title: Tumor necrosis factor mediates temporomandibular joint bone tissue resorption in rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate if TNF, IL-1 or their endogenous controls, in relation to ACPA, are associated with radiological signs of ongoing temporomandibular joint (TMJ) bone tissue resorption and disc displacement in RA patients.
  
  
  METHODS
  Twenty-two consecutive outpatients with TMJ of RA were included. Systemic inflammatory activity was assessed by DAS28. The number of painful regions in the body and ESR, CRP, RF and ACPA were analyzed. TMJ synovial fluid and blood samples were obtained and analyzed for TNF, TNFsRII, IL-1ra, IL-1sRII and ACPA. The ratios between the mediators and their endogenous control receptors were used in the statistical analysis. Magnetic resonance imaging was performed in closed- and open-mouth positions and evaluated regarding disc position and presence of condylar and temporal erosions of the TMJ.
  
  
  RESULTS
  A high TNF level in relation to TNFsRII in TMJ synovial fluid correlated to the degree of TMJ condylar erosion. A high IL-1ra level in relation to TNF in TMJ synovial fluid was also correlated to the degree of TMJ condylar erosion. The total degree of TMJ condylar erosion was correlated with the number of painful regions.
  
  
  CONCLUSIONS
  This study indicates that TNF in TMJ synovial fluid mediates TMJ cartilage and bone tissue resorption in RA. The study also suggests that the degree of endogenous cytokine control is of importance for development of bone tissue destruction.
authors.affiliation: Department of Dental Medicine, Section for Orofacial Pain and Jaw Function, Karolinska Institutet , Huddinge , Sweden.
authors.forename: Neveen
authors.initials: N
authors.lastname: Ahmed
authors.forename: Arne
authors.initials: A
authors.lastname: Petersson
authors.forename: Anca Irinel
authors.initials: AI
authors.lastname: Catrina
authors.forename: Hamid
authors.initials: H
authors.lastname: Mustafa
authors.forename: Per
authors.initials: P
authors.lastname: Alstergren
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000473:pathology; D001323:Autoantibodies / Q000032:analysis; D001799:Blood Sedimentation; D001862:Bone Resorption / Q000276:immunology; D002097:C-Reactive Protein / Q000032:analysis; D002358:Cartilage, Articular / Q000276:immunology; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D004204:Joint Dislocations / Q000276:immunology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008335:Mandibular Condyle / Q000276:immunology; D008875:Middle Aged; D010146:Pain / Q000276:immunology; D053574:Receptors, Interleukin-1 Type II / Q000032:analysis; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000032:analysis; D013582:Synovial Fluid / Q000276:immunology; D013704:Temporomandibular Joint / Q000276:immunology* / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000276:immunology; D013705:Temporomandibular Joint Disorders / Q000276:immunology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D001323:Autoantibodies; C508592:IL1R2 protein, human; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D053574:Receptors, Interleukin-1 Type II; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: MRI; TMJ; cytokines; disc displacement; erosion; rheumatoid arthritis