Frank Florian, Kaltseis Katharina, Messlinger Karl, Broessner Gregor
Department of Neurology, Headache Outpatient Clinic, Medical University of Innsbruck, Innsbruck, Austria.
Institute of Physiology and Pathophysiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Front Neurol. 2022 Jul 28;13:925748. doi: 10.3389/fneur.2022.925748. eCollection 2022.
Calcitonin gene related peptide (CGRP) plays a key role in the pathophysiology of migraine and is therefore considered a potential biomarker for primary headache disorders. The challenge remaining is establishing standardized protocols for its assessment in various extracellular compartments and identifying pathological situations associated with an increase in CGRP.
We performed longitudinal measurements of CGRP plasma levels in 30 volunteers with the diagnosis of episodic migraine with and without aura under controlled circumstances during an induced migraine attack under a hypoxic challenge. Blood samples were collected from a cubital vein and CGRP plasma levels measured using ELISA.
CGRP levels varied significantly between the subjects at baseline (15.48-1,889.31 pg/ml) but were neither associated with socio-demographic data nor with headache/migraine frequency or intensity collected before hypoxic exposure. CGRP levels during hypoxia fluctuated around baseline and increased with prolonged hypoxia but did not differ significantly in subjects with migraine or headache compared to those without. However, subjects experiencing migraine without aura showed significantly higher levels than those with aura. Ictal CGRP levels were increased in females, in subjects with a negative family history regarding headaches, in those older than 30 years of age or with a recent headache attack before the experiment ( < 0.05).
CGRP plasma levels seem to be highly variable even at baseline in migraine patients and increased during hypoxic challenge and migraine attacks. This is the first in human longitudinal measurement of peripheral CGRP levels during induced migraine attacks using a highly standardized protocol.
降钙素基因相关肽（CGRP）在偏头痛的病理生理学中起关键作用，因此被认为是原发性头痛疾病的潜在生物标志物。目前仍面临的挑战是建立在各种细胞外区室中评估CGRP的标准化方案，并确定与CGRP升高相关的病理情况。
我们对30名诊断为发作性偏头痛（有或无先兆）的志愿者在低氧刺激下诱发偏头痛发作的受控情况下进行了CGRP血浆水平的纵向测量。从肘静脉采集血样，使用酶联免疫吸附测定法（ELISA）测量CGRP血浆水平。
受试者在基线时的CGRP水平差异显著（15.48 - 1889.31 pg/ml），但与社会人口统计学数据、低氧暴露前收集的头痛/偏头痛频率或强度均无关。低氧期间CGRP水平在基线附近波动，并随低氧时间延长而升高，但偏头痛或头痛患者与无偏头痛或头痛患者相比无显著差异。然而，无先兆偏头痛患者的CGRP水平显著高于有先兆患者。发作期CGRP水平在女性、头痛家族史阴性的受试者、年龄大于30岁或实验前近期有头痛发作的受试者中升高（P<0.05）。
偏头痛患者即使在基线时CGRP血浆水平似乎也高度可变，并在低氧刺激和偏头痛发作期间升高。这是首次使用高度标准化方案对人类在诱发偏头痛发作期间外周CGRP水平进行纵向测量。
