keratan-sulfate and Temporomandibular-Joint-Disorders

Results from our previous studies suggest that surgical induction of anterior disk displacement (ADD) in the rabbit craniomandibular joint (CMJ) leads to histopathological alterations consistent with osteoarthritis. In addition, molecular changes in collagens and glycosaminoglycans (GAGs) were observed using immunohistochemistry. The purpose of the present study was to further characterize those molecular changes in collagens and GAGs using immuno-electron microscopy.. The right joint of 15 rabbits was exposed surgically and all discal attachments were cut except for the posterior attachment (the bilaminar zone). The disc was then repositioned anteriorly and sutured to the zygomatic arch. The left joint was used as a sham-operated control. Ten additional joints were used as non-operated controls. Mandibular condyles were removed 2 weeks following surgery and processed for light and immuno-electron microscopy using colloidal gold-labeled antibodies against collagen type I, II, VI and IX and against keratan sulfate, chondroitin-4 and -6-sulfate, and link protein.. Light microscopic results showed osteoarthritic changes. Immuno-electron microscopy of osteoarthritic cartilage demonstrated a decline in type II collagen, the abnormal presence of type I collagen and loss of type VI and IX collagens. Quantitative colloidal gold immuno-electron microscopy confirmed the depletion of keratan sulfate, chondroitin-4 and -6-sulfate, and link protein in osteoarthritic cartilage.. Anterior disk displacement leads to molecular alterations in both the collagen and the proteoglycans of rabbit condylar cartilage characteristic of osteoarthritis in other synovial joints. These alterations are consistent with loss of the shock absorber function of the cartilage and injury of the underlying bone.

Topics: Animals; Antibodies; Cartilage; Chondroitin Sulfates; Collagen; Collagen Type I; Collagen Type II; Collagen Type IX; Collagen Type VI; Extracellular Matrix Proteins; Gold Colloid; Immunohistochemistry; Joint Dislocations; Keratan Sulfate; Male; Mandibular Condyle; Microscopy, Immunoelectron; Osteoarthritis; Proteins; Proteoglycans; Rabbits; Temporomandibular Joint Disc; Temporomandibular Joint Disorders

The aetiology of temporomandibular joint (TMJ) disc displacement has been investigated using human post-mortem material. Twenty TMJ specimens were used for a histological procedure with haematoxylin and eosin staining and orcein staining. Immunohistological analysis with chondroitin-6-sulphate and keratan sulphate was also carried out on the same specimens. Immunohistochemically, the specific localization of chondroitin-6-sulphate and keratan sulphate in the antero-medial parts of the anteriorly displaced deformed TMJ disc, which may be load-bearing areas, was observed. Orcein staining revealed that specific elastic fibres pulling the anterior band and stretching the disc continuously, may be an important factor in disc displacement. On the basis of these results, we were able to propose a significant new hypothesis for the aetiology of disc displacement.

Topics: Adult; Aged; Aged, 80 and over; Chondroitin Sulfates; Elastic Tissue; Extracellular Matrix; Female; Humans; Immunoenzyme Techniques; Joint Dislocations; Keratan Sulfate; Male; Middle Aged; Pterygoid Muscles; Synovial Membrane; Temporomandibular Joint Disc; Temporomandibular Joint Disorders

The specific aim of this investigation was to assess differences between primary and secondary osteoarthritis (OA) of the temporomandibular joint (TMJ) using clinical evaluation and synovial fluid analysis for proteoglycans.. Arthroscopic surgery was performed on 101 TMJs from patients with significant pain or dysfunction and who had failed to respond to treatment. Joints were assessed for primary and secondary osteoarthritis. Synovial fluid aspirates were obtained and analyzed to determine the levels of keratan sulfate (KS) epitope and a novel 3B3(-) epitope by enzyme-linked immunosorbent assay (ELISA).. Fifty-four patients and 67 joints had OA diagnosed by both clinical examination and arthroscopy. Primary OA was diagnosed in 14 joints (20%), and the remaining 53 joints were regarded as having secondary OA. No differences were detected in the levels of KS in the synovial fluid from the primary and secondary OA joints. Furthermore, the 3B3(-) epitope was not detectable in the synovial fluid aspirates of any TMJ.. Secondary OA is a common disorder of the TMJ. However, there is no apparent difference in the metabolism of the joints with primary and secondary OA as assessed by proteoglycans in the synovial fluid. The apparent absence of the 3b3(-) epitope, in contrast to its presence in OA of other major synovial joints, suggests that there are some differences between the cartilage metabolism of the TMJ and these other joints during OA.

Topics: Adult; Arthroscopy; Cartilage; Chondroitin Sulfates; Enzyme-Linked Immunosorbent Assay; Epitopes; Female; Humans; Keratan Sulfate; Male; Osteoarthritis; Proteoglycans; Statistics, Nonparametric; Synovial Fluid; Temporomandibular Joint Disc; Temporomandibular Joint Disorders

The specific aims of this investigation were to determine if there is a relationship between an arthroscopic diagnosis of synovitis and osteoarthritis, and if the presence of synovitis influences the level of cartilage degradation, as evidenced by keratan sulfate levels in the synovial fluid.. Arthroscopic surgery was performed on 114 temporomandibular joints in 88 patients who had significant pain or dysfunction and whose condition had failed to improve with conservative treatment. Synovial fluid aspirates were obtained immediately before arthroscopy and used for the determination of keratan sulfate levels. Arthroscopic examination included assessment of the presence or absence of osteoarthritis and synovitis.. Synovitis was present in 90% of joints, and osteoarthritis was present in 62% of joints examined arthroscopically. Both osteoarthritis and synovitis existed in 57% of the joints. Joints with an arthroscopic diagnosis of synovitis had significantly lower levels of keratan sulfate in the synovial fluid aspirates than joints with osteoarthritis. Synovial fluid aspirates from temporomandibular joints with osteoarthritis had significantly higher levels of keratan sulfate than synovial fluids from joints without osteoarthritis.. Osteoarthritis and synovitis are common diagnoses and are often present concurrently in patients with symptomatic temporomandibular joints. Osteoarthritis is associated with elevated keratan sulfate levels; however, the elevation of keratan sulfate is less in patients with concomitant synovitis.

