期刊
CLINICAL JOURNAL OF PAIN
卷 30, 期 2, 页码 168-173出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0b013e31828c4bf1
关键词
burning mouth syndrome; depression; anxiety; immune; endocrine; pain
资金
- Eli Lilly Pharm. (Indianapolis, IN)
- Jazz Pharm. (Philadelphia, PA)
- Abbot Pharm. (Abbott Park, IL)
- Wyeth Pharm. (Overland Park, KS)
- D C Rheumatological Society
- Grants-in-Aid for Scientific Research [24593065] Funding Source: KAKEN
Objectives: Research suggests that varied etiologic factors are responsible for burning mouth syndrome (BMS). We examined the role of immune and endocrine function in the pathology of BMS.Methods:We conducted a case-control study to evaluate immune (lymphocyte subpopulations) and endocrine (hypothalamus-pituitary-adrenal axis and sympathetic-adrenomedullary system) function in 47 female BMS patients and 47 age-matched female controls presenting at an university clinic. Psychological state was assessed with the Zung Self-Rating Depression Scale and Taylor Manifest Anxiety Scale.Results:BMS patients were significantly more anxious than controls (P=0.011). Plasma adrenaline level was significantly lower (P=0.020) in BMS patients than in controls, and linear regression analysis of all patients combined revealed that depression level was significantly positively associated with plasma noradrenaline and cortisol levels (P=0.002 and 0.001, respectively). However, as compared with controls, BMS patients had a significantly lower CD8(+) cell count (P<0.001) and a significantly higher CD4/CD8 ratio (P=0.002). Discriminant analysis revealed that CD8(+) cell count and CD4/CD8 ratio were independent variables that distinguished BMS patients from controls.Discussion:The immunoendocrine system is substantially involved, and may have a key role, in the mechanism of chronic pain in BMS patients. Immune function was significantly and specifically suppressed in BMS, although the hypothalamic-pituitary-adrenal axis and sympathetic nervous system were predominantly activated by psychological stress that was not specific to BMS.
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