engleski

Diagnostic accuracy of salivary matrix- metalloproteinase-3 to diagnose anterior disc displacement in temporomandibular joints in patients with axial spondyloarthritis

Background: Th17 immune response underlying osteoarthritis acts proinflammatory inducing osteoclastic process with osteolysis, which is partially mediated by the activity of matrix metalloproteinase-3 (MMP-3). Disc displacement (DD) is the most common temporomandibular disorder, which correlates with neck pain and makes SpA clinically more severe. Aim: The aim of this study was to analyze salivary MMP-3 diagnostic accuracy for DD in patients with SpA with neck pain, as well as MMP-3 correlation with laboratory and functional status of patients. Methods: Patients with non-radiographic axial SpA (N 90), diagnosed according to ASAS (Assessment of Spondyloarthritis International Society) criteria, who reported neck pain, were examined according to the Diagnostic Criteria for temporomandibular disorders (DC/TMD). SpA was assessed with BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and BASFI (Bath Ankylosing Spondylitis Functional Index). Unstimulated saliva was sampled for MMP-3 analysis (ELISA) and serum for C- reactive protein (CRP) and antistreptolysin-O titer (automatic analyzer). Results: Salivary MMP- 3 increased in patients with DD in comparison with healthy TMJ (P= 0.045) and showed diagnostic accuracy for DD with cut-off value at 104 pg/mL, specificity 100%, and sensitivity 29%. Salivary MMP-3 positively correlated with antistreptolysin- O titer, BASFI, limitation of mandibular movement, and with physical symptoms of general health measured with DC/TMP protocol. It did not correlate with BASDAI, CRP, chronic pain, anxiety and depressive disorder. Conclusion: Salivary MMP- 3 could help in diagnosis of DD in patients with non-radiografic axial SpA with 100% specificity. It mirrors local and systemic functional status of patients, particularly with enhanced antistreptolysin-O titer. However, due to a low sensitivity of the test, a large proportion of patients might remain undiagnosed this way.

disc displacement ; matrix metalloproteinase-3 ; spondyloarthritis ; temporomandibular disorder ; temporomandibular joint

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