Topics: Analysis of Variance; Arthroscopy; Cartilage, Articular; Humans; Keratan Sulfate; Osteoarthritis; Paracentesis; Synovial Fluid; Synovitis; Temporomandibular Joint; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome

The purpose of this study was to determine the effects of surgically induced anterior disc displacement (ADD) on sulfated glycosaminoglycans (GAGs) such as keratan sulfate (KS), chondroitin-4-sulfate (C4S), and chondroitin-6-sulfate (C6S), hyaluronic acid (HA), and link protein (LP) of the rabbit craniomandibular joint (CMJ) using histochemical and immunohistochemical techniques.. The right joint of 20 rabbits was exposed surgically, and all discal attachments were severed except for the posterior attachment. The disc was then repositioned anteriorly and sutured to the zygomatic arch. The left joint served as a sham-operated control. Ten additional joints were used as nonoperated controls. Deeply anesthetized rabbits were perfused with 2% buffered formalin 2 weeks (10 rabbits) or 6 weeks (10 rabbits) after surgery. Discs, bilaminar zones, condyles, and articular eminences were excised. Condyles and articular eminences were decalcified in ethylenediaminetetraacetic acid (EDTA). All tissues were sectioned at 10 microns in a cryostat. Sections were incubated with alcian blue and monoclonal antibodies directed against KS, C4S, C6S, HA, or LP. After incubation in the appropriate fluorescein isothiocyanate (FITC)-labeled secondary antibodies, tissue sections were studied under the fluorescence microscope.. The results showed a reduction in alcian blue staining and KS, C4S, C6S, HA, and LP immunostaining in the disc and articular surfaces at 2 weeks after induction of ADD. This reduction was followed by an increase in their immunostaining at 6 weeks. Also, there was a progressive increase in alcian blue staining, and KS, C4S, C6S, and HA immunostaining in the bilaminar zone at 2 and 6 weeks.. It was concluded that surgical induction of ADD in the rabbit CMJ leads to alterations in KS, C4S, C6S, HA, and LP content, consistent with similar changes accompanying osteoarthritis of other synovial joints.

Topics: Alcian Blue; Animals; Cartilage, Articular; Chondroitin Sulfates; Coloring Agents; Extracellular Matrix Proteins; Fluorescein-5-isothiocyanate; Fluorescent Dyes; Glycosaminoglycans; Histocytochemistry; Hyaluronic Acid; Immunohistochemistry; Joint Dislocations; Keratan Sulfate; Male; Mandibular Condyle; Microscopy, Fluorescence; Proteins; Proteoglycans; Rabbits; Temporal Bone; Temporomandibular Joint Disorders

Glycosaminoglycans in normal and osteoarthrotic temporomandibular joint disks were studied by means of high-performance liquid chromatography methods. Normal disk tissue contains galactosaminoglycans (chondroitin sulfate and dermatan sulfate) as the main polysaccharides and with smaller amounts of hyaluronate and heparan sulfate. The galactosaminoglycans are mainly sulfated in 6-position, and some of the disaccharides contain iduronic acid. There was a slight general variation in glycosaminoglycan concentration with increasing age. In the severely arthrotic disks the content of glycosaminoglycans was considerably lower than in normal disk tissue. This decrease was far more extensive than that observed in relation to age in normal tissue. The 4/6-sulfate ratio of the galactosaminoglycans was increased, whereas the proportion of iduronic acid was markedly decreased.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cartilage, Articular; Chondroitin Sulfates; Chromatography, High Pressure Liquid; Dermatan Sulfate; Female; Glycosaminoglycans; Heparitin Sulfate; Humans; Hyaluronic Acid; Keratan Sulfate; Male; Middle Aged; Osteoarthritis; Temporomandibular Joint; Temporomandibular Joint Disorders

The role of osteoarthrosis (OA) and proteoglycan degradation in the pathogenesis of temporomandibular joint (TMJ) disorders has not been well established. The orthopaedic literature has demonstrated that proteoglycan degradation plays a significant role in the pathology of many joints. The purpose of this investigation was to determine if levels of immunoreactive keratan sulfate (an important component of cartilage proteoglycans) present in synovial fluid aspirates from TMJs correlated with arthroscopically demonstrated OA. Temporomandibular joint arthroscopy was performed on 25 joints in 20 patients and synovial fluid aspirates were obtained just prior to the insertion of arthroscopic cannulas. The results showed that synovial fluid aspirates from joints that arthroscopically demonstrated OA had significantly higher levels of keratan sulfate than synovial fluid aspirates from those joints that showed no evidence of OA (NON-OA). This study gives support to the theory that the pathogenesis of OA of the TMJ is similar to that of chondromalacia of other synovial joints. The combination of TMJ arthroscopy and synovial fluid analysis is an important model that can be used for investigation of the pathogenesis of TMJ disorders.

Topics: Adult; Arthroscopy; Female; Humans; Keratan Sulfate; Male; Osteoarthritis; Proteoglycans; Synovial Fluid; Temporomandibular Joint Disorders