Identification of Chlamydia trachomatis in the human temporomandibular joint.
OBJECTIVE
Reactive arthritis (ReA) as a consequence of triggering Chlamydia trachomatis infections has been extensively studied to better understand inflammatory arthritis. This study investigated whether the presence of C trachomatis can be shown in the TMJ of patients with internal derangement.


METHODS
Posterior bilaminar tissue removed from 31 patients (29 F, 2 M) during TMJ articular disc repositioning and posterior ligament repair was tested for the presence of C trachomatis. Cryosections were stained using a monoclonal antibody that identifies all chlamydial serovars. Highly specific polymerase chain reaction (PCR) assays independently targeting two genes of C trachomatis also were performed; these assays also identify all serovars of this organism.


RESULTS
TMJ tissue from 6 of 30 patients (20%) showed the presence of C trachomatis in the posterior bilaminar tissue on immunostaining. PCR screening identified 12 of 31 patients (39%) as having C trachomatis DNA in tissue, including four of six positive by immunostaining. All chlamydia-positive patients were female, with an average age of 36.7 years (15 to 48 years).


CONCLUSIONS
The presence of C trachomatis in the human TMJ has not been previously shown. The presence of this organism may serve as the pathogenetic mechanism for TMJ dysfunction, as demonstrated in other joints. Nonapparent chlamydial infection in females may also explain the marked prevalence of TMJ symptoms in women.
Henry
C H
CH
Boston University Goldman School of Dental Medicine, MA, USA. chenry@pol.net
Hudson
A P
AP
Gérard
H C
HC
Franco
P F
PF
Wolford
L M
LM
D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000382:microbiology*; D015373:Bacterial Typing Techniques; D016010:Binomial Distribution; D002692:Chlamydia trachomatis / Q000302:isolation & purification / Q000472:pathogenicity*; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D004204:Joint Dislocations / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D013704:Temporomandibular Joint / Q000382:microbiology*; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000382:microbiology*
D004269:DNA, Bacterial; C000717331:PHB2 protein, human; D000091402:Prohibitins