Peripheral Levels of Inflammatory Mediators in Migraineurs During Headache‐free Periods

Abstract

Objectives.-The present study investigated the peripheral inflammatory changes of the trigeminovascular system by measuring the inflammatory mediators leukotriene B 4 (LTB 4 ), prostaglandin E 2 (PGE 2 ), and thromboxane B 2 (TXB 2 ) in the nasal fluid, as well as saliva, of patients with migraine.Background.-Migraine has been hypothesized to be as a result of changes in the peripheral or central nervous system or both. It is still unclear whether peripheral changes in the trigeminovascular system are involved in the pathogenesis of migraine.Methods.-Participants were 18 subjects, 9 patients with migraine and 9 controls, matched for age and sex. Each subject took part in one experimental session during which nasal lavage fluid and saliva samples were collected. These samples were analyzed by competitive enzyme immunoassay using goat anti-rabbit polyclonal antibody.Results.-With the exception of TXB 2 , correlational analyses indicated good correlations between results obtained using nasal lavage or saliva (LTB 4 , r 18 ϭ 0.91; PGE 2 , r 18 ϭ 0.95). When comparing inflammatory mediators measured in controls and migraineurs, the LTB 4 level was significantly lower in migraineurs, while no differences were found for PGE 2 and TXB 2 .Conclusions.-The study demonstrated that nasal lavage, a noninvasive method, can be easily used for investigations of pathophysiological mechanisms of migraine. In addition, the results may indicate that there is no peripheral trigeminal sensitization in the headache-free period of migraineurs compared with controls when PGE 2 , LTB 4 , and TXB 2 in saliva and nasal lavage samples are measured.

Urinary leukotriene E4 and prostaglandin F2a concentrations in children with migraine: a randomized study

“…Urinary PG-F2a levels were significantly higher during migraine episodes than during headache-free periods. The similar levels of proinflammatory mediators during non-episodic periods in migraine patients and in healthy controls suggest the desensitization and lack of inflammation in nociceptors in the trigeminal vascular space (24). PG-F2a levels in patients with migraine start to increase during the first hour of a headache episode, peaking during the second hour and returning to normal levels after six hours; the algogenic and vasoactive features of PG-F2a that initiates migraine headaches have been highlighted (30).…”

“…Urinary LT-E4 levels were found to increase in patients with inflammatory bowel diseases, especially during periods of active mucosal inflammation, suggesting that non-invasive measurements of urinary LT-E4 levels may indicate disease activation and that these patients may benefit from treatment with leukotriene inhibitors (23). A study measuring peripheral inflammatory mediators, including LT-B4, PG-E2 and thromboxane B2, in migraine patients showed that LT-B4 levels were lower during pain-free periods than during headaches (24). Concentrations of LT-B4 and LT-C4, which have been implicated in migraine pathophysiology, were found to increase during migraine episodes but to be normal between episodes (25).…”

A human capsaicin model to quantitatively assess salivary CGRP secretion

“…Further development of analytic techniques may be of interest, especially for diseases in which dysfunction of the trigeminal system is known, for analysis of specific salivary compounds that are released into the saliva. In diseases such as (primary) headache syndromes including cluster headache (31) and migraine (10,(31)(32)(33)(34)(35)(36), but also in tension-type headache (36), and other diseases, analytical techniques that help qualifying and quantifying salivary (neuro)peptides including CGRP could be useful in elucidating pathophysiologic mechanisms.…”

Coenzyme Q10 Deficiency and Response to Supplementation in Pediatric and Adolescent Migraine

“…Migraine has also been shown to be associated with vascular inflammation that can be treated with nonsteroidal anti-inflammatories. 15,27 Inflammation produces oxygen-free radicals and it could be speculated that as inflammation in an acute or chronic migraine persists, an inability to respond to this with antioxidants may exacerbate attacks.…”