偏头痛患者血清肾素-血管紧张素系统标志物水平的改变

Altered Serum Levels of Renin-Angiotensin System Markers in Migraine.

作者信息

Bhering Martins Laís, Silva de Miranda Aline, Rodrigues Ana Maria Dos Santos, Braga Tibaes Jenneffer Rayane, Gomez Rodrigo Santiago, Ferreira Adaliene Versiani Matos, Teixeira Antonio Lúcio

机构信息

Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Headache. 2020 Oct;60(9):1995-2002. doi: 10.1111/head.13949. Epub 2020 Sep 2.

DOI:10.1111/head.13949

PMID:32880958

Abstract

OBJECTIVE

To compare the serum levels of renin-angiotensin system (RAS) components between patients with migraine and healthy controls, and to evaluate whether these levels are associated with migraine severity. We hypothesized that migraine would be associated with the activation of the inflammatory arm of the RAS, possibly leading to increased levels of angiotensin (Ang) II.

BACKGROUND

Recent studies have proposed the use of drugs that interfere with RAS, a hormonal system primarily implicated in blood pressure regulation, as a prophylactic strategy for migraine. However, no previous studies have directly assessed RAS components in migraine.

METHODS

This was a cross-sectional study involving 30 patients with episodic migraine who were in the interictal period and 20 healthy controls. This study was conducted at Hospital das Clínicas (Universidade Federal de Minas Gerais, Belo Horizonte, Brazil) outpatient clinic. Headache severity was evaluated using the Headache Impact Test, version 6 (HIT-6) and the Migraine Disability Test (MIDAS) questionnaires. Given that migraine is comorbid with mood disorders, depressive and anxious symptoms were evaluated using the Beck Anxiety and Depression Inventories (BDI and BAI), respectively. Clinical and demographic data were also collected. Serum levels of angiotensin-converting enzyme (ACE), ACE2, Ang II, and Ang (1-7) were measured by enzyme-linked immunosorbent assay.

RESULTS

Patients with migraine and controls were comparable in age, body mass index, blood pressure, and depressive and anxious symptoms. Patients with migraine showed lower levels of ACE [85.2 (66.8, 101.2) vs 65.5 (54.2, 77.5); P = .005] and lower ACE/ACE2 ratio [4.3 (3.4, 5.2) vs 3.5 (2.9, 4.1); P = .032] than controls. Conversely, patients with migraine had higher levels of Ang II [309.7 ± 147.4 vs 605.4 ± 200.4; difference: -287.1 (95% CI: -391.4--182.8), P < .001] and Ang (1-7) [214.4 ± 155.8 vs 397.9 ± 217.9; difference: -184.6 (95% CI: -296.7--72.6), P = .001] than controls. There were no correlations between RAS serum markers and migraine severity scores (HIT and MIDAS) or depressive and anxious symptoms (BDI and BAI) (P > .05).

CONCLUSIONS

Altogether, our results suggest the participation of RAS in migraine pathophysiology, but not in its severity.

摘要

目的

比较偏头痛患者与健康对照者血清肾素 - 血管紧张素系统（RAS）各成分水平，并评估这些水平是否与偏头痛严重程度相关。我们假设偏头痛与RAS炎症分支的激活有关，可能导致血管紧张素（Ang）II水平升高。

背景

最近的研究提出使用干扰RAS的药物作为偏头痛的预防策略，RAS是主要参与血压调节的激素系统。然而，以前没有研究直接评估偏头痛患者的RAS成分。

方法

这是一项横断面研究，纳入30例处于发作间期的发作性偏头痛患者和20名健康对照者。本研究在巴西贝洛奥里藏特米纳斯吉拉斯联邦大学临床医院门诊进行。使用头痛影响测试第6版（HIT - 6）和偏头痛残疾测试（MIDAS）问卷评估头痛严重程度。鉴于偏头痛常与情绪障碍共病，分别使用贝克焦虑和抑郁量表（BDI和BAI）评估抑郁和焦虑症状。还收集了临床和人口统计学数据。通过酶联免疫吸附测定法测量血清血管紧张素转换酶（ACE）、ACE2、Ang II和Ang（1 - 7）水平。

结果

偏头痛患者和对照组在年龄、体重指数、血压以及抑郁和焦虑症状方面具有可比性。偏头痛患者的ACE水平[85.2（66.8，101.2）对65.5（54.2，77.5）；P = 0.005]和ACE/ACE2比值[4.3（3.4，5.2）对3.5（2.9，4.1）；P = 0.032]低于对照组。相反，偏头痛患者的Ang II水平[309.7 ± 147.4对605.4 ± 200.4；差异： - 287.1（95% CI： - 391.4--182.8），P < 0.001]和Ang（1 - 7）水平[214.4 ± 155.8对397.9 ± 217.9；差异： - 184.6（95% CI： - 296.7--72.6），P = 0.001]高于对照组。RAS血清标志物与偏头痛严重程度评分（HIT和MIDAS）或抑郁和焦虑症状（BDI和BAI）之间无相关性（P > 0.05）。