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Deficient cytokine control modulates temporomandibular joint pain in rheumatoid arthritis
Author(s) -
Ahmed Neveen,
Catrina Anca I.,
Alyamani Ahmed O.,
Mustafa Hamid,
Alstergren Per
Publication year - 2015
Publication title -
european journal of oral sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.802
H-Index - 93
eISSN - 1600-0722
pISSN - 0909-8836
DOI - 10.1111/eos.12193
Subject(s) - medicine , temporomandibular joint , rheumatoid arthritis , pain control , arthritis , cytokine , dentistry , orthodontics , physical therapy , surgery
The aim was to investigate how endogenous cytokine control of tumor necrosis factor ( TNF ) influences temporomandibular joint ( TMJ ) pain in relation to the role of anti‐citrullinated peptide antibodies ( ACPA ) in patients with rheumatoid arthritis ( RA ). Twenty‐six consecutive patients with TMJ RA were included. Temporomandibular joint pain intensity was assessed at rest, on maximum mouth opening, on chewing, and on palpation. Mandibular movement capacity and degree of anterior open bite (a clinical sign of structural destruction of TMJ tissues) were also assessed. Systemic inflammatory activity was assessed using the Disease Activity Score in 28 joints ( DAS 28) for rheumatoid arthritis. Samples of TMJ synovial fluid and blood were obtained and analyzed for TNF , its soluble receptor, soluble TNF receptor II ( TNF s RII ), and ACPA . A high concentration of TNF in relation to the concentration of TNF s RII in TMJ synovial fluid was associated with TMJ pain on posterior palpation on maximum mouth opening. The ACPA concentration correlated significantly to the TNF concentration, but not to the TNF s RII concentration, indicating that increased inflammatory activity is mainly caused by an insufficient increase in anti‐inflammatory mediators. This study indicates that TMJ pain on palpation in patients with RA is related to a deficiency in local cytokine control that contributes to increased inflammatory activity, including sensitization to mechanical stimuli over the TMJ .