发作期脂肪因子与发作性偏头痛的疼痛严重程度及治疗反应相关。
Ictal adipokines are associated with pain severity and treatment response in episodic migraine.
作者信息
Chai Nu Cindy, Gelaye Bizu, Tietjen Gretchen E, Dash Paul D, Gower Barbara A, White Linda W, Ward Thomas N, Scher Ann I, Peterlin B Lee
机构信息
From the Department of Neurology (N.C.C., L.W.W., B.L.P.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Anesthesia (N.C.C.), University of California, San Francisco; Department of Epidemiology (B.G.), Harvard School of Public Health, Boston, MA; Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (P.D.D.), Johns Hopkins Community Physicians, Baltimore, MD; Department of Nutrition Sciences (B.A.G.), University of Alabama at Birmingham; Department of Neurology (T.N.W.), Dartmouth Hitchcock Medical Center, Lebanon, NH; and Uniformed Services University (A.I.S.), Bethesda, MD.
出版信息
Neurology. 2015 Apr 7;84(14):1409-18. doi: 10.1212/WNL.0000000000001443. Epub 2015 Mar 6.
OBJECTIVE
To evaluate ictal adipokine levels in episodic migraineurs and their association with pain severity and treatment response.
METHODS
This was a double-blind, placebo-controlled trial evaluating peripheral blood specimens from episodic migraineurs at acute pain onset and 30 to 120 minutes after treatment with sumatriptan/naproxen sodium vs placebo. Total adiponectin (T-ADP), ADP multimers (high molecular weight [HMW], middle molecular weight, and low molecular weight [LMW]), leptin, and resistin levels were evaluated by immunoassays.
RESULTS
Thirty-four participants (17 responders, 17 nonresponders) were included. In all participants, pretreatment pain severity increased with every quartile increase in both the HMW:T-ADP ratio (coefficient of variation [CV] 0.51; 95% confidence interval [CI]: 0.08, 0.93; p = 0.019) and resistin levels (CV 0.58; 95% CI: 0.21, 0.96; p = 0.002), but was not associated with quartile changes in leptin levels. In responders, T-ADP (CV -0.98; 95% CI: -1.88, -0.08; p = 0.031) and resistin (CV -0.95; 95% CI: -1.83, -0.07; p = 0.034) levels decreased 120 minutes after treatment as compared with pretreatment. In addition, in responders, the HMW:T-ADP ratio (CV -0.04; 95% CI: -0.07, -0.01; p = 0.041) decreased and the LMW:T-ADP ratio (CV 0.04; 95% CI: 0.01, 0.07; p = 0.043) increased at 120 minutes after treatment. In nonresponders, the LMW:T-ADP ratio (CV -0.04; 95% CI: -0.07, -0.01; p = 0.018) decreased 120 minutes after treatment. Leptin was not associated with treatment response.
CONCLUSIONS
Both pretreatment migraine pain severity and treatment response are associated with changes in adipokine levels. Adipokines represent potential novel migraine biomarkers and drug targets.
目的
评估发作性偏头痛患者发作期脂肪因子水平及其与疼痛严重程度和治疗反应的关联。
方法
这是一项双盲、安慰剂对照试验，评估发作性偏头痛患者在急性疼痛发作时以及使用舒马曲坦/萘普生钠与安慰剂治疗后30至120分钟的外周血样本。通过免疫测定法评估总脂联素（T-ADP）、脂联素多聚体（高分子量[HMW]、中分子量和低分子量[LMW]）、瘦素和抵抗素水平。
结果
纳入了34名参与者（17名反应者，17名无反应者）。在所有参与者中，随着HMW:T-ADP比值（变异系数[CV] 0.51；95%置信区间[CI]：0.08，0.93；p = 0.019）和抵抗素水平（CV 0.58；95% CI：0.21，0.96；p = 0.002）每增加一个四分位数，治疗前疼痛严重程度增加，但与瘦素水平的四分位数变化无关。在反应者中，与治疗前相比，治疗后120分钟时T-ADP（CV -0.98；95% CI：-1.88，-0.08；p = 0.031）和抵抗素（CV -0.95；95% CI：-1.83，-0.07；p = 0.034）水平降低。此外，在反应者中，治疗后120分钟时HMW:T-ADP比值（CV -0.04；95% CI：-0.07，-0.01；p = 0.041）降低，LMW:T-ADP比值（CV 0.04；95% CI：0.01，0.07；p = 0.043）升高。在无反应者中，治疗后120分钟时LMW:T-ADP比值（CV -0.04；95% CI：-0.07，-0.01；p = 0.018）降低。瘦素与治疗反应无关。
结论
治疗前偏头痛疼痛严重程度和治疗反应均与脂肪因子水平变化有关。脂肪因子是潜在的新型偏头痛生物标志物和药物靶点。
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