Department of Biomedical Sciences, College of Osteopathic Medicine, Biddeford, ME, United States.
Center for Excellence in the Neurosciences, University of New England, Biddeford, ME, United States.
Pain. 2019 Sep;160(9):2036-2049. doi: 10.1097/j.pain.0000000000001598.
Temporomandibular joint osteoarthritis (TMJOA) is a prevalent source of temporomandibular joint disorder (TMD). Women are more commonly diagnosed with TMD and are more likely to seek care at tertiary orofacial pain clinics. Limited knowledge regarding mechanisms underlying temporomandibular joint (TMJ) pain impairs development of improved pain management strategies. In a rat model of unilateral TMJOA, monosodium iodoacetate (MIA) produces joint pathology in a concentration-dependent manner. Unilateral MIA produces alterations in meal patterns in males and females without altering overnight time spent eating or weight across 2 weeks. Monosodium iodoacetate (80 mg/mL)-treated males develop ongoing pain within 2 weeks after MIA injection. Females develop ongoing pain at a 5-fold lower MIA concentration (16.6 mg/m). Monosodium iodoacetate (80 mg/mL)-treated males show spread of tactile hypersensitivity across the face during the first week after injection and then to the fore paws and hind paws during the second week after injection, indicating development of central sensitization. At the lower dose, female rats demonstrate a similar spread of tactile hypersensitivity, whereas male rats do not develop ongoing pain or spread of tactile hypersensitivity outside the area of the ipsilateral temporomandibular joint. These observations indicate that females have a higher susceptibility to development of ongoing pain and central sensitization compared with male rats that is not due to differences in MIA-induced joint pathology. This model of TMJOA pain can be used to explore sex differences in pain processes implicated in development of neuropathic pain, ongoing pain, and central sensitization, allowing for development of individualized strategies for prevention and treatment of TMD joint pain.
颞下颌关节骨关节炎(TMJOA)是颞下颌关节紊乱(TMD)的常见病因。女性更容易被诊断为 TMD,并且更有可能在三级口腔颌面疼痛诊所寻求治疗。对颞下颌关节(TMJ)疼痛的潜在机制了解有限,这会妨碍制定更好的疼痛管理策略。在单侧 TMJOA 的大鼠模型中,碘乙酸单钠(MIA)以浓度依赖的方式产生关节病理学。单侧 MIA 会改变雄性和雌性的进食模式,但不会改变 2 周内的夜间进食时间或体重。MIA 注射后 2 周内,MIA(80 mg/mL)处理的雄性大鼠会出现持续性疼痛。而雌性大鼠在 MIA 浓度低 5 倍(16.6 mg/mL)时会发展出持续性疼痛。MIA(80 mg/mL)处理的雄性大鼠在注射后第一周表现出面部触觉过敏的扩散,然后在第二周扩散到前爪和后爪,表明发生了中枢敏化。在较低剂量下,雌性大鼠表现出类似的触觉过敏扩散,而雄性大鼠则不会在同侧颞下颌关节区域之外发展出持续性疼痛或触觉过敏扩散。这些观察结果表明,与雄性大鼠相比,雌性大鼠对持续性疼痛和中枢敏化的发展具有更高的易感性,这与 MIA 诱导的关节病理学差异无关。这种 TMJOA 疼痛模型可用于研究涉及神经病理性疼痛、持续性疼痛和中枢敏化发展的疼痛过程中的性别差异,从而为 TMD 关节疼痛的预防和治疗制定个体化策略。