Abstract:

Objective　To investigate the relationship between the peripheral blood tumor necrosis factor alpha (TNFα)/nuclear factor-κB (NF-κB)/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-α mRNA, NF-κB mRNA, and NEAT1 mRNA in peripheral blood were compared between the 3 groups. The correlations of the levels of TNF-α mRNA, NF-κB 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, χ² test, and analysis of variance were used. The relationship of levels of TNF-α mRNA, NF-κB mRNA, and NEAT1 mRNA with TMD was analyzed by multivariate logistic regression analysis. Results　The levels of TNF-α mRNA, 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-α mRNA, 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-α mRNA, 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 (χ²=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, TNFα mRNA, NF-κB mRNA, and NEAT1 mRNA were associated with TMD (all P<0.05). Conclusion　The peripheral blood TNFα/NF-κB/NEAT1 signaling pathway is positively correlated with pain level in patients with TMD, and may be involved in the development of TMD.

Key words:

Necrosis factor α, Nuclear factor-κB, Long non-coding RNA NEAT1, Temporomandibular disorder, Chronic pain

摘要：

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-α mRNA、NF-κB mRNA、NEAT1 mRNA水平，Pearson分析外周血TNF-α mRNA、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-α mRNA、NF-κB mRNA、NEAT1 mRNA水平，并通过多因素logistic回归分析外周血TNF-α mRNA、NF-κB mRNA、NEAT1 mRNA水平与TMD的关系。统计学方法采用t检验、χ²检验及方差分析。结果　重度疼痛患者TNF-α mRNA、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-α mRNA、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-α mRNA、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（χ²=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-α mRNA、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。

关键词:

肿瘤坏死因子α, 核因子-κB, 长链非编码RNA核富含丰富的转录本1, 颞下颌关节紊乱, 慢性疼痛