Comment; Toxin-producing coagulase negative staph are associated with increased pain. This is not surprising. We know that MARCoNS breaks down α-Melanocyte Stimulating Hormone (MSH). Low MSH is linked with amplified sensation of pain and worsening of all the symptoms common in CIRS
- L. BUTT, R. H. DUNSTAN”, N. R. McGREGORT, T. K. ROBERTS*, MARIA” ZERBES* and I. J. KLlNEBERG-f Collaborative Pain Research Unit (CPRU), Division of Microbiology and Infectious Disease, Hunter Area Pathology Service, John Hunter Hospital, Newcastle, ‘Department of Biological Sciences, University of Newcastle, Newcastle and Faculty of Dentistry, University of Sydney, Westmead Hospital, Westmead, Australia
Forty-six patients presenting with chronic orofacial muscle pain and eight age- and sexmatched 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 versus 9 isolates/lO 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-l), suggesting that pyrogenic toxins do not significantly contribute to the aetiology of chronic muscle pain. There was a significantly higher prevalence of 6-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 colonised with CNS that produced significant amount of either 6- or ‘horse’-haemolysin, whereas 35 of 44 patients with chronic orofacial muscle pain were colonised with CNS that produced significant amounts of ‘horse’-haemolysin, 37 that produced 6-haemolysin and 33 that produced both 6- and horse-haemolysin. This study suggests that membrane-damaging toxins, like 6- and ‘horse’-haemolysin, may play a role in the aetiology of chronic orofacial muscle pain.