title: Neuropeptides in the arthritic TMJ and symptoms and signs from the stomatognathic system with special consideration to rheumatoid arthritis.
abstract: The contribution of the nervous system to the pathophysiology of rheumatoid arthritis has been proposed to be mediated by certain neuropeptides. Neuropeptide Y, calcitonin gene-related peptide, substance P, and neurokinin A are considered modulators of inflammatory joint disease. Parameters of pain, as well as occlusal signs of tissue destruction from the arthritic TMJ and the corresponding neuropeptide concentrations in TMJ synovial fluid, were investigated in patients with various inflammatory joint diseases. The patients with rheumatoid arthritis were also examined in a separate diagnostic group. Visual analog scale, palpatory tenderness, maximal voluntary mouth opening, and anterior open bite were correlated to neuropeptide-like immunoreactivities of the above four neuropeptides. It was found that high concentrations of calcitonin gene-related peptide and neuropeptide Y in TMJ fluid are associated with pain, impairment of mandibular mobility, and occlusal signs of TMJ destruction in patients with rheumatoid arthritis. The results indicated neuropeptide involvement in rheumatoid arthritis, proposing a potentiation of the symptoms and signs by the inflammatory action of calcitonin gene-related peptide and neuropeptide Y.
authors.affiliation: Department of Clinical Oral Physiology, Faculty of Dentistry, Karolinska Institute, Huddinge, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Appelgren
authors.forename: B
authors.initials: B
authors.lastname: Appelgren
authors.forename: S
authors.initials: S
authors.lastname: Kopp
authors.forename: T
authors.initials: T
authors.lastname: Lundeberg
authors.forename: E
authors.initials: E
authors.lastname: Theodorsson
mesh_terms: D000328:Adult; D001168:Arthritis / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis / Q000502:physiology; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015213:Neuroimmunomodulation; D015288:Neurokinin A / Q000032:analysis / Q000502:physiology; D009478:Neuropeptide Y / Q000032:analysis / Q000502:physiology; D009479:Neuropeptides / Q000032:analysis / Q000502:physiology*; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D013373:Substance P / Q000032:analysis / Q000502:physiology; D013582:Synovial Fluid / Q000737:chemistry; D013705:Temporomandibular Joint Disorders / Q000097:blood / Q000276:immunology / Q000503:physiopathology*
chemical_list: D018836:Inflammation Mediators; D009478:Neuropeptide Y; D009479:Neuropeptides; D013373:Substance P; D015288:Neurokinin A; D015740:Calcitonin Gene-Related Peptide