Nuria Riesco1, Eva Cernuda-Morollón1, Julio Pascual2. 1. Service of Neurology, University Hospital Central de Asturias, Oviedo, Spain. 2. Service of Neurology, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008, Santander, Spain. juliopascual@telefonica.net.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to revise current evidence on trigemino-vascular system (TVS) neuropeptides as potential biomarkers for chronic primary headaches, mainly for chronic migraine (CM). RECENT FINDINGS: Within sensory neuropeptides, released by an activated trigeminal nerve, calcitonin gene-related peptide (CGRP) levels seem to be a good biomarker of acute migraine and somewhat sensitive and specific for CM. CGRP, however, is not increased in 20-30% of CM patients, which suggests that CGRP is not the only neuropeptide involved in migraine pain generation and maintenance. Data for other sensory neuropeptides are inconsistent (neurokinin, substance P) or absent (amylin and cholecystokinin-8). Among parasympathetic neuropeptides, vasoactive intestinal polypeptide (VIP) is increased interictally in CM, and in at least some migraine cases ictally, pituitary adenylate cyclase-activating peptide (PACAP) has been shown to be increased ictally in jugular blood, but interictal, peripheral data do not indicate such an increase, and there are no data for other parasympathetic peptides. Finally, S100B, as a potential marker of glial TVS activation, has been studied with inconsistent results in migraine patients. Current data on TVS neuropeptides as potential migraine biomarkers must be taken with caution, even for the promising case of CGRP. We do not know with certainty whether increased levels are the reflection of TVS activation, the reliability and homogeneity of the different laboratory tests, or what is the influence on these measurements of the short half-life of many of these peptides or of preventive treatments. One further limitation would be whether the described increases in levels of some neuropeptides such as CGRP are specific for migraine versus other headaches.
PURPOSE OF REVIEW: The purpose of this review is to revise current evidence on trigemino-vascular system (TVS) neuropeptides as potential biomarkers for chronic primary headaches, mainly for chronic migraine (CM). RECENT FINDINGS: Within sensory neuropeptides, released by an activated trigeminal nerve, calcitonin gene-related peptide (CGRP) levels seem to be a good biomarker of acute migraine and somewhat sensitive and specific for CM. CGRP, however, is not increased in 20-30% of CMpatients, which suggests that CGRP is not the only neuropeptide involved in migraine pain generation and maintenance. Data for other sensory neuropeptides are inconsistent (neurokinin, substance P) or absent (amylin and cholecystokinin-8). Among parasympathetic neuropeptides, vasoactive intestinal polypeptide (VIP) is increased interictally in CM, and in at least some migraine cases ictally, pituitary adenylate cyclase-activating peptide (PACAP) has been shown to be increased ictally in jugular blood, but interictal, peripheral data do not indicate such an increase, and there are no data for other parasympathetic peptides. Finally, S100B, as a potential marker of glial TVS activation, has been studied with inconsistent results in migrainepatients. Current data on TVS neuropeptides as potential migraine biomarkers must be taken with caution, even for the promising case of CGRP. We do not know with certainty whether increased levels are the reflection of TVS activation, the reliability and homogeneity of the different laboratory tests, or what is the influence on these measurements of the short half-life of many of these peptides or of preventive treatments. One further limitation would be whether the described increases in levels of some neuropeptides such as CGRP are specific for migraine versus other headaches.
Authors: Jes Olesen; Hans-Christoph Diener; Ingo W Husstedt; Peter J Goadsby; David Hall; Ulrich Meier; Stephane Pollentier; Lynna M Lesko Journal: N Engl J Med Date: 2004-03-11 Impact factor: 91.245
Authors: Robert Belvís; Pablo Irimia; Patricia Pozo-Rosich; Carmen González-Oria; Antonio Cano; Javier Viguera; Belén Sánchez; Francisco Molina; Isabel Beltrán; Agustín Oterino; Elisa Cuadrado; Angel Gómez-Camello; Miguel Alberte-Woodward; Carmen Jurado; Teresa Oms; David Ezpeleta; Javier Díaz de Terán; Noemí Morollón; Germán Latorre; Marta Torres-Ferrús; Alicia Alpuente; Raquel Lamas; Carlos Toledano; Rogelio Leira; Sonia Santos; Margarita Sánchez Del Río Journal: J Headache Pain Date: 2021-07-17 Impact factor: 7.277
Authors: Weihua Meng; Mark J Adams; Harry L Hebert; Ian J Deary; Andrew M McIntosh; Blair H Smith Journal: EBioMedicine Date: 2018-01-31 Impact factor: 8.143