Temporomandibular Joint Pain is Negatively Correlated to TNF Alpha and Osteoprotegrin Content in Synovial Fluid in Patients with Juvenile Idiopathic Arthritis.

Abstract

Objective: Temporomandibular joint (TMJ) involvement occurs in up to 80% of children with juvenile idiopathic arthritis (JIA). Little is known with regard to the complexity of the protein profile in synovial fluid (SF) from JIA arthritis during growth as compared to both JIA and rheumatoid arthritis (RA) of adults.

Design: Synovial fluid was collected from 54 joints/30 patients with TMJ arthritis (JIA 35 joints/20 patients, JIA adults 9 joints/5 patients, RA 10 joints/5 patients). Three cytokines and seven bone markers were quantified using Luminex multiplex assays and compared to demographic and clinical data of function and pain.

Results: Pain (spontaneous and upon palpation) and duration of pain were all negatively correlated with the TMJ SF content of tumor necrosis factor (TNF)-α. The level of Adrenocorticotropic hormone (ACTH) was negatively correlated to TMJ pain upon palpation and post-treatment pain and function. The concentration of ACTH was significantly lower in SF in JIA (1.4 ± 2.8 pg/ml) compared to adults with JIA (4.7 ± 12.2 pg/ml) and significantly higher compared to adults with RA (0.8 ± 1.5 pg/ml). Osteoprotegerin (OPG) was negatively correlated to spontaneous pain.

Conclusions: Our results indicate that the local concentrations of TNF-α, ACTH and OPG in TMJ fluid may not contribute to TMJ pain and tissue destruction in JIA/RA patients.

© 2014 Olsen-Bergem H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.