Peripheral, Interictal Serum S100B Levels are Not Increased in Chronic Migraine Patients

Abstract

Background The trigemino‐vascular system (TVS) plays a key role in migraine pathophysiology. Glial cells are abundant in the TVS system and mainly in the trigeminal ganglion. S100B protein is a calcium‐binding protein, found in the cytoplasm of glial cells in the central nervous system, which is released in response to inflammatory stimuli. Previous works analyzing S100B in migraineurs have offered contradictory results. Objective In this case‐control study, we analyzed serum levels of S100B as a possible biomarker of the glial TVS activation in chronic migraine (CM). Patients and Methods The study group consisted of patients attending our clinic with CM and, as control groups, patients with episodic migraine (EM), cluster headache (CH) outside of a bout and healthy volunteers (HV) with no headache history. S100B levels were determined interictally in peripheral blood samples by ELISA. Results We assessed serum samples from 43 patients with CM, 19 with EM, 29 HV (mostly women), and 22 with (CH). S100B levels in CM (mean 22.9 ± 9.8 pg/mL) were not different (P = .727) when compared to EM patients (21.2 ± 9.3 pg/mL), difference of 1.7 (95% CI −5.7 to 8.9), CH patients (22.4 ± 7.8 pg/mL), difference of 0.5 (−5.7 to 6.7), and HV (20.6 ± 8.3 pg/mL), difference of 2.3 (−3.7 to 8.3). Conclusion In contrast to other neuropeptides such as calcitonin gene‐related‐peptide and vasoactive intestinal peptide, which are increased in CM, interictal serum S100B levels are not elevated in these patients. According to our results, S100B levels do not seem to be a useful peripheral biomarker of the glial TVS activation in CM.

How does the brain change in chronic migraine? Developing disease biomarkers

“…Previous works analysing S100B in migraineurs have offered contradictory results. The first study in CM has shown S100B levels in the range of healthy controls (109).…”

Elevated Blood S100B Levels in Patients With Migraine: A Systematic Review and Meta-Analysis

“…This may imply that S100B is involved in the pathological process of the occurrence and development of migraine. In these two studies including data of patients with episodic migraine and chronic migraine, the S100B levels of both chronic and episodic migraine in the Riesco et al study were not significant increases from those in the control group (24), unlike the findings of Gönen et al (22). This may be related to the fact that preventive medication was not withdrawn before blood samples were collected in the Riesco et al study.…”

“…This may indicate that brain cell damage caused by local inflammation leads to the elevation of S100B levels. Subsequently, several studies found that the S100B level in migraine during the interictal period also increased (22,24,(26)(27)(28)(29)(30). These findings suggest that migraine may be an ongoing or progressive disorder with a subclinical course, rather than a paroxysmal disorder characterized by intermittent headaches.…”

“…We identified 13 studies that were potentially eligible for inclusion after scanning the titles and abstracts. After the full-text assessment, nine studies were evaluated for eligibility and included in the quantitative analysis (22)(23)(24)(25)(26)(27)(28)(29)(30). A flowchart of the process used to select the studies is shown in Figure 1.…”

Exploring Novel Therapeutic Targets in the Common Pathogenic Factors in Migraine and Neuropathic Pain

“…A pilot RCT in CM patients revealed that ibudilast (a potential glia inhibitor) treatment did not reduce the frequency of headache, but it was well-tolerated [79]. In a case-control trial, serum levels of S100B were analyzed in EM and CM patients, and the results showed no interictal S100B elevation [80]. In EM and CM patients, the serum level of S100B was significantly higher compared to controls, and there was no difference between the two patient groups [81].…”