Evaluation of Inflammatory State in Migraineurs: A Case-control Study
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Abstract
Due to inconclusive findings of previous researches, we aimed to evaluate inflammatory state biomarkers in episodic and chronic migraineurs (EM and CM patients) compared to headache-free controls in the current study.
Seventy-one migraine patients and 19 age-sex-matched controls were recruited. After obtaining demographic data and recording headache characteristics, blood samples were gathered and analyzed to evaluate the serum levels of C-reactive protein (CRP), tumor necrosis factor(TNF)-α and interleukin (IL)-6.
Serum levels of IL-6, CRP and TNF-α were significantly higher among subjects with CM than the EM and controls. Further, positive correlations were noted for number of headache days/month and serum IL-6 (r=0.53, p<0.001), CRP (r=0.62, p<0.001), and TNF-α (r=0.58, p<0.001).
In sum, according to current findings, a pro-inflammatory state was detected among chronic and episodic migraineurs compared to healthy control, as revealed by augmented concentrations of pro-inflammatory cytokines (e.g. IL6, CRP, and TNF-α). It was also underlined that with increasing levels of inflammatory factors, headaches tended to be more chronic. However, in order to confirm the hypothesis that neuroinflammation plays a role in migraine pain genesis, long-term cohort studies and well-designed experimental and randomized controlled trials are required.
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12. Tietjen GE, Khubchandani J. Vascular biomarkers in migraine. Cephalalgia. 2015;35(2):95-117.
13. Martami F, Razeghi Jahromi S, Togha M, Ghorbani Z, Seifishahpar M, Saidpour A. The serum level of inflammatory markers in chronic and episodic migraine: a case-control study. Neurol Sci. 2018;39(10):1741-9.
14. Guldiken B, Guldiken S, Demir M, Turgut N, Kabayel L, Ozkan H, et al. Insulin resistance and high sensitivity C-reactive protein in migraine. Can J Neurol Sci. 2008;35(4):448-51.
15. Yilmaz N, Yilmaz M, Sirin B, Yilmaztekin S, Kutlu G. The relationship between levels of plasma-soluble urokinase plasminogen activator receptor (suPAR) and presence of migraine attack and aura. J Recept Signal Transduct Res. 2017;37(5):447-52.
16. Vanmolkot F, De Hoon J. Increased C‐reactive protein in young adult patients with migraine. Cephalalgia. 2007;27(7):843-6.
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18. Jahromi SR, Abolhasani M, Ghorbani Z, Sadre-Jahani S, Alizadeh Z, Talebpour M, et al. Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache. Obes Surg. 2017;28(1):87-96.
19. Sarchielli P, Alberti A, Baldi A, Coppola F, Rossi C, Pierguidi L, et al. Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache. 2006;46(2):200-7.
20. Güzel I, Taşdemir N, Çelik Y. Evaluation of serum transforming growth factor β1 and C-reactive protein levels in migraine patients. Neurol Neurochir Pol. 2013;47(4):357-62.
21. Perini F, D'andrea G, Galloni E, Pignatelli F, Billo G, Alba S, et al. Plasma cytokine levels in migraineurs and controls. Headache. 2005;45(7):926-31.
22. Fidan I, Yuksel S, Ymir T, Irkec C, Aksakal FN. The importance of cytokines, chemokines and nitric oxide in pathophysiology of migraine. J Neuroimmunol. 2006;171(1-2):184-8.
23. Tietjen G, Khubchandani J, Khan A, Herial N. Adiponectin and Inflammatory Cytokines in Young Women with Migraine2010.
24. Yücel M, Kotan D, Çiftçi GG, Çiftçi I, Cikriklar H. Serum levels of endocan, claudin-5 and cytokines in migraine. Eur Rev Med Pharmacol Sci. 2016;20(5):930-6.
25. Heshmat-Ghahdarijani K, Javanmard SH, Sonbolestan SA, et al. Endothelial Function in Patients with Migraine without Aura during the Interictal Period. Int J Prev Med. 2015;6:2.
26. Mustafa C, Omer Faruk B, Sinan B, Ömer A, Ahmet Y, Dilcan K. Serum levels of pentraxin-3 and other inflammatory biomarkers in migraine: Association with migraine characteristics. Cephalalgia. 2015;36(6):518-25.
