TNF-α levels and presence of SNP-308G/A of TNF-α gene in temporomandibular disorder patients

CAMPELLO, Camilla Porto; LIMA, Elker Lene Santos de; FERNANDES, Renata Silva Melo; PORTO, Mirza; MUNIZ, Maria Tereza Cartaxo

doi:10.1590/2177-6709.27.1.e2220159.oar

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ORIGINAL ARTICLE • Dental Press J. Orthod. 27 (01) • 2022 • https://doi.org/10.1590/2177-6709.27.1.e2220159.oar linkcopy

TNF-α levels and presence of SNP-308G/A of TNF-α gene in temporomandibular disorder patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction: Temporomandibular disorder (TMD) refers to a group of conditions that compromise the harmonious movement and function of the temporomandibular joint, masticatory muscles, and associated structures. The etiopathogenesis of TMD is multifactorial but not well-understood, with the role of genetic factors still being unclear.

Objective: This review aims to summarize the results of studies that evaluated TNF-α levels and the -308G/A TNF-α polymorphism in TMD patients. This study emphasizes the importance of a more selective treatment involving TNF-α inhibitors that can potentially reduce inflammation and pain, and improve quality of life.

Methods: The MEDLINE/PubMed database, Cochrane Library, and Web of Science database were searched for case-control studies published until September 2020 that compared levels of TNF-α or presence of its -308G/A polymorphism in TMD patients and healthy individuals.

Results: Six case-control studies were identified with a total of 398 TMD patients, aged between 12 and 78 years. The control group consisted of 149 subjects, aged between 18 and 47 years. The occurrence of TMD was predominant in females. Majority of studies found high TNF-α levels in TMD patients, compared to the control group. One of these studies found a positive correlation between the GA genotype and the development of TMD.

Conclusion: Majority of the TMD patients showed elevated TNF-α levels, and a possible explanation for this could be the presence of the -308G/A polymorphism.

Keywords: Temporomandibular disorder; Interleukin; Polymorphism

	Study, year	(n)		Gender		Age (years)
	Study, year	Patients	Controls	Patients	Controls	Patients	Controls
TMD TNF-α levels	Takahashi et al.¹⁵, 1998	51	6	46 females	0 females	17-78	27-39
	Takahashi et al.¹⁵, 1998	62 TMJ	10 TMJ	5 males	6 males	17-78	27-39
	Kaneyama et al.¹⁶, 2002	117	7	123 females	0 females	12-74	27-35
	Kaneyama et al.¹⁶, 2002	121 TMJ	9 TMJ	14 males	7 males	12-74	27-35
	Lee et al.¹⁷, 2010	24	5	Not informed	Not informed	Not informed	Not informed
	Lee et al.¹⁷, 2010	24 TMJ	5 TMJ	Not informed	Not informed	Not informed	Not informed
	Park, Chung¹⁸, 2016	40	20	40 females	20 females	32.9 ± 13.3	32.9 ± 13.3
	Park, Chung¹⁸, 2016	40	20	0 male	0 males	32.9 ± 13.3	32.9 ± 13.3
	Louca Jounger et al.¹⁹, 2017	20	20	20 females	20 females	Above 18	Above 18
	Louca Jounger et al.¹⁹, 2017	20	20	0 male	0 male	Above 18	Above 18
TMD SNP	Furquim et al.²⁰, 2016	152	91	136 females	82 females	36.07 ± 11.00	34.68 ± 11.47
TMD SNP	Furquim et al.²⁰, 2016	152	91	14 males	9 males	36.07 ± 11.00	34.68 ± 11.47

Studies	Diagnostic criteria	Diagnostic (n)	Sample type	Patients	Controls	p -value
Takahashi et al.¹⁵	Reciprocal click in the joint, joint pain and short-term intermittent block for DD with click. TMJ block, impairment of joint mobility, joint pain and history of intermittent clicks and blocks for intermittent disc displacement. Impaired joint mobility, joint pain and bone degenerative changes in the joint surface observed in tomography and magnetic resonance for TMJ-OA	DD with click (8) DD with locking (25) TMJ-OA (18)	Synovial fluid	Detected in 5 joints	Not detected	>0.05
Kaneyama et al.¹⁶	The same of Takahashi et al.¹⁵	DD with click (8) DD with locking (54) TMJ-OA (59)	Synovial fluid	0.03 pg / mL DD with click; 0.17 pg / mL DD with locking; 0.17 pg / mL TMJ-OA	Not detected	<0.05
Lee et al.¹⁷	Pain, mouth opening limitation and clicking	TMD acute pain (14) TMD chronic pain (10)	Synovial fluid	0.39± 0.05 pg/mL	0.36 ± 0.03pg/L	0.05
*Park, Chung¹⁸	RDC/TMD²¹	Greater disability (20) Lesser disability (20)	Plasma	4.55 pg / mL Greater disability; 1.86 pg / mL Lesser disability	0.11 pg / mL	≤ 0.001
^#Louca Jounger et al.¹⁹	RDC/TMD²¹	TMD Myalgia (20)	Masseter muscle	10 pg / mL After repetitive dental tightening	3.5 pg / mL After repetitive dental tightening	0.042

Study	Diagnostic criteria	Diagnostic (n)	Sample type	Patients genotype	Controls genotype	P	OR genotype GA	P^O
Furquim et al.²⁰	RDC/TMD²¹	TMD (152)	Synovial fluid	GG - GA - AA 111 - 32 - 9	GG - GA - AA 79 - 8 - 4	<0.05	2.873	0.0116

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[TFN1] n = number, TMJ = temporomandibular joint.