2003 Fiscal Year Annual Research Report

顎関節症における関節疼痛のメカニズムに関する病態機構の解明

Research Project

Project/Area Number	13672129
Research Institution	Kanazawa Medical University
Principal Investigator	金山景錫金沢医科大学, 医学部, 助手 (50329380)
Co-Investigator(Kenkyū-buntansha)	佐藤淳金沢医科大学, 医学部, 講師 (60319069) 吉村弘金沢医科大学, 医学部, 講師 (90288845) 瀬上夏樹金沢医科大学, 医学部, 教授 (40148721)
Keywords	顎関節症 / 関節液 / 関節組織 / 発痛物質 / サイトカイン / 神経伝達機構 / 破骨細胞抑制因子
Research Abstract	今回の研究により以下の成果・新知見が得られた。 1.臨床的・基礎的研究顎関節症患者の関節液や関節組織の解析で、サイトカイン(TNF-α、IL-6、IL-11、VEGF、RANKLなど)、サイトカインレセプター(sTNFR-I/-II、IL6sR、OPGなど)、発痛物質(Bradykininなど)の局在を蛋白レベルで確認し、関節疼痛や関節破壊などの病態との関連が明かとなった。これらを列挙すると(1)顎関節症では滑膜の炎症を中心とした病態の進行とともにIL-6、TNF-α、sTNFR-I/-II、IL6sR、VEGF、炎症性蛋白の発現が増強し、相互に関連しあってサイトカインネットワークを形成していた。 (2)関節内における骨変化の機序として骨吸収因子(IL-6ファミリー:IL-6、IL-11)の刺激による破骨細胞細胞分化因子(RANKL)の発現と抑制因子(OPG)の低下が一因であることが示唆された。 2.臨床的研究 (1)患者の関節液・関節組織においてBradykininが顎関節の疼痛や滑膜炎と相関して発現しており、関節腔洗浄療法を行うことでその発現が減少することから、この治療における疼痛消失のメカニズムが明かとなってきた。 (2)MRI画像上のサインであるでjoint effusion像が滑膜炎、炎症性サイトカインなどの炎症生産物であることが示唆された。 3.基礎的研究 (1)ラットでの活性酸素(過酸化水素)誘発性急性顎関節炎モデルにて関節炎側に高度の関節破壊がおこっていた。 (2)中枢側での神経伝達機構の研究ではモルモットでの大脳新皮質における化学感覚受容野の空間分布を調べ、末梢受容器からの化学感覚情報が大脳新皮質において、空間的に符号化されて伝達されてた。今研究によって顎関節症の病態機構とその主症状である関節疼痛のメカニズムが明かとなり有意義な結果が得られた。

Research Products
(12 results)

All Other

All Publications (12 results)

