Pinessi L, Piazza D, Vaula G, Rainero I, De Gennaro T, Bergamasco B, Farri A
Clinica Neurologica I, Università degli Studi di Torino.
Minerva Med. 1990 Oct;81(10):691-5.
Thanks to recent biochemical and neuroendocrine findings, migraine belonging to the group of primary headaches appears as a pathology of the antinociceptive system with evolutive character. It has been demonstrated, in fact, that right at the early stage of migraine, there is a significant reduction in liquoral concentrations of beta-endorphin (beta-E), endogenous opioid peptide followed by a similar change in the plasma opioid system. The opioid system deficiency is even more evident after stimulation tests that point to reduced reactivity of the hypothalamo-hypophyseal system with respect to stimuli that in normal subjects trigger hypophyseal beta-E incretion. Caffeine, a member of the methyl-xanthine group, is an interesting molecule in the study of migraine patients because the chronic intake of this substance, contained in numerous analgesics, has been related to the chronic nature of the pain. The purpose of the present study is to assess the relationship between caffeine consumption and plasma opioid system. With the administration of a single oral dose of caffeine, normal subjects present an increase in plasma concentrations of beta-E, while in patients with chronic migraine, the response is significantly lower. These data confirm the poor reactivity of the plasma opioid system to pharmacological stimuli in migraine. Average daily consumption of caffeine has also been determined. It was not possible to establish a correlation between consumption of caffeine and plasma concentrations of beta-E whether basal or after stimulus with caffeine.
由于近期的生化和神经内分泌学研究结果,属于原发性头痛组的偏头痛表现为一种具有演变特征的抗伤害感受系统疾病。事实上,已经证明,在偏头痛的早期阶段,内源性阿片肽β-内啡肽(β-E)的脑脊液浓度会显著降低,随后血浆阿片系统也会发生类似变化。在刺激试验后,阿片系统缺陷更为明显,这些试验表明,下丘脑-垂体系统对正常受试者中能触发垂体β-E分泌增加的刺激的反应性降低。咖啡因是甲基黄嘌呤类的一种,在偏头痛患者的研究中是一个有趣的分子,因为这种存在于多种镇痛药中的物质的长期摄入与疼痛的慢性性质有关。本研究的目的是评估咖啡因摄入与血浆阿片系统之间的关系。给正常受试者单次口服一剂咖啡因后,其血浆β-E浓度会升高,而慢性偏头痛患者的反应则显著较低。这些数据证实了偏头痛患者血浆阿片系统对药理刺激的反应性较差。还测定了咖啡因的日均摄入量。无论是基础状态还是在咖啡因刺激后,都无法确定咖啡因摄入量与血浆β-E浓度之间的相关性。