Effects of intra-articular administration of sodium hyaluronate on plasminogen activator system in temporomandibular joints with osteoarthritis
Received 24 August 2009; received in revised form 2 November 2009; accepted 5 November 2009. published online 25 February 2010.
Objective
The aim of this study was to investigate the effect of intra-articular sodium hyaluronate (SH) injections on the main components of plasminogen activator (PA) system in the synovial fluid of temporomandibular joint (TMJ) osteoarthritis (OA).
Study design
Forty patients diagnosed with TMJ OA and 20 healthy control subjects were included in this study. Synovial fluid was collected in the OA group and the healthy group at baseline. The OA patients were randomly divided into 2 groups (20 patients for each group): One group received 5 injections of SH, and the other received 5 injections of physiologic saline solution in the upper joint space at weekly intervals. Synovial fluid was collected before and after treatment. Urokinase-type PA (uPA), soluble uPA receptor (suPAR) and PA inhibitor 1 (PAI-1) levels in synovial fluid were quantified by enzyme-linked immunosorbent assay.
Results
The OA patients had significantly higher uPA activity and levels of uPA (median 80.01 ng/L), suPAR (median 7.54 ng/L), and PAI-1 (median 54.9 ng/mL) than the healthy control subjects (median 20.47 ng/L uPA, 2.34 ng/L suPAR, and 19.9 ng/mL PAI-1; (P < .05). The uPA activity and levels of uPA, suPAR, and PAI-1 were significantly decreased after SH injections in TMJs of OA patients (P < .05), and there was no difference after saline injection. Visual analog pain score reduction correlated with changes in uPA and uPAR levels as well as uPA activity.
Conclusion
The effects of SH on PA system provide new insight into a possible underlying mechanism by which SH alleviates pain of patients with TMJ OA.
aState Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
bDepartment of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, China
Reprint requests: Xin-hua Liang, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, No.14, Sec. 3, Renminnan Road, Chengdu Sichuan 610041, China
Supported by the National Natural Science Foundation of China (grant nos. 30300391 and 30872889) and by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry (grant no. 20098-8-2).
The first two authors contributed equally to this work.
ABSTRACT