Alstergren Per, Ernberg Malin, Nilsson Mikael, Hajati Anna-Kari, Sessle Barry J, Kopp Sigvard
Karolinska Institutet, Institute of Odontology, Box 4064, 141 04 Huddinge, Sweden.
J Orofac Pain. 2010 Spring;24(2):172-80.
To determine if glutamate injected into the healthy temporomandibular joint (TMJ) evokes pain through peripheral N-methyl-D-aspartate (NMDA) receptors and if such pain is influenced by sex or sex steroid hormones.
Sixteen healthy men and 36 healthy women were included and subjected to two randomized and double-blind intra-articular injections of the TMJ. Experimental TMJ pain was induced by injection of glutamate (1.0 mol/L) and NMDA block was achieved by co-injection of the NMDA antagonist ketamine (10 mmol/L). The TMJ pain intensity in the joint before and during a 25-minute postinjection period was continuously recorded on an electronic visual analog scale (0 to 10). Estradiol, progesterone, and testosterone levels in serum were analyzed.
Glutamate-induced pain showed a median (25/75 percentile) duration of 8.3 (5.2/12.2) minutes. The peak pain intensity was 6.1 (4.2/8.2), the time to peak was 50 (30/95) seconds, and the area under the curve was 59 (29/115) arbitrary units. The women reported higher maximum pain intensity than the men and shorter time to peak. The sex hormone levels were not significantly related to the glutamate-induced TMJ pain. NMDA block significantly reduced the glutamate-induced TMJ pain, mainly in the women. There were no significant correlations between sex hormone levels and the effects of NMDA block for any pain variable.
Glutamate evokes immediate pain in the healthy human TMJ that is partly mediated by peripheral NMDA receptors in the TMJ.
确定注入健康颞下颌关节（TMJ）的谷氨酸是否通过外周N-甲基-D-天冬氨酸（NMDA）受体引发疼痛，以及这种疼痛是否受性别或性类固醇激素影响。
纳入16名健康男性和36名健康女性，对其TMJ进行两次随机双盲关节内注射。通过注射谷氨酸（1.0 mol/L）诱导实验性TMJ疼痛，并通过联合注射NMDA拮抗剂氯胺酮（10 mmol/L）实现NMDA阻断。在注射后25分钟内，使用电子视觉模拟量表（0至10）连续记录关节内TMJ疼痛强度。分析血清中的雌二醇、孕酮和睾酮水平。
谷氨酸诱导的疼痛中位（25/75百分位数）持续时间为8.3（5.2/12.2）分钟。疼痛峰值强度为6.1（4.2/8.2），达到峰值的时间为50（30/95）秒，曲线下面积为59（29/115）任意单位。女性报告的最大疼痛强度高于男性，达到峰值的时间更短。性激素水平与谷氨酸诱导的TMJ疼痛无显著相关性。NMDA阻断显著减轻了谷氨酸诱导的TMJ疼痛，主要在女性中。性激素水平与NMDA阻断对任何疼痛变量的影响之间无显著相关性。
谷氨酸在健康人体TMJ中引发即时疼痛，部分由TMJ中的外周NMDA受体介导。
