Increase in plasma calcitonin gene-related peptide from the extracerebral circulation during nitroglycerin-induced cluster headache attack.
Increase in plasma calcitonin gene-related peptide from the extracerebral circulation during nitroglycerin-induced cluster headache attack.
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DOI：
10.1016/0304-3959(94)00097-x
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发表时间：
1995-02-01
期刊：
影响因子：
7.4
通讯作者：
Michelacci, Sergio
中科院分区：
文献类型：
--
作者：
Fanciullacci, Marcello;Alessandri, Massimo;Michelacci, Sergio
在这项研究中，血浆降钙素基因相关肽（CGRP）和P物质（SP）水平的变化在自发性丛集性头痛发作硝酸甘油引起的评价。还评估了自发或舒马曲坦诱导缓解后的肽变化。从30例男性丛集性头痛患者疼痛侧同侧的颈外静脉采集血液; 18例男性处于活动期，12例处于缓解期。CGRP和SP的血浆水平测定使用敏感的放射免疫测定每种肽。CGRP样免疫反应性（CGRP-LI）被发现在活跃期的患者中增强，并在激发发作的高峰期进一步升高。自发和舒马曲坦诱导缓解后发生完全逆转。而缓解期患者硝酸甘油既未引起丛集性头痛发作，也未改变CGRP-LI。增加水平的CGRP-LI测量硝酸甘油给药前后，当挑起的攻击达到最大强度，表明激活的三叉神经血管系统在丛集性头痛的活跃期。此外，舒马曲坦的临床和生化作用表明，5-羟色胺参与了丛集性头痛的机制。
In this study, changes in plasma levels of calcitonin gene-related peptide (CGRP) and substance P (SP) during a spontaneous-like cluster headache attack provoked by nitroglycerin were evaluated. Peptide variations after spontaneous or sumatriptan-induced remission were also assessed. Blood was collected from the external jugular vein homolateral to the pain side of 30 male cluster headache patients; 18 men were in an active and 12 in a remission one. Plasma levels of CGRP and SP were determined using sensitive radioimmunoassays for each peptide. CGRP-like immunoreactivity (CGRP-LI) was found to be augmented in patients in an active period and became elevated further at the peak of the provoked attack. A complete reversal occurred both after spontaneous and sumatriptan-induced remission. On the contrary, nitroglycerin neither provoked a cluster headache attack nor altered CGRP-LI in the patients in a remission period. The augmented levels of CGRP-LI measured before and after nitroglycerin administration, when the provoked attack reached the maximum intensity, suggest an activation of the trigeminovascular system during the active period of cluster headache. Moreover, the clinical and biochemical actions showed by sumatriptan stress the involvement of serotonin in cluster headache mechanisms.