Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Spain.
Cephalalgia. 2011 Mar;31(4):481-7. doi: 10.1177/0333102410382793. Epub 2010 Sep 3.
The study was designed to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), immunoglobulin A (IgA) (immune system) concentrations and α-amylase (sympathetic nervous system [SNS]) activity between children with chronic tension-type headache (CTTH) and healthy children.
Thirty-six children, 10 boys and 26 girls (age: 9 ± 2 years) with CTTH and 36 age- and sex-matched healthy children were recruited. Salivary cortisol, α-amylase activity, salivary flow rate, IgA concentration and IgA rate were collected from non-stimulated saliva. A headache diary was used for collecting data on intensity, frequency and duration of headache for four weeks.
Children with CTTH showed lower IgA concentration (p = .008) and IgA rate (p = .039), but not lower cortisol concentration (p = .447), salivary flow rate (p = .289) or α-amylase activity (p = .559), as compared to healthy children. Neither age (p > .582) nor gender (p > .227) influenced salivary markers. A significant association between the number of years with headache and IgA concentration (r(s) = - 0.385; p = .023) was found: the greater the number of years with headache, the lower the IgA concentration.
These results suggest that children with CTTH present with deficits in the immune system, but not dysfunction in the HPA axis or SNS. Future studies are needed to elucidate the direction of these relationships.
本研究旨在比较慢性紧张型头痛(CTTH)患儿与健康儿童唾液皮质醇(下丘脑-垂体-肾上腺皮质轴 [HPA] 轴)、免疫球蛋白 A(IgA)(免疫系统)浓度和 α-淀粉酶(交感神经系统 [SNS])活性的差异。
共纳入 36 例 CTTH 患儿(男 10 例,女 26 例,年龄:9±2 岁)和 36 例年龄和性别匹配的健康儿童。采集非刺激唾液,检测唾液皮质醇、α-淀粉酶活性、唾液流率、IgA 浓度和 IgA 率。采用头痛日记记录 4 周内头痛的强度、频率和持续时间。
与健康儿童相比,CTTH 患儿的 IgA 浓度(p=0.008)和 IgA 率(p=0.039)较低,但皮质醇浓度(p=0.447)、唾液流率(p=0.289)或 α-淀粉酶活性(p=0.559)无差异。年龄(p>0.582)和性别(p>0.227)均不影响唾液标志物。头痛持续时间与 IgA 浓度呈显著负相关(r(s)=-0.385;p=0.023):头痛持续时间越长,IgA 浓度越低。
这些结果表明 CTTH 患儿存在免疫系统功能缺陷,但 HPA 轴或 SNS 无功能障碍。需要进一步研究阐明这些关系的方向。