Nappi G, Facchinetti F, Martignoni E, Petraglia F, Manzoni G C, Sances G, Sandrini G, Genazzani A R
Cephalalgia. 1985 May;5 Suppl 2:201-10. doi: 10.1177/03331024850050S240.
The role of opioid peptides in modulating the nervous system adaptability has been demonstrated recently; proopiomelanocortin (POMC)-related peptides, in particular, serve in pain perception, in adaptation to stress, and in modulating higher brain functions. Primary headaches, besides pain, involve neuroendocrine/autonomic/adaptive processes as well as mood and personality factors. The view that primary headaches can be taken as a possible model of POMC-related peptides dysfunction led us to evaluate the resting plasma and CSF peptide levels and their plasma changes in response to various stimuli affecting their release. The data obtained from basal and dynamic studies agree with the concept that primary headaches are sustained by opioid system disturbance. In particular the reduced release of endogenous opioids by anterior pituitary in response to physical, endocrine or pharmacological stimuli agrees with a weak adaptive ability of headache sufferers. This impairment of endorphin responsiveness could play a key role in headache susceptibility to environmental stimuli. Primary headaches constitute a wide, intriguing field, including several subgroups bordering on "ischemic" and behavioral/affective disorders. The development of neuroendocrine techniques could be a useful means for supporting the clinical criteria identifying subpopulations of headache sufferers.
阿片肽在调节神经系统适应性方面的作用最近已得到证实；特别是促肾上腺皮质激素原（POMC）相关肽，在疼痛感知、应激适应以及调节高级脑功能方面发挥作用。原发性头痛除了疼痛外，还涉及神经内分泌/自主神经/适应过程以及情绪和个性因素。原发性头痛可被视为POMC相关肽功能障碍的一种可能模型，这一观点促使我们评估静息状态下血浆和脑脊液中肽的水平，以及它们在各种影响其释放的刺激下血浆中的变化。基础研究和动态研究获得的数据与原发性头痛由阿片系统紊乱所致的观点一致。特别是垂体前叶对内源性阿片类物质的释放因物理、内分泌或药理刺激而减少，这与头痛患者适应性能力较弱相符。内啡肽反应性的这种损害可能在头痛对环境刺激的易感性中起关键作用。原发性头痛构成了一个广泛且引人入胜的领域，包括几个与“缺血性”以及行为/情感障碍接壤的亚组。神经内分泌技术的发展可能是支持识别头痛患者亚群临床标准的一种有用手段。