27. Lippi G, Mattiuzzi C, Cervellin G. C-reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52(9):1265-72.
28. Yildiz BT, Koca TT. Is migraine an inflammatory event? Which inflammatory markers can we use for migraine? coronary artery disease. 2019;6:9.
29. Paolo Martelletti and Rigmor Jensen e. Pathophysiology of Headaches From Molecule to Man. Paolo Martelletti RJ, editor: Springer, Cham; 2015.
30. Oliveira AB, Bachi ALL, Ribeiro RT, Mello MT, Tufik S, Peres MFP. Unbalanced plasma TNF-α and IL-12/IL-10 profile in women with migraine is associated with psychological and physiological outcomes. J Neuroimmunol. 2017;313:138-44.
31. Chaudhry SR, Lendvai IS, Muhammad S, Westhofen P, Kruppenbacher J, Scheef L, et al. Inter-ictal assay of peripheral circulating inflammatory mediators in migraine patients under adjunctive cervical non-invasive vagus nerve stimul. 2019;12(3):643-51.
32. Longoni M, Ferrarese C. Inflammation and excitotoxicity: role in migraine pathogenesis. Neurol Sci. 2006;27(2):s107-s10.
33. Pardutz A, Schoenen J. NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data. Pharmaceuticals (Basel). 2010;3(6):1966-87.
34. Ho KY, Gwee KA, Cheng YK, Yoon KH, Hee HT, Omar AR. Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice. J Pain Res. 2018;11:1937-48.
35. Eren Y, Dirik E, Neselioglu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg. 2015;115(4):643-9.
2. Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76-87.
3. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
4. Dodick DW. A Phase-by-Phase Review of Migraine Pathophysiology. Headache. 2018;(58 Suppl 1):4-16.
5. Pietrobon D. Migraine: new molecular mechanisms. The Neuroscientist. 2005;11(4):373-86.
6. Hepp Z, Bloudek LM, Varon SF. Systematic review of migraine prophylaxis adherence and persistence. J Manag Care Pharm. 2014;20(1):22-33.
7. Blumenfeld AM, Bloudek LM, Becker WJ, Buse DC, Varon SF, Maglinte GA, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: results from the second international burden of migraine study (IBMS-II). Headache. 2013;53(4):644-55.
8. Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Rasekh Magham R, Haghighi S, et al. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci. 2019;40(12):2459-77.
9. Ramachandran R. Neurogenic inflammation and its role in migraine. Semin Immunopathol. 2018;40(3):301-14.
10. Fidan I, Yüksel S, Ýmir T, İrkeç C, Aksakal FN. The importance of cytokines, chemokines and nitric oxide in pathophysiology of migraine. J Neuroimmunol. 2006;171(1):184-8.
11. Uzar E, Evliyaoglu O, Yucel Y, Ugur Cevik M, Acar A, Guzel I, et al. Serum cytokine and pro-brain natriuretic peptide (BNP) levels in patients with migraine. Eur Rev Med Pharmacol Sci. 2011;15(10):1111-6.
12. Tietjen GE, Khubchandani J. Vascular biomarkers in migraine. Cephalalgia. 2015;35(2):95-117.
13. Martami F, Razeghi Jahromi S, Togha M, Ghorbani Z, Seifishahpar M, Saidpour A. The serum level of inflammatory markers in chronic and episodic migraine: a case-control study. Neurol Sci. 2018;39(10):1741-9.
14. Guldiken B, Guldiken S, Demir M, Turgut N, Kabayel L, Ozkan H, et al. Insulin resistance and high sensitivity C-reactive protein in migraine. Can J Neurol Sci. 2008;35(4):448-51.
15. Yilmaz N, Yilmaz M, Sirin B, Yilmaztekin S, Kutlu G. The relationship between levels of plasma-soluble urokinase plasminogen activator receptor (suPAR) and presence of migraine attack and aura. J Recept Signal Transduct Res. 2017;37(5):447-52.
16. Vanmolkot F, De Hoon J. Increased C‐reactive protein in young adult patients with migraine. Cephalalgia. 2007;27(7):843-6.
