Please use this identifier to cite or link to this item: https://app.uff.br/riuff/handle/1/6398
Title: Avaliação clínico-genética das dores articulares sistêmicas crônicas em indivíduos com desordens temporomandibulares
Other Titles: Clinical and genetic evaluation of systemic chronic joint pain in patients with temporomandibular disorders
Authors: Bonato, Letícia Ladeira
metadata.dc.contributor.advisor: Casado, Priscila Ladeira
Issue Date: 2016
Citation: BONATO, Letícia Ladeira. Avaliação clínico-genética das dores articulares sistêmicas crônicas em indivíduos com desordens temporomandibulares. 2016. 150 f. Tese (Doutorado) - Curso de Odontologia, Faculdade de Odontologia, Universidade Federal Fluminense, Niterói, 2016.
Abstract: A dor presente nas desordens temporomandibulares (DTM) está com frequência sobreposta à sintomas físicos associados à outras desordens dolorosas crônicas e comorbidades, como dores musculares e articulares generalizadas. Contudo, a possível associação entre a presença conjunta da dor orofacial com outros tipos de artralgia é pouco explorada. O objetivo deste estudo foi determinar a possível associação entre a presença conjunta de dores crônicas articulares na ATM, e em outras articulações do corpo, com polimorfismos em genes relacionados à: (a) sensibilidade dolorosa, (b) metabolismo de osteoblastos e condroblastos, e (c) alterações hormonais. Trezentos e trinta e sete voluntários foram avaliados clinicamente, através da aplicação da ferramenta Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), para avaliação quanto à presença das DTM, sendo questionados sobre a presença de dores articulares crônicas sistêmicas, sendo divididos nos seguintes grupos: indivíduos com artralgias crônicas e DTM muscular; artralgias crônicas e DTM articular; artralgias crônicas e DTM muscular e articular; indivíduos sem DTM e com artralgias crônicas e; grupo controle. Trinta polimorfismos nos genes COMT (rs165774, rs6269, rs9332377), ADRB2 (rs2053044, rs1042713, rs1042714), HTR1A (rs1364043, rs13361335), OPG (rs11573919, rs11573875, rs11573854, rs11573838, rs11573817 e rs11573816), RANK (rs474369, rs9498322, rs504762, rs6920383, rs237033), RANKL (rs492956,rs13215304 e rs12660731), ESR1 (rs12154178, rs1884051, rs2273206, rs7774230) e ESRRB (rs1676303, rs4903399, rs10132091, rs7151924) foram avaliados. A significância das variáveis nominais e contínuas foi analisada através dos testes do qui-quadrado, T-Student / Mann-Whitney, respectivamente. Valores de p<0.05 foram considerados estatisticamente significantes. Os principais resultados encontrados foram: (a) Polimorfismos no gene COMT possuem relação com a presença de DTM de origem muscular associada a artralgias crônicas. Neste mesmo grupo de indivíduos, alterações nos genes ADRB2 associaram-se com a proteção ao desenvolvimento de DTM muscular. (b) Haplótipos nos genes OPG e RANK encontram-se associados ao risco de desenvolvimento de artralgias crônicas, mesmo na ausência de DTM; e (c) Polimorfismo no gene ESR1 possuem relação com a presença de DTM de origem muscular associada a artralgias crônicas. Alterações no gene ESRRB associaram-se com a presença de DTM articular. O presente trabalho sugere haver base genética e clínica para o desenvolvimento comórbido de artralgias crônicas em indivíduos com DTM.
metadata.dc.description.abstractother: Pain from temporomandibular disorder (TMD) is often associated with physical symptoms and other chronic pain disorders and comorbidities, such as generalized muscle and joint pain. However, the association between the presence of orofacial pain and other types of arthralgia is not widely studied. The aim of this study was to determine the association between the presence of chronic temporomandibular joint (TMJ) pain, and other body joints, with polymorphisms in genes related to: (a) pain sensitivity, (b) osteoblast and chondroblasts metabolism and (c) hormonal changes. Three hundred and thirty-seven volunteers were clinically evaluated by applying the Research Diagnostic Criteria tool for Temporomandibular Disorders (RDC / TMD) in order to evaluate the presence of TMD. In addition, volunteers were questioned about the presence of systemic chronic joint pain. Based on these information, volunteers were divided into the following groups: individuals with chronic joint pain and muscle TMD; arthralgia and chronic articular TMD; arthralgia and chronic muscle and joint TMD; individuals without TMD and chronic joint pain and; control group . Thirty polymorphisms in the genes COMT (rs165774, rs6269, rs9332377), ADRB2 (rs2053044, rs1042713, rs1042714), HTR1A (rs1364043, rs13361335), OPG (rs11573919, rs11573875, rs11573854, rs11573838, rs11573817 and rs11573816), RANK (rs474369, rs9498322, rs504762, rs6920383, rs237033), RANKL (rs492956, rs13215304 and rs12660731) ESR1 (rs12154178, rs1884051, rs2273206, rs7774230) and ESRRB (rs1676303, rs4903399, rs10132091, rs7151924) were evaluated. The chi-square test and the Student's t-test / Mann-Whitney test were used to assess the significance of the nominal and continuous variables, respectively. A p-value <0.05 was considered significant. The main findings were: (a) polymorphisms in the COMT gene are related to the presence of myogenic TMD associated with chronic arthralgia. In this same group of individuals, alterations in the ADRB2 gene were associated with the protection against the development of muscular TMD. (B) haplotypes in the OPG and RANK genes are associated with the risk of developing chronic arthralgia, even in the absence of TMD; and (c) Polymorphisms in the ESR1 gene are related to the presence of myogenic TMD associated with chronic arthralgia. Alterations in the ESRRB gene were associated with the presence of articular TMD. This study suggests that there is a clinical and genetic basis for comorbid chronic joint pain in individuals with TMD
URI: https://app.uff.br/riuff/handle/1/6398
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