TMD患者关节液中致炎细胞因子含量及其相关性研究

Concentration and interrelationship of proinflammatory cytokines in synovial fluid from TMJs in patients with TMD

目的:同时检测同一患者关节液标本中TNFα、IL-1β、IL-6、IL-8及IFNγ的含量,探讨致炎细胞因子在TMD病理生理过程中的相互关系。方法:在关节造影或关节冲洗时,抽取51名TMD患者56侧关节的关节液,15名正常志愿者的15侧关节液为对照组;采用用双抗体夹心酶联免疫法(ABC-ELISA),对患者组及对照组每一关节液标本中,上述诸细胞因子水平进行检测,依据关节损害程度,进一步将患者组关节液分为轻症组与重症组。结果:患者组关节液中TNFα、IL-1β、IL-6的水平显著高于对照组,且三者间呈明确正相关;IL-8仅在部分患者中检出,IFNγ在患者组及对照组中均未检出;IL-1β水平在重症组中,显著高于轻症组。结论:提示在TMJ中TNFα、IL-1β、IL-6构成细胞因子网络发挥作用,其中IL-1β在关节损害过程中起主导作用,IL-8可能参与了TMD病理破坏过程,IFNγ的作用有待进一步证实。

Objective: To simultaneously measure the levels of TNFα、IL-1β、IL-6、IL-8 and IFNγ in synovialfluid from the same patient and thus investigate their interrelationship in pathologic process of TMD. Methods: Synovialfluid samples were obtained from 56 TMJs in 51 TMD patients who underwent arthrography or joint lavage and samplesfrom 15 TMJs in 15 asymptomatic volunteers served as control group. Enzyme-linked immunosorbent assay was used tomeasure the levels of cytokines. Results: The levels of TNFα、IL-1β、IL-6 in synovial fluid of patients weresignificantly higher than that of control, and there were positive correlation among them. IL-8 was detected only in synovialfluid of some patients, IFNγ was not detected in all samples. The levels of IL-1β was significantly higher in TMJswith severe lesion than in TMJs with mild lesion. Conclusions: The results suggest that TNFα、IL-1β and IL-6,among which IL-1β is predominant, exert their biological function by forming cytokine networks. IL-8 may play a rolein pathologic process of TMD and the role of IFNγ in TMD needs further study.