[Publications] K.Kaneyama: "Outcomes of 152 temporomandibular joints following arthroscopic antero-lateral capsular release by Holmium-YAG laser or electrocautery."Oral Surg Oral Med Oral Pathol. (In press). (2004)
[Publications] K.Kaneyama: "Interleukin-6 family of cytokines as a biochemical marker of osseous changes in temporomandibular joint disorders."Br.J Oral Maxillofac Surg.. (In press). (2004)
[Publications] K.Kaneyama: "The ideal lavage volume for removing bradykinin, interleukin-6 and protein from the temporomandibular joint by arthrocentesis."J Oral Maxillofac Surg. (In press). (2004)
[Publications] M Nishimura: "Comparison of cytokine level in synovial fluid between successful and unsuccessful cases in arthrocentesis of the temporomandibular joint."J Oral Maxillofac Surg. (In press). (2004)
[Publications] J Sato: "Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia."Oral Surg Oral Pathol Oral Radil Endod. 97. 18-22 (2004)
[Publications] K.Kaneyama: "Expression of Osteoprotegerin in Synovial Tissue and Degradation of Articular Cartilage : Comparison with Arthroscopic Findings of the Temporomandibular Joint Disorders."Oral Surg Oral Pathol Oral Radil Endod. 96. 258-262 (2003)
[Publications] K.Kaneyama: "Osteoclastogenesis Inhibitory Factor/osteoprotegerin in Synovial Fluid From Patients With Temporomandibular Disease."Int J Oral Maxillofac Surg.. 32. 404-407 (2003)
[Publications] J Sato: "Levels of fibroblast growth factor-2 in synovial fluids in human patients with internal derangement of the temporomandibular joint."Oral Surg Oral Pathol Oral Radil Endod. 96. 673-679 (2003)
[Publications] N Segami: "Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2 Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthritis."Oral Surg Oral Med Oral Pathol. 94. 515-521 (2002)
[Publications] K.Kaneyama: "Importance of Proinflammatory Cytokines in Synovial Fluid from 121 Joints with Temporomandibular Disorders."Br J Oral Maxillofac Surg. 60. 418-423 (2002)
[Publications] Nishimura M: "Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint."Oral Surg Oral Med Oral Pathol. 94. 328-332 (2002)
[Publications] J.Sato: "The expression of vascular endothelial growth factor in synovial tissue in patients with internal derangement of the temporomandibular joint."Oral Surg Oral Med Oral Pathol. 93. 251-256 (2002)

2003 Fiscal Year Annual Research Report

顎関節症における関節疼痛のメカニズムに関する病態機構の解明

Principal Investigator

金山 景錫 金沢医科大学, 医学部, 助手 (50329380)

Research Products

[Publications] K.Kaneyama: "Outcomes of 152 temporomandibular joints following arthroscopic antero-lateral capsular release by Holmium-YAG laser or electrocautery."Oral Surg Oral Med Oral Pathol. (In press). (2004)

[Publications] K.Kaneyama: "Interleukin-6 family of cytokines as a biochemical marker of osseous changes in temporomandibular joint disorders."Br.J Oral Maxillofac Surg.. (In press). (2004)

[Publications] K.Kaneyama: "The ideal lavage volume for removing bradykinin, interleukin-6 and protein from the temporomandibular joint by arthrocentesis."J Oral Maxillofac Surg. (In press). (2004)

[Publications] M Nishimura: "Comparison of cytokine level in synovial fluid between successful and unsuccessful cases in arthrocentesis of the temporomandibular joint."J Oral Maxillofac Surg. (In press). (2004)

[Publications] J Sato: "Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia."Oral Surg Oral Pathol Oral Radil Endod. 97. 18-22 (2004)

[Publications] K.Kaneyama: "Expression of Osteoprotegerin in Synovial Tissue and Degradation of Articular Cartilage : Comparison with Arthroscopic Findings of the Temporomandibular Joint Disorders."Oral Surg Oral Pathol Oral Radil Endod. 96. 258-262 (2003)

[Publications] K.Kaneyama: "Osteoclastogenesis Inhibitory Factor/osteoprotegerin in Synovial Fluid From Patients With Temporomandibular Disease."Int J Oral Maxillofac Surg.. 32. 404-407 (2003)

[Publications] J Sato: "Levels of fibroblast growth factor-2 in synovial fluids in human patients with internal derangement of the temporomandibular joint."Oral Surg Oral Pathol Oral Radil Endod. 96. 673-679 (2003)

[Publications] K.Kaneyama: "Importance of Proinflammatory Cytokines in Synovial Fluid from 121 Joints with Temporomandibular Disorders."Br J Oral Maxillofac Surg. 60. 418-423 (2002)

[Publications] Nishimura M: "Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint."Oral Surg Oral Med Oral Pathol. 94. 328-332 (2002)

[Publications] J.Sato: "The expression of vascular endothelial growth factor in synovial tissue in patients with internal derangement of the temporomandibular joint."Oral Surg Oral Med Oral Pathol. 93. 251-256 (2002)

金山景錫金沢医科大学, 医学部, 助手 (50329380)