Publication: Trigeminal nevralji hastalarında SLC6A4 promotor L/ S polimorfizminin ve kortizol seviyelerinin değerlendirilmesi
Abstract
Amaç: Trigeminal nevralji, trigeminal sinirin yüzde etkilediği alanlarda epizodik ataklar şeklinde görülen ağrılı durumdur. Trigeminal nevraljinin nedenleri hala tam olarak bilinememektedir. Fakat genetik nedenler üzerine birçok araştırma yapılmış ve serotoninin (5 hydroxytryptamine,5-HT) santral sinir sisteminde büyük çoğunlukta fizyolojik etkisi olan önemli bir neuromodulator olması nedeniyle trigeminal sistem ile ilişkili ağrılı durumlar, migren ve temporomandibular ağrıları içeren ağrı hastalıklarıyla ilişkilendirilir. Bu nedenle hipotalamik fonksiyonu araştırmanın bir yolu, hipotalamik-hipofiz-adrenal eksenin hormon düzeylerini izlemektir. Hipotalamik-hipofiz-adrenal eksen hormon düzeylerine bakmanın en etkili rolü kortizol düzeylerine bakmaktır.Bu bilgilerden yola çıkarak çalışmamızda trigeminal nevralji hastalarında serotonin geni SLC6A4 promotor L/ S polimorfizminin ve kortizol seviyelerinin ilişkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamıza trigeminal nevralji tanısı konmuş 20 hasta ve kontrol olarak 20 sağlıklı birey dahil edildi. Hastalardan alınan venöz kanlarından PureLink DNA izolasyon kiti kullanılarak DNA elde edildi. DNA'daki SLC6A4 promotor L/ S polimorfizmi, gerçek zamanlı PCR cihazı ve TaqMan genotipleme testi kullanılarak belirlendi. Kortizol düzeyi için enzim-immünassay(EIA) yöntemi ile ticari kit kullanılarak değerlendirildi. Bulgular: SLC6A4 L/ S analizinde 20 trigeminal nevralji hastasından 7’si (%33,33) LL, 8'inde (%38,10) LS ve 6'sında (%28,57) SS genotipi ; kontrol grubunda (n=20) 4 kişide (%20,00) LL, 10 kişide (%50,00) LS ve 6 kişide (%30,00) SS genotipi olduğu belirlendi. Elde edilen sonuçlar hasta ve sağlıklı bireyler arasında kortizol düzeyleri açısından istatistiksel olarak anlamlı bir fark bulunduğunu göstermektedir (p < 0.001). Sonuç: Trigeminal nevralji hasta ve kontrol grubunda genotip ve allelik dağılımları arasında istatistiksel olarak anlamlı bir farklılık saptanmamıştır. İlgili hasta grubunda HPA aksının daha aktif olabileceğini veya stres yanıtlarının daha belirgin olabileceğini düşündürmektedir.
Objective: Trigeminal neuralgia is a painful condition seen in the form of episodic attacks in the areas affected by the trigeminal nerve on the face.However, many studies have been carried out on genetic causes and since serotonin ((5 hydroxytryptamine,5-HT) is an important neuromodulator with mostly physiological effects in the central nervous system, it is associated with painful conditions related to the trigeminal system, migraine and pain diseases including temporomandibular pain.Therefore, one way to investigate hypothalamic function is to monitor hormone levels of the hypothalamic-pituitary-adrenal axis. The most effective role of monitoring hypothalamic-pituitary-adrenal axis hormone levels is to monitor cortisol levels. Based on this information, we aimed to evaluate the relationship between serotonin gene SLC6A4 promoter L/ S polymorphism and cortisol levels in patients with trigeminal neuralgia. Materials and Methods: 20 patients diagnosed with trigeminal neuralgia and 20 healthy individuals as controls were included in our study. DNA was obtained from the venous blood of the patients using the PureLink DNA isolation kit. SLC6A4 promoter L/ S polymorphism in DNA was determined using real-time PCR device and TaqMan genotyping test. Cortisol level was evaluated by enzyme-immunassay (EIA) method using commercial kit. Results: In the SLC6A4 L/ S analysis, 7 (33.33%), 8 (38.10%) and 6 (28.57%) of 20 trigeminal neuralgia patients had LL, LS and SS genotypes, respectively, while 4 (20.00%), 10 (50.00%) and 6 (30.00%) of the control group had LL, LS and SS genotypes, respectively. The results showed that there was a statistically significant difference in cortisol levels between patients and healthy individuals (p < 0.001). Conclusion: There was no statistically significant difference between the genotype and allelic distributions in the trigeminal neuralgia patient and control groups. This suggests that the HPA axis may be more active or stress responses may be more prominent in the relevant patient group.
Objective: Trigeminal neuralgia is a painful condition seen in the form of episodic attacks in the areas affected by the trigeminal nerve on the face.However, many studies have been carried out on genetic causes and since serotonin ((5 hydroxytryptamine,5-HT) is an important neuromodulator with mostly physiological effects in the central nervous system, it is associated with painful conditions related to the trigeminal system, migraine and pain diseases including temporomandibular pain.Therefore, one way to investigate hypothalamic function is to monitor hormone levels of the hypothalamic-pituitary-adrenal axis. The most effective role of monitoring hypothalamic-pituitary-adrenal axis hormone levels is to monitor cortisol levels. Based on this information, we aimed to evaluate the relationship between serotonin gene SLC6A4 promoter L/ S polymorphism and cortisol levels in patients with trigeminal neuralgia. Materials and Methods: 20 patients diagnosed with trigeminal neuralgia and 20 healthy individuals as controls were included in our study. DNA was obtained from the venous blood of the patients using the PureLink DNA isolation kit. SLC6A4 promoter L/ S polymorphism in DNA was determined using real-time PCR device and TaqMan genotyping test. Cortisol level was evaluated by enzyme-immunassay (EIA) method using commercial kit. Results: In the SLC6A4 L/ S analysis, 7 (33.33%), 8 (38.10%) and 6 (28.57%) of 20 trigeminal neuralgia patients had LL, LS and SS genotypes, respectively, while 4 (20.00%), 10 (50.00%) and 6 (30.00%) of the control group had LL, LS and SS genotypes, respectively. The results showed that there was a statistically significant difference in cortisol levels between patients and healthy individuals (p < 0.001). Conclusion: There was no statistically significant difference between the genotype and allelic distributions in the trigeminal neuralgia patient and control groups. This suggests that the HPA axis may be more active or stress responses may be more prominent in the relevant patient group.