TNF-α-308位点基因多态性与颞下颌关节紊乱病的相关性分析

Relationship between TNF-αgene polymorphism-308 and Temporomandibular Disorders

目的探讨肿瘤坏死因子α基因启动子308位点(TNF-α-308)G/A基因多态性与颞下颌关节紊乱病及其压痛阈值程度的关系。方法选取152例TMD患者(观察组)和107名健康受试者(对照组)做为研究对象,用手持式压力测力计记录两组受试者颞下颌关节、颞肌前束和咬肌的压痛阈值。应用TaqMan qRT-PCR方法测定TNF-α-308 DNA滴度,分析TNF-α-308不同基因型与TMD发病的相关性以及TNF-α-308不同基因型与TMD患者颞下颌关节、颞肌前束和咬肌的压痛阈值的相关性。结果TNF-α-308位点AA基因型频率和A等位基因频率的差异均不显著(P>0.05),GA基因型频率差异显著(P<0.05)。2组受试者TNF-α-308位点GA、AA、GA+AA基因型、A等位基因OR值及其95%可信区间(confidence interval,CI)分别为2.873(1.256~6.569)、1.616(0.4804~5.435)、2.454(1.212~4.698)和1.427(0.779~2.612)。TNF-α-308位点A等位基因(GA+AA)与TMD呈正相关(P<0.05)。不同基因类型TMD患者的压痛阈值测定结果显示,AA基因型的TMD患者,颞下颌关节、颞肌前束及咬肌疼痛敏感性显著降低(P<0.05)。GG基因型与A等位基因携带者(GA/GA+AA)相比较,颞下颌关节、颞肌前束及咬肌压痛阈值差异无统计学意义(P>0.05)。结论肿瘤坏死因子α基因启动子308位点基因多态性可能是TMD患病的相关因素,A等位基因能够显著降低颞下颌关节、颞肌前束及咬肌疼痛敏感性。

Objective To investigate the relation between the gene polymorphism-308 of TNF-αand temporomandibular disorders.Methods 152 TMD patients(observation group)and 182 healthy subjects(control group)were selected as the research objects.The pressure pain threshold of TMD,TMJ,anterior fascicle of the temporal muscle and masseter were recorded by hand-held manometer.TaqMan QRT PCR was used to determine the DNA titer of TNF-α-308.The correlation between different genotypes of TNF-α-308 and the onset of TMD,and the correlation between different genotypes of TNF-α-308 and the pressure pain threshold of TMD patients were analyzed.Results there was no significant difference in the frequency of AA genotype and A allele at TNF-α-308 locus(P>0.05),but significant difference in the frequency of GA genotype(P<0.05).The OR and 95%confidence interval(CI)of GA,AA,GA+AA genotype,a allele of TNF-α-308 were 2.873(1.256~6.569),1.616(0.4804~5.435),2.454(1.212~4.698)and 1.427(0.779~2.612),respectively.TNF-α-308 A allele(GA+AA)was positively correlated with TMD(P<0.05).The pressure pain threshold of TMD patients with different genotypes showed that the pain sensitivity of TMD patients with AA genotype was significantly lower than that of TMD patients with AA genotype(P<0.05).The pressure pain threshold between GG genotype and a allele carriers were no significant difference(GA/GA+AA)(P>0.05).Conclusion The polymorphism of tumor necrosis factor-αgene promoter 308 may be related to TMD.In TMD with Allele A,the pain sensitivity significantly reduced in TMJ,anterior fascicle of the temporal muscle and masseter muscle.