Septic Arthritis – Does Bacterial infection Associate with Temporomandiular Pain?

Objectives: Septic arthritis of the temporomandiular joint (TMJ) is an inflammatory reaction in response to either a local or systemic bacterial infection. The presence of Chlamydia trachomatis in the TMJ has been well documented, although the association between C. trachomatis infection and TMJ pain has yet to be investigated. Host response to bacterial infection can be measured by interluekin-8 (IL-8) production. Excessive IL-8 due to LPS from bacterial infection leads to nociceptor sensitization in the TMJ. The purpose of this study was to evaluate the potential comorbidity between C. trachomatis infection/IL-8 production and TMJ pain in a patient population. 

Methods: 25 tissue samples and 30 blood samples were obtained from female patients who underwent TMJ surgery. Patient venous blood samples were collected, centrifuged, and isolated serum was removed and quantified for IL-8 enzyme-linked immunosorbent assays (ELISA) analysis. Likewise, patient tissue samples from hyperplastic TMJ growths were collected, lysed, and the protein content was quantified using following the Bradford method.  Samples were then subjected to ELISA analyses to detect for C. trachomatis and IL-8 antigens in patient biopsies.

Results: In patient tissue samples, C. trachomatis and IL-8 antigen presentation were positively correlated with reported TMJ pain, albeit with variations prescribing to non-significance.  However, in patient blood samples, IL-8 antigen revealed a positive and statistically significant correlation (*p<0.05, Student’s T-test) in patients reporting TMJ pain. 

Conclusions: In both sets of patient tissue and blood samples, C. trachomatis/IL-8 antigenic presence and TMJ pain demonstrated a positive correlation.  From these results, we conclude that C. trachomatis may be associated with TMJ pain as measured by IL-8 production, but that TMJ pain cannot be wholly pre-indicated by C. trachomatis infection.  This work was supported by NIH GRANT NS016884 and the department of Oral and Maxillofacial Surgery at UTHSCSA.