Mast cell involvement in the pathophysiology of migraine headache: A hypothesis
Mast cell involvement in the pathophysiology of migraine headache: A hypothesis
复制标题
DOI：
10.1111/j.1526-4610.2006.00485.x
复制
发表时间：
2006-06-01
期刊：
影响因子：
5
通讯作者：
Strassman, Andrew M.
中科院分区：
文献类型：
--
作者：
Levy, Dan;Burstein, Rami;Strassman, Andrew M.
偏头痛发作是由多种条件引发的，包括内源性和外源性因素。有证据表明，初级传入脑膜伤害性神经元（三叉血管系统的外周臂）的激活和敏化是促进偏头痛颅内疼痛的最早事件之一。然而，各种触发因素与脑膜伤害性神经元激活之间的联系尚不完全清楚。局部炎症以及局部免疫/炎症细胞释放介质被认为在这种神经元反应中发挥着关键作用。脑膜肥大细胞可能发挥这样的作用，因为它们靠近脑膜血管和伤害性轴突，并且能够释放大量促炎/镇痛介质。本文回顾了与肥大细胞在偏头痛触发物激活后导致偏头痛发生这一假设相关的数据。流行病学发现、临床数据以及对肥大细胞的解剖和生理特征的观察都表明这些免疫细胞在偏头痛的发病机制中发挥着重要作用。偏头痛触发因素可能直接或间接促进脑膜肥大细胞分泌介质，从而引起炎症和三叉血管系统的激活。虽然一致，但迄今为止支持肥大细胞参与偏头痛发生的证据在很大程度上是间接的。需要进一步的研究来直接测试肥大细胞参与偏头痛发病机制的性质。
Migraine attacks are triggered by a variety of conditions including endogenous and exogenous factors. Evidence suggests that activation and sensitization of primary afferent meningeal nociceptive neurons, the peripheral arm of the trigeminovascular system, constitutes one of the earliest events promoting the intracranial pain of migraine. However, the link between the varied triggering factors and activation of meningeal nociceptive neurons is not completely understood. Local inflammation with release of mediators from local immune/inflammatory cells is thought to play a critical role in such neuronal response. Meningeal mast cells may play such a role by virtue of their proximity both to meningeal blood vessels and nociceptive axons and their ability to release a host of proinflammatory/algesic mediators. This paper reviews data relevant to the hypothesis that mast cells, upon activation by migraine triggers, contribute to the genesis of migraine headache. Epidemiologic findings, clinical data, and observations on anatomical and physiological characteristics of mast cells converge to suggest an important role of these immune cells in the pathogenesis of migraine. Migraine triggers might directly or indirectly promote mediator secretion from meningeal mast cells, and thereby cause inflammation and activation of the trigeminovascular system. While consistent, the evidence supporting mast cell involvement in the genesis of migraine is largely circumstantial to date. Further studies are needed to test directly the nature of mast cell involvement in the pathogenesis of migraine headache.