Theoharides Theoharis C, Donelan Jill, Kandere-Grzybowska Kristiana, Konstantinidou Aphrodite
Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine and Tufts-New England Medical Center, 136 Harrison Avenue, Boston, MA 02111, USA.
Brain Res Brain Res Rev. 2005 Jul;49(1):65-76. doi: 10.1016/j.brainresrev.2004.11.006.
Mast cells are critical players in allergic reactions, but they have also been shown to be important in immunity and recently also in inflammatory diseases, especially asthma. Migraines are episodic, typically unilateral, throbbing headaches that occur more frequently in patients with allergy and asthma implying involvement of meningeal and/or brain mast cells. These mast cells are located perivascularly, in close association with neurons especially in the dura, where they can be activated following trigeminal nerve, as well as cervical or sphenopalatine ganglion stimulation. Neuropeptides such as calcitonin gene-related peptide (CGRP), hemokinin A, neurotensin (NT), pituitary adenylate cyclase activating peptide (PACAP), and substance P (SP) activate mast cells leading to secretion of vasoactive, pro-inflammatory, and neurosensitizing mediators, thereby contributing to migraine pathogenesis. Brain mast cells can also secrete pro-inflammatory and vasodilatory molecules such as interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF), selectively in response to corticotropin-releasing hormone (CRH), a mediator of stress which is known to precipitate or exacerbate migraines. A better understanding of brain mast cell activation in migraines would be useful and could lead to several points of prophylactic intervention.
肥大细胞是过敏反应中的关键参与者，但它们在免疫中也很重要，最近在炎症性疾病，尤其是哮喘中也发挥着重要作用。偏头痛是发作性的，通常为单侧搏动性头痛，在过敏和哮喘患者中更常见，这意味着脑膜和/或脑肥大细胞参与其中。这些肥大细胞位于血管周围，与神经元密切相关，尤其是在硬脑膜中，在三叉神经以及颈神经节或蝶腭神经节受到刺激后，它们可以被激活。降钙素基因相关肽（CGRP）、血红蛋白A、神经降压素（NT）、垂体腺苷酸环化酶激活肽（PACAP）和P物质（SP）等神经肽可激活肥大细胞，导致血管活性、促炎和神经致敏介质的分泌，从而促进偏头痛的发病机制。脑肥大细胞也可以选择性地分泌促炎和血管舒张分子，如白细胞介素-6（IL-6）和血管内皮生长因子（VEGF），以响应促肾上腺皮质激素释放激素（CRH），CRH是一种已知会引发或加重偏头痛的应激介质。更好地了解偏头痛中脑肥大细胞的激活将是有益的，并可能带来多个预防性干预点。
