血清 CGRP 测量作为慢性偏头痛生物标志物的可行性：批判性再评价。
Feasibility of serum CGRP measurement as a biomarker of chronic migraine: a critical reappraisal.
机构信息
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea.
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
出版信息
J Headache Pain. 2018 Jul 13;19(1):53. doi: 10.1186/s10194-018-0883-x.
BACKGROUND
Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.
METHODS
We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.
RESULTS
A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.
CONCLUSIONS
Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice.
背景
降钙素基因相关肽（CGRP）在慢性偏头痛中被报道升高。我们旨在验证间歇期外周血样本中血清 CGRP 浓度作为慢性偏头痛生物标志物的作用。
方法
我们于 2015 年 8 月至 2016 年 5 月在三星医疗中心前瞻性招募了发作性和慢性偏头痛患者以及正常对照者（NCs）。根据预先指定的方案，从肘前静脉采集间歇期血样。在中央实验室由一位经验丰富的技术人员进行血清 CGRP 测量，该技术人员对临床信息不知情。每次就诊时都评估偏头痛亚型、前一个月头痛天数以及测量前后±2 天头痛的存在和特征。
结果
本研究共纳入 156 例偏头痛患者（106 例发作性和 50 例慢性）和 27 例 NCs。与 NCs（75.7±20.07 pg/mL）和发作性偏头痛患者（67.0±20.70 pg/mL）相比，慢性偏头痛患者的间歇期血清 CGRP 水平并未升高（64.9±15.32 pg/mL）。血清 CGRP 浓度与头痛状态（发作期与间歇期）、偏头痛亚型（有先兆与无先兆偏头痛）、预防性或急性药物的使用以及共病药物滥用无关。较高的血清 CGRP 浓度并不能预测慢性偏头痛患者的治疗反应。
结论
血清 CGRP 浓度可能不是慢性偏头痛的可行生物标志物。在 CGRP 可用于临床实践之前，需要进一步验证。
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