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Saliva emerges as a promising, noninvasive window into disease activity, revealing elevated proinflammatory cytokines in children with juvenile idiopathic arthritis affecting the jaw.
Proinflammatory cytokines play a pivotal role in driving disease mechanisms and stand as key therapeutic targets in chronic inflammatory conditions. Researchers executed a cross-sectional study to examine cytokine concentrations in saliva, serum, and temporomandibular joint (TMJ) synovial fluid. Consecutive children with juvenile idiopathic arthritis (JIA) and TMJ arthritis scheduled for corticosteroid injections and non-JIA controls were recruited from 3 Norwegian centers. Demographics, disease activity, TMJ involvement, and medication history were documented.
Unstimulated saliva, serum, and TMJ synovial fluid samples were collected, with synovial fluid volumes quantified using the hydroxocobalamin method following the push-and-pull technique. Cytokine concentrations were then examined by Luminex xMAP technology. A total of 15 kids with JIA and TMJ arthritis (median age 15.0 years, [interquartile range (IQR) 11.0–16.0]) and 34 controls (median age 13.0 years, IQR 9.8–15.0) were assessed. Saliva samples were obtained from 13 JIA-TMJ patients and 28 controls, serum from 11 patients and 16 controls, and TMJ synovial fluid from 8 patients.
Salivary analysis revealed higher concentrations of interleukin (IL)-1β, IL-4, IL-5, IL-9, IL-10, IL-12, IL-13, IL-17, eotaxin, fibroblast growth factor (FGF) basic, granulocyte-macrophage colony-stimulating factor (GM-CSF), platelet-derived growth factor BB isoform (PDGF-BB), tumor necrosis factor, and regulated on activation, normal T cell expressed and secreted (RANTES) in JIA-TMJ compared with controls, whereas interferon gamma-induced protein 10 (IP-10) appeared at markedly lower levels.
Analysis of TMJ synovial fluid—available for 3 patients meeting strict sampling criteria—revealed higher cytokine concentrations in JIA-TMJ, consistent with findings from earlier Nordic studies. This exploratory study highlighted saliva as a promising, noninvasive biomarker source, demonstrating distinct peaks of proinflammatory cytokines in children with JIA-TMJ compared with controls. While serum showed no group differences, synovial fluid from affected joints carried higher cytokine loads, thereby strengthening the potential of saliva-based profiling for early detection and monitoring of TMJ involvement in JIA.
Pediatric Rheumatology Online Journal
Cytokines in saliva, serum, and temporomandibular joint synovial fluid in children with juvenile idiopathic arthritis: An explorative cross-sectional study
Paula Frid et al.
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