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УДК: 611.724 - 018.4 - 02:616.153.455.01] - 092.9
Гнатюк М.С., Рубас Л.В.
Тернопольский национальный медицинский университет
им. И.Я. Горбачевського DOI: 10.24412/2520-2480-2021-289-58-60 ОСОБЕННОСТИ СТРУКТУРЫ ДИСКА ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА ПРИ ЕКСПЕРИМЕНТАЛЬНОЙ ГИПЕРГЛИКЕМИИ
Hnatiuk M.S., Rubas L. V.
I. Ya. Horbachevsky Ternopil National Medical University
PECULIARITIES OF STRUCTURE OF DISK OF TEMPOROMANDIBULAR JOINT IN EXPERIMENTAL HYPERGLYCEMIA
Аннотация.
Цель: установить структурные особенности диска ВНЧС при экспериментальной гипергликемии.
Материалы и методы. Эксперимент выполнен на 90 белых крысах-самцах. Животные были разделены на 6равных групп (по 15 особей в каждой). Гипергликемия была вызвана у крыс 1, 2 и 3 групп инъекцией стрептозотоцина от «Sigma». Наблюдение за этими группами длилось 30, 60 и 90 дней соответственно. Группы 4, 5 и 6 были использованы в качестве контроля в соответствующий период. Убой животных осуществляли под наркозом тиопентала натрия путем кровопускания, после чего забирали биологический материал. Гистологические срезы готовили по общепринятому методу, размещали на предметных стеклах, окрашивали гематоксилин-эозином и исследовали с помощью микроскопов при различных увеличениях.
Результаты. Гистологических изменений в структуре диск ВНЧС у контрольных животных не обнаружили. Однако отмечалась его ремоделирование у крыс с гипергликемией. Отек коллагеновых волокон, единичные гистиоциты, а также утолщение артериальных и расширение венозных стенок микроцирку-ляторного русла наблюдались после первого месяца эксперимента. Утолщение волокон, преобладание фибробластов, макрофагов и тучных клеток, сужение просвета артерий и артериол и полнокровие в венах наблюдались через два месяца после моделирования гипергликемии. Значительное утолщение колла-геновых волокон и резкое увеличение клеточного инфильтрата визуализировались после трех месяцев эксперимента. В венозных сосудах отмечались полнокровие, расширение и диапедезные кровоизлияния. Просвет артерий и артериол значительно сузился, их стенки утолщены.
Выводы. Ремоделирования структуры диска ВНЧС при экспериментальной гипергликемии представлены мукоидным и фибринозным отеком коллагеновых волокон и изменениями микроциркуляторного сосудистого русла, которые проявляются утолщением стенок артерий и сужением их просвета, а также расширением и делятациею венозных сосудов. Эти морфологические изменения приводят к гипоксии, дистрофии и атрофии диска ВНЧС, а затем и к различным расстройствам этого диартроза.
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Abstract.
Purpouse: to establish structural peculiarities of the TMJ disk in case of experimental hyperglycemia.
Material and methods. Experiment was performed on 90 white male rats. Animals were divided into 6 equal groups (15 individuals in each). Hyperglycemia was caused in rats of groups 1, 2 and 3 by injection of strepto-zotocin from "Sigma ". The observation of those groups lasted 30, 60 and 90 days accordingly. Groups 4, 5 and 6 were used as controls at the appropriate period. Animals were slaughtered by injection of sodium thiopental after which biological material was collected. Histological sections were prepared according to conventional methods, placed on slide glasses, stained with hematoxylin-eosin and examined using microscopes.
Results. Histologically, TMJ disc in control animals did not change. Its' restructuring was marked in rats with diabetes. Swelling in the collagen fibers and single histiocytes as well as thickening of arterial walls and widening ofvenous walls were observed after the first month of experiment. Thickening ofthe fibers, predominance offibroblasts, macrophages and fat cells, narrowing of arteries' and arterioles' lumen and plethora in the veins were observed after two months lasting hyperglycemia. Collagen fibers thickened significantly and amount of cellular infiltrate increased dramatically after three months of experiment. There were plethora, enlargement and diapedesis hemorrhage in venous vessels. The lumen of arteries and arterioles significantly narrowed, their walls thickened.
Conclusions. Remodeling of structure of the TMJ disk in experimental hyperglycemia are presented by both mucoid and later fibrinous swelling of collagen fibers and changes in the vascular bed, which manifest itself by the thickening of the arterial walls and the narrowing of their lumen, as well as the enlargement and dilation of the venous vessels. These morphological changes lead to hypoxia, dystrophy and atrophy of the TMJ disc and thus to various disorders of this diarthrosis.
Ключевые слова: височно-нижнечелюстной сустав, стрептозотоцин, стрептозотоцин-индуцирова-ный сахарный диабет, гипергликемия.
