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炎症和疼痛基因多态性在颞下颌关节紊乱和压痛敏感性中的作用。

Role of inflammatory and pain genes polymorphisms in temporomandibular disorder and pressure pain sensitivity.

机构信息

Department of Restorative Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.

Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil.

出版信息

Arch Oral Biol. 2020 Oct;118:104854. doi: 10.1016/j.archoralbio.2020.104854. Epub 2020 Jul 31.

Abstract

OBJECTIVE

The aim of this study was to assess the correlation of inflammatory and pain genes polymorphisms with the presence of temporomandibular disorder (TMD) patients and with pressure pain sensitivity.

DESIGN

Data was collected from 268 consecutive subjects at Bauru School of Dentistry. Subjects aged younger than 20 years, with dental and neuropathic pain, sinusitis, cognitive and neurologic disorder were excluded. Included subjects were evaluated using the Research Diagnostic Criteria for Temporomandibular disorders and divided into two groups: TMD cases and healthy controls. Groups were submitted to pressure pain threshold (PPT) test for the temporomandibular joint, anterior temporalis and masseter muscles and genotyped for Val158Met, IL6-174, IL-1β-3954 and TNFA-308. Student's t-test and Pearson chi-square test were used to comparisons between groups. A linear multiple regression was used to evaluate the influence of genetics variables on the PPT and a bivariate analysis was used to assesses the influence of genetics variables on pain sensitivity below the PPT cut off of the structures in TMD group.

RESULTS

TMD group showed significantly lower PPT values for all structures when compared with control group (p < 0.001). SNP IL6-174 predicted higher pain sensitivity in the temporomandibular joint (p < 0.005) and in anterior temporalis muscle (p < 0.044) and SNP Val158Met in the masseter muscle (p < 0.038); when TMD group was divided according to PPT cut-off values the SNP Val158Met influenced increase pain sensibility in the masseter muscle.

CONCLUSION

TNFA-308 was associated with TMD and SNP IL6-174 and SNP Val158Met influenced pain sensitivity of patients with TMD.

摘要

目的

本研究旨在评估炎症和疼痛基因多态性与颞下颌关节紊乱(TMD)患者的存在以及与压痛敏感性的相关性。

设计

数据来自巴鲁牙科学校的 268 名连续受试者。排除年龄小于 20 岁、有牙科和神经性疼痛、鼻窦炎、认知和神经障碍的受试者。纳入的受试者采用颞下颌关节紊乱研究诊断标准进行评估,并分为两组:TMD 病例组和健康对照组。两组均接受颞下颌关节、前颞肌和咬肌的压痛阈(PPT)测试,并进行 Val158Met、IL6-174、IL-1β-3954 和 TNFA-308 的基因分型。采用 Student's t 检验和 Pearson 卡方检验进行组间比较。采用线性多元回归分析评估遗传变量对 PPT 的影响,采用双变量分析评估遗传变量对 TMD 组各结构 PPT 截断值以下疼痛敏感性的影响。

结果

TMD 组各结构的 PPT 值均显著低于对照组(p<0.001)。SNP IL6-174 预测颞下颌关节(p<0.005)和前颞肌(p<0.044)的疼痛敏感性较高,SNP Val158Met 预测咬肌的疼痛敏感性较高(p<0.038);当 TMD 组根据 PPT 截断值进行分组时,SNP Val158Met 影响咬肌疼痛敏感性的增加。

结论

TNFA-308 与 TMD 相关,SNP IL6-174 和 SNP Val158Met 影响 TMD 患者的疼痛敏感性。

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