Gasbarrini A, Gabrielli M, Fiore G, Candelli M, Bartolozzi F, De Luca A, Cremonini F, Franceschi F, Di Campli C, Armuzzi A, Ojetti V, Serricchio M, Pola R, Gasbarrini G, Giacovazzo M, Pola P
Angiology Department, Catholic University, Rome, Italy.
Cephalalgia. 2000 Jul;20(6):561-5. doi: 10.1046/j.1468-2982.2000.00077.x.
Recent studies have suggested an association between Helicobacter pylori infection and migraine. However, various strains of the bacterium are present, some endowed with greater pathogenicity. In particular, H. pylori type I CagA-positive strains induce a higher release of proinflammatory substances by the gastric mucosa that could trigger systemic vasospasms. The aim of the present study was to assess the prevalence of H. pylori CagA-positive strains in subjects with migraine. One hundred and seventy-five patients affected by migraine (49 with aura, 126 without aura) were consecutively enrolled and matched for sex, age, social background and geographical origin with 152 controls. Helicobacter pylori infection was assessed through 13C-urea breath test. Specific serological IgG against CagA were detected through ELISA. The prevalence of H. pylori infection was similar in migraine patients and in controls (40% vs. 39%, respectively). Among migraine patients, prevalence of infection was not related to presence or absence of aura (45% vs. 37%, respectively). However, among infected subjects, a significantly higher prevalence of CagA-positive strains was observed in patients affected by migraine with aura when compared with those affected by migraine without aura (41% vs. 19%, P < 0.01) and with controls (41% vs. 17%, P < 0.01). CagA-positive H. pylori strains were found to be strongly associated with migraine with aura. A higher inflammatory response of the gastric mucosa to more virulent strains could release substances that may act as triggers of vasospasm in peculiar cerebral arterial districts, probably implicated in the 'aura' phenomenon.
近期研究表明幽门螺杆菌感染与偏头痛之间存在关联。然而，该细菌存在多种菌株，其中一些具有更强的致病性。特别是，I型CagA阳性幽门螺杆菌菌株可诱导胃黏膜释放更多促炎物质，进而引发全身性血管痉挛。本研究旨在评估偏头痛患者中CagA阳性幽门螺杆菌菌株的流行情况。连续纳入175例偏头痛患者（49例有先兆，126例无先兆），并按照性别、年龄、社会背景和地理来源与152名对照进行匹配。通过¹³C尿素呼气试验评估幽门螺杆菌感染情况。通过酶联免疫吸附测定法检测针对CagA的特异性血清IgG。偏头痛患者和对照组中幽门螺杆菌感染的流行率相似（分别为40%和39%）。在偏头痛患者中，感染率与有无先兆无关（分别为45%和37%）。然而，在感染患者中，与无先兆偏头痛患者相比，有先兆偏头痛患者中CagA阳性菌株的流行率显著更高（41%对19%，P<0.01），与对照组相比也更高（41%对17%，P<0.01）。发现CagA阳性幽门螺杆菌菌株与有先兆偏头痛密切相关。胃黏膜对毒性更强的菌株产生的更高炎症反应可能释放出一些物质，这些物质可能作为特定脑动脉区域血管痉挛的触发因素，可能与“先兆”现象有关。
