Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, Germany.
Ann Clin Transl Neurol. 2021 Jun;8(6):1251-1259. doi: 10.1002/acn3.51360. Epub 2021 May 2.
Migraine, endometriosis, and the comorbidity of both are frequent pain disorders of special relevance for women. The neuropeptide calcitonin gene-related peptide (CGRP) is critically involved in migraine, and circumstantial evidence suggests a role in endometriosis. We assessed CGRP levels at different times of menstrual cycle in four groups: healthy women, women with migraine or endometriosis and with the comorbidity of both.
Women with episodic migraine and women with a histologically confirmed endometriosis were recruited from specialized centers. For CGRP determination with a commercial enzyme immunoassay kit, cubital vein blood samples were collected on menstrual cycle day 2 ± 2 (during menstruation) and on day 15 ± 2 (periovulatory period). The primary endpoint of the study was the absolute difference of CGRP plasma levels between the menstrual and the periovulatory phase of all study groups. Groups were compared using nonparametric test procedures.
A total of 124 women were included in the study. The change of CGRP plasma levels between menstruation and the periovulatory period was different between groups (p = 0.007). Women with comorbid migraine and endometriosis showed an increase of CGRP in the menstrual phase of +6.32 (interquartile range, IQR -3.64-13.60) compared to the periovulatory time, while healthy controls had a decrease of -10.14 (-22.54-0.91, p = 0.004). CGRP levels were different in the periovulatory phase among groups (p = 0.008), with highest values in healthy controls.
CGRP levels change significantly during the menstrual cycle. Different patterns in women with the comorbidity point to a deviant regulation of CGRP release.
偏头痛、子宫内膜异位症以及两者的合并症都是女性常见的特殊疼痛疾病。降钙素基因相关肽（CGRP）在偏头痛中起着至关重要的作用，并有间接证据表明其在子宫内膜异位症中起作用。我们评估了四个组在月经周期不同时间的 CGRP 水平：健康女性、偏头痛女性、子宫内膜异位症女性以及两者的合并症女性。
从专门的中心招募了患有阵发性偏头痛和经组织学证实的子宫内膜异位症的女性。使用商业酶联免疫吸附试剂盒测定 CGRP 时，在月经周期的第 2 ± 2 天（月经期）和第 15 ± 2 天（排卵前期）采集肘静脉血样。本研究的主要终点是所有研究组月经和排卵前期之间 CGRP 血浆水平的绝对差异。使用非参数检验程序比较组间差异。
共有 124 名女性纳入研究。组间 CGRP 血浆水平在月经和排卵前期之间的变化不同（p = 0.007）。患有偏头痛和子宫内膜异位症合并症的女性在月经期的 CGRP 增加了+6.32（四分位距[IQR] -3.64-13.60），而健康对照组则减少了-10.14（-22.54-0.91，p = 0.004）。组间在排卵前期的 CGRP 水平不同（p = 0.008），健康对照组的 CGRP 水平最高。
CGRP 水平在月经周期中显著变化。患有合并症的女性的 CGRP 释放模式不同，表明 CGRP 释放的调节异常。
