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儿茶酚氧位甲基转移酶的遗传多态性:与颞下颌关节紊乱病和术后疼痛的关系。

Genetic Polymorphisms of Catechol-O-Methyltransferase: Association with Temporomandibular Disorders and Postoperative Pain.

出版信息

J Oral Facial Pain Headache. 2016;30(4):302-310. doi: 10.11607/ofph.1688.

DOI:10.11607/ofph.1688
PMID:27792797
Abstract

AIMS

To evaluate the association between catechol-O-methyltransferase (COMT) gene polymorphisms and temporomandibular disorders (TMD), TMD pain, psychosocial impairment related to TMD, and postoperative pain.

METHODS

A total of 90 patients with a diagnosis of painful TMD and 92 matched controls were investigated for the presence of TMD, TMD pain, and psychosocial variables by the Research Diagnostic Criteria for TMD. In a prospective cohort study of 40 subjects who underwent extraction of at least one fully impacted mandibular third molar, subjects had 6 months post-surgery follow-up of postoperative pain. DNA extracted from peripheral blood was genotyped for three COMT polymorphisms (rs4680, rs6269, and rs165774) by real-time TaqMan method. The association between COMT polymorphisms and clinical variables was determined by calculating odds ratios (OR) and their 95% confidence intervals (CI).

RESULTS

Homozygous AA genotype and heterozygous variant A allele carriers (genotype AG/AA) for rs165774 polymorphism were associated with increased risk of TMD compared to wild type (wt) GG genotype (OR = 9.448, P = .006; OR = 2.088, P = .017, respectively). In addition, AA genotype was associated with increased risk of arthralgia (OR = 4.448, P = .011), myofascial pain (OR = 3.543, P = .035), and chronic TMD pain (OR = 6.173, P = .006), compared to wt genotype. AA genotype for rs6269 polymorphism was related to less postoperative chronic TMD pain (P = .025) and lower postoperative acute pain at the extraction site (P = .030). No associations with depression and somatization were observed.

CONCLUSION

AA genotype of rs165774 could be a significant risk factor for the development of TMD and TMD pain, while AA genotype of rs6269 presents less postoperative chronic TMD pain and acute pain at a dental extraction site.

摘要

目的

评估儿茶酚-O-甲基转移酶(COMT)基因多态性与颞下颌关节紊乱(TMD)、TMD 疼痛、与 TMD 相关的心理社会障碍以及术后疼痛之间的关联。

方法

通过 TMD 研究诊断标准,对 90 例诊断为疼痛性 TMD 的患者和 92 例匹配对照者进行 TMD、TMD 疼痛和心理社会变量的调查。在一项前瞻性队列研究中,对 40 例至少有一颗完全埋伏下颌第三磨牙的患者进行了手术,在术后 6 个月对术后疼痛进行了随访。采用实时 TaqMan 法,从外周血中提取 DNA,对 3 个 COMT 多态性(rs4680、rs6269 和 rs165774)进行基因分型。通过计算比值比(OR)及其 95%置信区间(CI),确定 COMT 多态性与临床变量之间的关系。

结果

与野生型(wt)GG 基因型相比,rs165774 多态性的纯合 AA 基因型和杂合变异 A 等位基因携带者(基因型 AG/AA)发生 TMD 的风险增加(OR=9.448,P=0.006;OR=2.088,P=0.017)。此外,与 wt 基因型相比,AA 基因型与关节痛(OR=4.448,P=0.011)、肌筋膜痛(OR=3.543,P=0.035)和慢性 TMD 疼痛(OR=6.173,P=0.006)的发生风险增加有关。与 rs6269 多态性的 AA 基因型与术后慢性 TMD 疼痛减少(P=0.025)和拔牙部位术后急性疼痛降低(P=0.030)有关。未观察到与抑郁和躯体化的相关性。

结论

rs165774 的 AA 基因型可能是 TMD 和 TMD 疼痛发生的显著危险因素,而 rs6269 的 AA 基因型则表现出术后慢性 TMD 疼痛和拔牙部位急性疼痛较轻。

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