Bhatt Deepak K, Gupta Saurabh, Olesen Jes, Jansen-Olesen Inger
Danish Headache Center, Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
Danish Headache Center, Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
Cephalalgia. 2014 Oct;34(11):877-86. doi: 10.1177/0333102414523846. Epub 2014 Feb 21.
In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing. Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation.
MCs were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control and MCD rats was recorded by using the genuine closed-cranial window (CCW) model. Vasoactive intestinal polypeptide (VIP) infusion was given only in control rats. A combination of the histamine H1 receptor antagonist mepyramine (4 mg kg(-1) i.v.) and the H2 receptor antagonist famotidine (1 mg kg(-1) i.v.) was given 10 minutes prior to PACAP-38 infusion. Increasing doses of PACAP-38, PACAP-27 and VIP were infused through the intracarotid artery (i.c.) in control and MCD rats to see the direct effects of these peptides on MMA diameter change.
There was no significant change in CGRP-induced MMA diameter increase in control and MCD rats, and the dilated MMA immediately returned back to baseline after stopping the infusion. The delayed MMA dilation induced by PACAP-38 was abolished in MCD and antihistamine (AH)-pretreated rats. Compared to PACAP-38, the PACAP-27 i.v. infusion gave smaller peak dilation of MMA in control rats. In MCD rats, PACAP-27 did not induce any significant dilation. VIP i.v. infusion reduced MABP but did not dilate MMA significantly. PACAP(6-38), which is a potent MC degranulator, also gave a significant delayed dilation of MMA. PACAP-38 i.c. responses (direct receptor mediated response) were not affected by MC depletion. Only the maximum response (% E max) value of PACAP-27 (i.c.) was significantly lower in MCD rats compared to control rats.
The delayed MMA dilatory responses to PACAP-38 infusion were attenuated in MCD and AH-pretreated rats, indicating a role of the MC mediator-histamine in PACAP-38-induced delayed dilation of MA.
在健康人类志愿者和偏头痛患者中,输注垂体腺苷酸环化酶激活多肽-38(PACAP-38)可导致脑膜中动脉(MMA)持续血管舒张,并引发即刻和延迟性头痛。所有研究对象均出现面部潮红。肥大细胞(MCs)可能在PACAP-38输注的持久效应中发挥作用。我们推测,在肥大细胞耗竭(MCD)大鼠中,由于MC脱颗粒过程中释放的血管舒张产物缺乏,对PACAP-38的血管反应会低于对照大鼠。
通过用化合物48/80进行慢性治疗来耗竭MCs。使用真正的闭颅窗(CCW)模型记录20分钟静脉输注降钙素基因相关肽(CGRP)、PACAP-38、PACAP(6 - 38)(PAC-1受体拮抗剂)和PACAP-27对对照大鼠和MCD大鼠MMA直径及平均动脉血压(MABP)的影响。仅在对照大鼠中给予血管活性肠肽(VIP)输注。在输注PACAP-38前10分钟给予组胺H1受体拮抗剂美吡拉敏(4 mg kg⁻¹静脉注射)和H2受体拮抗剂法莫替丁(1 mg kg⁻¹静脉注射)的组合。通过颈内动脉(i.c.)向对照大鼠和MCD大鼠输注递增剂量的PACAP-38、PACAP-27和VIP,以观察这些肽对MMA直径变化的直接影响。
对照大鼠和MCD大鼠中,CGRP诱导的MMA直径增加无显著变化,停止输注后扩张的MMA立即恢复至基线。在MCD大鼠和抗组胺(AH)预处理大鼠中,PACAP-38诱导的延迟性MMA扩张被消除。与PACAP-38相比,PACAP-27静脉输注在对照大鼠中引起的MMA峰值扩张较小。在MCD大鼠中,PACAP-27未诱导任何显著扩张。VIP静脉输注降低了MABP,但未显著扩张MMA。作为有效的MC脱颗粒剂的PACAP(6 - 38)也引起了MMA的显著延迟扩张。PACAP-38的颈内动脉反应(直接受体介导反应)不受MC耗竭的影响。与对照大鼠相比,仅MCD大鼠中PACAP-27(颈内动脉)的最大反应(% E max)值显著较低。
在MCD大鼠和AH预处理大鼠中,对PACAP-38输注的延迟性MMA扩张反应减弱,表明MC介质组胺在PACAP-38诱导的MA延迟扩张中起作用。