Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine
Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine
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DOI：
10.1212/wnl.0b013e3182a6cb72
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发表时间：
2013-10-01
期刊：
影响因子：
9.9
通讯作者：
Pascual, Julio
中科院分区：
文献类型：
--
作者：
Cernuda-Morollon, Eva;Larrosa, Davinia;Pascual, Julio
目的：为了确定降钙素基因相关肽（CGRP）水平偏头痛发作外的外周血作为一个潜在的生物标志物慢性偏头痛（CM）。方法：年龄大于17岁的妇女和诊断与CM招募。无头痛史的健康女性和发作性偏头痛（EM）女性作为对照组，以及一系列无疼痛期的发作性丛集性头痛患者。在偏头痛发作前一天没有服用对症药物的情况下，通过ELISA测定从右肘前静脉获得的血样中的CGRP水平。出于道德原因，预防性治疗没有停止。结果：我们评估了103名妇女与CM，31名匹配的健康妇女，43名匹配的妇女与EM，和14名患者发作性丛集性头痛匹配的年龄血浆样本。与对照健康女性（33.74 pg/mL）、EM女性（46.37 pg/mL）和阵发性丛集性头痛患者（45.87 pg/mL）相比，CM患者的CGRP水平（74.90 pg/mL）显著升高。43.45和58.22 pg/mL的检测限分别优化了区分CM与健康对照和EM的灵敏度和特异性。在CM组中，CGRP水平在有先兆偏头痛病史的女性中显著升高，而在无先兆偏头痛的女性中显著升高。变量，如年龄，止痛药过度使用，抑郁症，纤维肌痛，血管危险因素，曲坦类药物的消费史，或预防性治疗的种类没有显着影响CGRP level.Conclusion：增加CGRP水平测量外周血偏头痛发作外，在没有对症药物治疗可能是一个生物标志物，有助于诊断CM。
Objective: To determine calcitonin gene-related peptide (CGRP) levels outside migraine attacks in peripheral blood as a potential biomarker for chronic migraine (CM).Methods: Women older than 17 years and diagnosed with CM were recruited. Matched healthy women with no headache history and women with episodicmigraine (EM) served as control groups, together with a series of patients with episodic cluster headache in a pain-free period. CGRP levels were determined in blood samples obtained from the right antecubital vein by ELISA outside a migraine attack and having taken no symptomatic medication the day before. For ethical reasons, preventatives were not stopped.Results: We assessed plasma samples from 103 women with CM, 31 matched healthy women, 43 matched women with EM, and 14 patients with episodic cluster headache matched for age. CGRP levels were significantly increased in CM (74.90 pg/mL) as compared with control healthy women (33.74 pg/mL), women with EM (46.37 pg/mL), and patients with episodic cluster headache (45.87 pg/mL). Thresholds of 43.45 and 58.22 pg/mL optimize the sensitivity and specificity to differentiate CM from healthy controls and EM, respectively. In the CM group, CGRP levels were significantly increased in women with a history of migraine with aura vs those only experiencing migraine without aura. Variables such as age, analgesic overuse, depression, fibromyalgia, vascular risk factors, history of triptan consumption, or kind of preventative treatment did not significantly influence CGRP levels.Conclusion: Increased CGRP level measured in peripheral blood outside migraine attacks and in the absence of symptomatic medication could be a biomarker helping in the diagnosis of CM.