PACAP-38 and sex hormones in women with migraine: exploratory analysis of a cross-sectional, matched cohort study.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY Journal of Headache and Pain Pub Date : 2024-06-11 DOI:10.1186/s10194-024-01804-4

Elisabeth Storch, Lucas H Overeem, Maria Terhart, Mira P Fitzek, Kristin S Lange, Uwe Reuter, Bianca Raffaelli

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Abstract

Background: Endogeneous and exogeneous sex hormones can impact the frequency and severity of migraine attacks, but the underlying mechanisms are poorly understood. In this study, we investigate the relationship between female sex hormones and Pituitary Adenylate Cyclase-Activating Polypeptide-38 (PACAP-38) concentrations in plasma of women with migraine and healthy controls, aiming to elucidate potential hormonal influences on PACAP dynamics and their relevance to migraine pathophysiology.

Methods: This analysis is part of a cross-sectional, matched-cohort study. We recruited two groups of women with episodic migraine: one with a regular menstrual cycle (M-RMC) and another undergoing combined oral contraceptive treatment (M-COC). Additionally, we included corresponding age-matched control groups without migraine for both categories (C-RMC and C-COC). For participants with a RMC, the study visits were scheduled during the perimenstrual period (menstrual cycle day 2 ± 2) and periovulatory period (day 13 ± 2). Participants using COC were examined at day 4 ± 2 of the hormone-free interval and between day 7-14 of the hormone intake phase. During these visits, PACAP-38 concentrations in plasma were measured using a commercial Enzyme-linked-immunosorbent assay (ELISA) kit.

Results: The study included 120 women, with 30 participants in each group. Women with migraine and a RMC had significantly higher PACAP-38 plasma concentrations compared to healthy controls at both study visits [day 2 ± 2: M-RMC: 2547.41 pg/ml (IQR 814.27 - 4473.48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 - 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 - 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 - 3038.36), p = 0.028]. In contrast, PACAP-38 levels were comparable between migraine and control groups receiving COC. Women with migraine and a RMC exhibited higher PACAP-38 concentrations during menstruation compared to those using COC during the hormone-free interval.

Conclusion: Systemic PACAP-38 concentrations in women vary based on the presence of migraine diagnosis and their hormonal status.

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偏头痛女性患者的 PACAP-38 和性激素：一项横断面匹配队列研究的探索性分析。

背景：内源性和外源性性激素可影响偏头痛发作的频率和严重程度，但其潜在机制却鲜为人知。在这项研究中，我们调查了偏头痛女性患者和健康对照者血浆中女性性激素与垂体腺苷酸环化酶激活多肽-38（PACAP-38）浓度之间的关系，旨在阐明激素对 PACAP 动态变化的潜在影响及其与偏头痛病理生理学的相关性：本分析是一项横断面匹配队列研究的一部分。我们招募了两组患有发作性偏头痛的女性：一组月经周期规律（M-RMC），另一组正在接受联合口服避孕药治疗（M-COC）。此外，我们还为这两个组别（C-RMC 和 C-COC）纳入了相应年龄匹配的无偏头痛对照组。对于RMC患者，研究访问安排在围月经期（月经周期第2±2天）和围排卵期（第13±2天）。使用 COC 的参与者在无激素间歇期的第 4±2 天和激素摄入期的第 7-14 天接受检查。在这些检查期间，使用商用酶联免疫吸附试验（ELISA）试剂盒测量血浆中的 PACAP-38 浓度：研究包括 120 名妇女，每组 30 人。与健康对照组相比，患有偏头痛并患有 RMC 的妇女在两次检查中的 PACAP-38 血浆浓度都明显较高[第 2 ± 2 天：M-RMC：2547.41 pg/ml (IQR 814.27 - 4473.48) vs. C-RMC：2547.41 pg/ml (IQR 814.27 - 4473.48)] 。48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 - 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 - 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 - 3038.36), p = 0.028]。相比之下，接受 COC 治疗的偏头痛组和对照组的 PACAP-38 水平相当。患有偏头痛并患有 RMC 的妇女在月经期间的 PACAP-38 浓度高于在无激素间歇期使用 COC 的妇女：结论：女性体内的 PACAP-38 浓度因偏头痛诊断和荷尔蒙状态而异。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.