantly higher than that of controls. The extent score of TRPV-1 showed no correlation with joint pain.

CONCLUSIONS

TRPV-1 was detected in the region of the posterior disk attachment of synovial tissues from the TMJ in patients with internal derangement and controls. TRPV-1 may play a role in maintenance of the physiologic condition of the TMJ.

Vascular endothelial growth factor concentrations in synovial fluids of patients with symptomatic internal derangement of the temporomandibular joint

BACKGROUND

Vascular endothelial growth factor (VEGF) is an inducer of angiogenesis and permeability of small blood vessels. We determined the concentrations of VEGF in synovial fluid of patients with symptomatic internal derangement of the temporomandibular joint (TMJ).

METHODS

Diluted synovial fluid was collected by a pumping procedure from 22 TMJs of patients with internal derangement and 10 control TMJs. VEGF concentration was determined by an enzyme-linked immunosorbent assay.

RESULTS

The VEGF was detected in 14 of the 22 joints (64%) of patients with internal derangement, at a mean concentration of 67 pg/ml, but in only one control joint (12.5 pg/ml) (P = 0.004 for the difference in concentration). There was a significant correlation between VEGF concentration and total protein concentration in the synovial fluid (P = 0.002).

CONCLUSIONS

The increased concentration of VEGF in patients with symptomatic internal derangement suggests that this growth factor may be involved in the pathogenesis of this condition.

Relationship of calcitonin gene-related peptide in synovial tissues and temporomandibular joint pain in humans

OBJECTIVE

To elucidate the expression of calcitonin gene-related peptide (CGRP) in synovial tissue taken from the human temporomandibular joint (TMJ) with internal derangement, and discuss the relationship between CGRP and joint pain.

STUDY DESIGN

Using an immunohistochemical technique, 48 joints in 48 patients were examined. As controls, synovial tissue specimens from 7 joints with habitual dislocation without pain were also examined.

RESULTS

In all of the internal derangement and control subjects, CGRP-positive cells were observed in the connective tissues around the blood vessels beneath the lining cells. The extent score of CGRP was significantly higher in the internal derangement group than in the control group (P=.033). There was a significant positive correlation between the extent score of CGRP and joint pain (P=.036, r=0.30).

CONCLUSIONS

These results suggest that the expression of CGRP is increased in the synovial tissues from patients with internal derangement, and that CGRP seems to play an important role in the mechanism of pain production in patients with symptomatic internal derangement.