Cupini L M, Bari M, Battista N, Argirò G, Finazzi-Agrò A, Calabresi P, Maccarrone M
Centro Cefalee, Clinica Neurologica, Ospedale S. Eugenio, Roma, Italy.
Cephalalgia. 2006 Mar;26(3):277-81. doi: 10.1111/j.1468-2982.2005.01031.x.
The endogenous cannabinoid anandamide (AEA) plays important roles in modulating pain. Head pain is an almost universal human experience, yet primary headache disorders, such as migraine without aura (MoA) or episodic tension-type headache (ETTH), can represent a serious threat to well-being when frequent and disabling. We assessed the discriminating role of endocannabinoids among patients with ETTH or MoA, and control subjects. We measured the activity of AEA hydrolase and AEA transporter, and the level of cannabinoid receptors in peripheral platelets from MoA, ETTH and healthy controls. Sixty-nine headache patients and 36 controls were selected. Diagnosis of headache type was made according to the International Headache Society criteria. We observed significant sex differences concerning AEA membrane transporter and fatty acid amide hydrolase activity in all groups. An increase in the activity of AEA hydrolase and AEA transporter was found in female but not male migraineurs. Cannabinoid receptors were the same in all groups. Here we show that the endocannabinoid system in human platelets is altered in female but not male migraneurs. Our results suggest that in migraineur women an increased AEA degradation by platelets, and hence a reduced concentration of AEA in blood, might reduce the pain threshold and possibly explain the prevalence of migraine in women. The involvement of the endocannabinoid system in migraine is new and broadens our knowledge of this widespread and multifactorial disease.
内源性大麻素花生四烯酸乙醇胺（AEA）在调节疼痛方面发挥着重要作用。头痛几乎是人类普遍的体验，然而，原发性头痛疾病，如无先兆偏头痛（MoA）或发作性紧张型头痛（ETTH），如果频繁发作且使人丧失能力，可能会对健康构成严重威胁。我们评估了内源性大麻素在ETTH或MoA患者以及对照受试者中的鉴别作用。我们测量了MoA、ETTH患者和健康对照者外周血小板中AEA水解酶和AEA转运体的活性以及大麻素受体的水平。选取了69例头痛患者和36例对照者。根据国际头痛协会标准进行头痛类型诊断。我们观察到所有组中关于AEA膜转运体和脂肪酸酰胺水解酶活性存在显著的性别差异。在女性偏头痛患者而非男性偏头痛患者中发现AEA水解酶和AEA转运体的活性增加。所有组中的大麻素受体相同。在此我们表明，人类血小板中的内源性大麻素系统在女性偏头痛患者而非男性偏头痛患者中发生了改变。我们的结果表明，在偏头痛女性患者中，血小板对AEA的降解增加，从而导致血液中AEA浓度降低，这可能会降低疼痛阈值，并可能解释女性偏头痛的患病率。内源性大麻素系统参与偏头痛是新的发现，拓宽了我们对这种广泛的多因素疾病的认识。
