AHMF: 98 Conference: Butt

An Association of Membrane-Damaging Toxins from Coagulase-Negative Staphylococci and Chronic Orofacial Muscle Pain

Butt HL [1,2], Dunstan RH [2], McGregor NR [2,3], Roberts TK [2], Zerbes M [2], and Klineberg IJ [3].

1 Collaborative Pain Research Unit
Department of Biological Sciences
The University of Newcastle
Callaghan NSW 2308
Australia
2 Department of Biological Sciences
University of Newcastle
Newcastle
Australia
3 Faculty of Dentistry
University of Sydney
Westmead Hospital
Westmead
Australia

Forty-six patients presenting with chronic orofacial muscle pain and eight age- and sex-matched control subjects were investigated for the carriage prevalence of, and exotoxin production by, coagulase-negative staphylococci (CNS). The eight control subjects were selected from an initial group of 41 subjects on the basis of the absence of musculoskeletal symptoms.

There was a significantly higher prevalence and multiple carriage of four or more strains of CNS in patients with chronic muscle pain than in control subjects (23 vs 9 isolates/10 subjects). Two of the 103 CNS isolates from patients with muscle pain and none from the control subjects produced toxic shock syndrome toxin 1 (TSST-1), suggesting that pyrogenic toxins do not significantly contribute to the aetiology of chronic muscle pain.

There was a significantly higher prevalence of d-haemolysin (41 of 114) and 'horse'-haemolysin (56 of 114) production by CNS isolates from patients with chronic muscle pain compared with those from control subjects. None of the control subjects was colonized with CNS that produced significant amount of either d- or 'horse'-haemolysin, whereas 35 of 44 patients with chronic orofacial muscle pain were colonized with CNS that produced significant amounts of 'horse'-haemolysin, 37 that produced d-haemolysin and 33 that produced both d- and 'horse'-haemolysin.

This study suggests that membrane-damaging toxins, like d- and 'horse'-haemolysin, may play a role in the aetiology of chronic orofacial muscle pain. (Accepted for publication: J Med Microbiol 1998; Vol 47.)