Crosslinking of fibrinogen and fibronectin by free radicals: A possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint

Purpose: Adhesion formation in osteoarthritis (OA) of the temporomandibular joint (TMJ) typically results in a sustained limitation of joint movement. We propose the hypothesis that free-radical-mediated crosslinking of proteins underlies this adhesion formation in affected joints. Free radicals may cause oxidative modification of proteins, creating an opportunity for the formation of intramolecular and intermolecular crosslinks via covalent bonds. This may stabilize protein aggregates, rendering them more resistant to degradation. In this study, the free-radical-mediated crosslinking of model proteins (fibrinogen and fibronectin) was investigated to test our hypothesis that free radicals contribute to adhesion formation via this mechanism in OA of the TMJ. Materials and Methods: Physiological clot formation of fibrinogen by thrombin and free-radical-induced-crosslinking of fibrinogen and of fibronectin were analyzed using spectrophotometric turbidity measurements, fight-scattering techniques, polyacrylamide gel electrophoresis (PAGE), and rotary shadowing. Results: Fibrinogen was shown to aggregate after free radical treatment, as detected using turbidity measurements and light-scattering techniques. Using PAGE, fibrinogen as well as fibronectin was shown to degrade under low oxidative stress. Under high oxidative stress, however, fragments from both proteins were found to be covalently crosslinked, resulting in high-molecular-weight protein aggregates. The aggregation was shown to be at random with rotary shadowing. Conclusion: The study shows that high oxidative stress contributes to the formation of crosslinked proteins that may serve as an initial scaffolding for the development of adhesions frequently seen in OA of the TMJ. (C) 2003 American Association of Oral and Maxillofacial Surgeons.