外周血TNF-α/NF-κB/NEAT1信号通路与颞下颌关节紊乱患者慢性疼痛的关系

Relationship between peripheral blood TNFα/NFκB/NEAT1 signaling pathway and chronic pain in patients with temporomandibular joint disorder

目的探讨外周血肿瘤坏死因子α(TNF-α)/核因子-κB(NF-κB)/长链非编码RNA(lncRNA)核富含丰富的转录本1(NEAT1)信号通路与颞下颌关节紊乱(TMD)患者慢性疼痛的关系。方法回顾性分析,选取2022年10月至2023年10月在解放军陆军第七十三集团军医院口腔科接受治疗的82例TMD患者作为研究组,其中男35例、女47例,年龄(33.69±9.84)岁,根据患者疼痛程度分为轻度疼痛(36例)、中度疼痛(27例)、重度疼痛(19例)。对比不同疼痛程度TMD患者外周血TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平,Pearson分析外周血TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平与视觉模拟评分法(VAS)评分的相关性。另选取同期口腔科健康体检者51例作为对照组,其中男29例、女22例,年龄(34.25±7.14)岁。对比两组基线资料及外周血TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平,并通过多因素logistic回归分析外周血TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平与TMD的关系。统计学方法采用t检验、χ^(2)检验及方差分析。结果重度疼痛患者TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平均高于中度疼痛、轻度疼痛患者[(0.93±0.11)比(0.76±0.14)比(0.61±0.16)、(0.88±0.12)比(0.64±0.17)比(0.53±0.15)、(3.14±0.57)比(2.63±0.66)比(1.96±0.59)],差异均有统计学意义(F=31.672、33.514、24.976,均P<0.05)。Pearson相关分析显示,TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平与VAS评分均呈正相关(r=0.273、0.260、0.245,均P<0.05)。研究组心理问题、睡眠质量占比及TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平均高于对照组[47.56%(39/82)比21.57%(11/51)、69.51%(57/82)比39.22%(20/51)、(0.73±0.14)比(0.36±0.08)、(0.65±0.15)比(0.28±0.07)、(2.45±0.61)比(1.17±0.18)],差异均有统计学意义(χ^(2)=9.055、11.840,t=17.193、16.515、14.578;均P<0.05)。多因素logistic回归分析显示,心理问题、睡眠质量、TNF-αmRNA、NF-κB mRNA、NEAT1 mRNA水平均与TMD有关(均P<0.05)。结论外周血TNF-α/NF-κB/NEAT1信号通路与TMD患者疼痛程度呈正相关,且TNF-α/NF-κB/NEAT1信号通路可能参与TMD的发生与发展。

Objective To investigate the relationship between the peripheral blood tumor necrosis factor alpha(TNFα)/nuclear factorκB(NFκB)/long-stranded noncoding RNA nuclear enriched transcript 1(NEAT1)signaling pathway and chronic pain in patients with temporomandibular disorder(TMD).Methods Eighty-two patients with TMD admitted to Department of Stomatology,73rd Group Army Hospital of People's Liberation Army of China from October 2022 to October 2023 were selected as a study group,including 35 males and 47 females who were(33.69±9.84)years old.According to the pain scores,the patients were divided into a mild pain group(36 cases),a moderated pain group(27 cases),and a severe pain group(19 cases).The levels of TNF-αmRNA,NF-κB mRNA,and NEAT1 mRNA in peripheral blood were compared between the 3 groups.The correlations of the levels of TNFαmRNA,NFκB mRNA,and NEAT1 mRNA with the score of Visual Analogue Scale(VAS)were analyzed by the Pearson analysis.Fifty-one healthy oral examinees during the same period were selected as a control group,including 29 males and 22 females who were(34.25±7.14)years old.The baseline data and levels of TNF-α,NF-κB,and NEAT1 were compared between the study group and the control group.t test,χ^(2)test,and analysis of variance were used.The relationship of levels of TNF-αmRNA,NF-κB mRNA,and NEAT1 mRNA with TMD was analyzed by multivariate logistic regression analysis.Results The levels of TNF-αmRNA,NF-κB mRNA,and NEAT1 mRNA in the severe pain group were(0.93±0.11),(0.88±0.12),and(3.14±0.57);the levels in the moderate pain group were(0.76±0.14),(0.64±0.17),and(2.63±0.66);the levels in the mild pain group were(0.61±0.16),(0.53±0.15),and(1.96±0.59);there were statistical differences(F=31.672,33.514,and 24.976;all P<0.05).The Pearson correlation analysis showed that the levels of TNF-αmRNA,NF-κB mRNA,and NEAT1 mRNA were positively correlated with the score of VAS(r=0.273,0.260,and 0.245;all P<0.05).The proportions of the ones with psychological problems and poor sleep quality and the levels of TNF-αmRNA,NF-κB mRNA,and NEAT1 mRNA in the study group were higher than those in the control group[47.56%(39/82)vs.21.57%(11/51),69.51%(57/82)vs.39.22%(20/51),(0.73±0.14)vs.(0.36±0.08),(0.65±0.15)vs.(0.28±0.07),and(2.45±0.61)vs.(1.17±0.18)],with statistical differences(χ^(2)=9.055 and 11.840;t=17.193,16.515,and 14.578;all P<0.05).The multivariate logistic regression analysis showed that psychological problems,sleep quality,TNFαmRNA,NFκB mRNA,and NEAT1 mRNA were associated with TMD(all P<0.05).Conclusion The peripheral blood TNFα/NFκB/NEAT1 signaling pathway is positively correlated with pain level in patients with TMD,and may be involved in the development of TMD.