Keywords: streptozotocin, diabetes, disc of temporomandibular joint, collagen, microcirculatory vessels.
Introduction
Diabetes mellitus (DM) is epidemic of XXI century because of its complications and premature death [1]. Insulin deficiency and hyperglycemia play important role in the development of pathological changes in bone tissue [2]. The literature data show that DM is dangerous by oxidative stress, which leads to releasing active oxygen forms that can affect bone tissue degrading bone microstructure [3, 4]. At the same time, the diseases of the temporomandibular joint (TMJ) occupy 3 place among the pathologies of the maxillofacial area [5]. The prevalence of signs and symptoms of TMJ disorders is high and ranges from 16 % to 88 % of the population of the Earth [6-8]. However, there is no scientific evidence on the effect of diabetes on the structural components of the TMJ.
Aim
Purpose of the research was to establish peculiarities of changes of structure of the disk of TMJ in case of experimental hyperglycemia.
Materials and methods
The experiment was performed on 90 white adult male rats of Vistar line, weighing 90-320 g, which were obtained the standard ration of the vivarium. Animals were divided into 6 groups. Group 1 consisted of 15 individuals with simulated diabetes, which were withdrawn from the experiment after 30 days. Group 2 included 15 rats with the noted endocrinological pathology, observation duration of which lasted 60 days. Group 3 consisted of 15 animals with hyperglycemia, which were withdrawn from the experiment after 90 days. Groups 4, 5 and 6 consisted of 15 animals each, which were used as controls at the appropriate observation times. Insulin-dependent diabetes mellitus in rats was caused by a single intraperitoneal administration of streptozotocin from "Sigma" at the rate of 50 mg / kg
[9]. The animals were slaughtered by injection of sodium thiopental after 1, 2 and 3 months after the start of the experiment after which biological material was collected.
Histological examination of the joint involved the study of all its components. In order to do this, bone fragments were fixed in 10 % neutral formalin solution, decalcified in 10% nitric acid solution, dehydrated in alcohols of increasing concentration and poured into paraffin blocks. Histological sections of 6-8 microns thick were prepared and stained with hematoxylin-eo-sin. [10, 11]. Histological specimens were displayed on a computer monitor using a Delta Optical microscope, a digital camera (Digital Camera SCMOS) and Toup-Wiew software at various magnifications for photographic documentation.
Results of the research and their discussion. The disc of TMJ of the control animals did not change. Histologically, the joint surfaces of the mandible and the fossa of the temporal bone are covered with fibrous cartilage. The TMJ disc consisted of a dense fibrous connective tissue with a small number of cellular elements of the fibroblastic row. The collagen fibers disperse upwards in the form of a fan in the direction of the temporal bone up to the calculus-tympanic cleft, and downwards up to the growth branch and its neck. The collagen fibers were located more loosely in the central layers than in the peripheral ones. Twisting thin, tightly and erratically placed elastic fibers with single fibroblasts, macrophages and mast cells between them were visualized along with the collagen fibers. Mature fibrocytes were mostly observed in the area of contact with the mandible and were located parallel to the surface of the disk. Between the fibrous elements (plates) of the disc, there are layers of more loose connective tissue, which often contain blood vessels, including thick-walled arteries (small and medium caliber).
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Considerable restructuring of the disk of the TMJ was marked rats with streptozotocin-induced diabetes mellitus. Swelling in the collagen fibers was observed, and single histiocytes were visualized after the first month from the start of the experiment. The walls of the arterial vascular bed were slightly thickened, and the walls of venous ones were widened. Thickening of the fibers and increasing the number of cellular infiltrate with a predominance of fibroblasts, macrophages and fat cells were observed in cases where the duration of hyperglycemia have lasted two months. The lumen of the arteries and arterioles narrowed. The plethora was visualized in the venous vasculature bed. The collagen fibers of the disc thickened significantly, the amount of cellular infiltrate increased dramatically after three months from the creation of the diabetes model. There were plethora, enlargement and diapedesis hemorrhage in the venous vessels of the hemomicrocirculatory bed. The lumen of the arteries and arterioles significantly narrowed, their walls thickened.
Conclusions
1. Experimental hyperglycemia negatively influence on the structure of TMJ disc. It results into mucoid and later fibrinous swelling of collagen fibers.
2. Streptozotocin-inducted diabetes significantly influences on the remodeling of the microvascular bed of the disc of TMJ. It is characterized by thickening of the arteries' walls, narrowing of their lumen, enlargement and plethora of venous vessels.
3. Mucoid and fibrinous swelling of collagen fibers and microvascular disorders caused by hypergly-cemia lead to hypoxia, dystrophy and atrophy of the disc and therefore may cause different TMJ disorders.
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