17. Welch K, Brandes AW, Salerno L, Brandes JL. C‐Reactive Protein May Be Increased in Migraine Patients Who Present With Complex Clinical Features. Headache. 2006;46(2):197-9.
18. Jahromi SR, Abolhasani M, Ghorbani Z, Sadre-Jahani S, Alizadeh Z, Talebpour M, et al. Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache. Obes Surg. 2017;28(1):87-96.
19. Sarchielli P, Alberti A, Baldi A, Coppola F, Rossi C, Pierguidi L, et al. Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache. 2006;46(2):200-7.
20. Güzel I, Taşdemir N, Çelik Y. Evaluation of serum transforming growth factor β1 and C-reactive protein levels in migraine patients. Neurol Neurochir Pol. 2013;47(4):357-62.
21. Perini F, D'andrea G, Galloni E, Pignatelli F, Billo G, Alba S, et al. Plasma cytokine levels in migraineurs and controls. Headache. 2005;45(7):926-31.
22. Fidan I, Yuksel S, Ymir T, Irkec C, Aksakal FN. The importance of cytokines, chemokines and nitric oxide in pathophysiology of migraine. J Neuroimmunol. 2006;171(1-2):184-8.
23. Tietjen G, Khubchandani J, Khan A, Herial N. Adiponectin and Inflammatory Cytokines in Young Women with Migraine2010.
24. Yücel M, Kotan D, Çiftçi GG, Çiftçi I, Cikriklar H. Serum levels of endocan, claudin-5 and cytokines in migraine. Eur Rev Med Pharmacol Sci. 2016;20(5):930-6.
25. Heshmat-Ghahdarijani K, Javanmard SH, Sonbolestan SA, et al. Endothelial Function in Patients with Migraine without Aura during the Interictal Period. Int J Prev Med. 2015;6:2.
26. Mustafa C, Omer Faruk B, Sinan B, Ömer A, Ahmet Y, Dilcan K. Serum levels of pentraxin-3 and other inflammatory biomarkers in migraine: Association with migraine characteristics. Cephalalgia. 2015;36(6):518-25.
27. Lippi G, Mattiuzzi C, Cervellin G. C-reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52(9):1265-72.
28. Yildiz BT, Koca TT. Is migraine an inflammatory event? Which inflammatory markers can we use for migraine? coronary artery disease. 2019;6:9.
29. Paolo Martelletti and Rigmor Jensen e. Pathophysiology of Headaches From Molecule to Man. Paolo Martelletti RJ, editor: Springer, Cham; 2015.
30. Oliveira AB, Bachi ALL, Ribeiro RT, Mello MT, Tufik S, Peres MFP. Unbalanced plasma TNF-α and IL-12/IL-10 profile in women with migraine is associated with psychological and physiological outcomes. J Neuroimmunol. 2017;313:138-44.
31. Chaudhry SR, Lendvai IS, Muhammad S, Westhofen P, Kruppenbacher J, Scheef L, et al. Inter-ictal assay of peripheral circulating inflammatory mediators in migraine patients under adjunctive cervical non-invasive vagus nerve stimul. 2019;12(3):643-51.
32. Longoni M, Ferrarese C. Inflammation and excitotoxicity: role in migraine pathogenesis. Neurol Sci. 2006;27(2):s107-s10.
33. Pardutz A, Schoenen J. NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data. Pharmaceuticals (Basel). 2010;3(6):1966-87.
34. Ho KY, Gwee KA, Cheng YK, Yoon KH, Hee HT, Omar AR. Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice. J Pain Res. 2018;11:1937-48.
35. Eren Y, Dirik E, Neselioglu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg. 2015;115(4):643-9.
| Files | ||
| Issue | Vol 19, No S1 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v19i(s1.r1).2864 | |
| PMID | 32534515 | |
| Keywords | ||
| Headache Inflammatory cytokines Migraine Neuroinflammation | ||
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How to Cite
1.
Togha M, Razeghi Jahromi S, Ghorbani Z, Ghaemi A, Rafiee P. Evaluation of Inflammatory State in Migraineurs: A Case-control Study. Iran J Allergy Asthma Immunol. 2020;19(S1):83-90.
