Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
J Headache Pain. 2024 Jun 7;25(1):95. doi: 10.1186/s10194-024-01800-8.
The pathogenesis of migraine remains unclear; however, a large body of evidence supports the hypothesis that immunological mechanisms play a key role. Therefore, we aimed to review current studies on altered immunity in individuals with migraine during and outside attacks.
We searched the PubMed database to investigate immunological changes in patients with migraine. We then added other relevant articles on altered immunity in migraine to our search.
Database screening identified 1,102 articles, of which 41 were selected. We added another 104 relevant articles. We found studies reporting elevated interictal levels of some proinflammatory cytokines, including IL-6 and TNF-α. Anti-inflammatory cytokines showed various findings, such as increased TGF-β and decreased IL-10. Other changes in humoral immunity included increased levels of chemokines, adhesion molecules, and matrix metalloproteinases; activation of the complement system; and increased IgM and IgA. Changes in cellular immunity included an increase in T helper cells, decreased cytotoxic T cells, decreased regulatory T cells, and an increase in a subset of natural killer cells. A significant comorbidity of autoimmune and allergic diseases with migraine was observed.
Our review summarizes the findings regarding altered humoral and cellular immunological findings in human migraine. We highlight the possible involvement of immunological mechanisms in the pathogenesis of migraine. However, further studies are needed to expand our knowledge of the exact role of immunological mechanisms in migraine pathogenesis.
偏头痛的发病机制仍不清楚；然而，大量证据支持免疫机制起关键作用的假说。因此，我们旨在综述目前关于偏头痛发作期间和发作间期个体免疫改变的研究。
我们检索了 PubMed 数据库，以调查偏头痛患者的免疫变化。然后，我们在检索中加入了其他关于偏头痛免疫改变的相关文章。
数据库筛选出 1102 篇文章，其中 41 篇被选中。我们又加入了另外 104 篇相关文章。我们发现了一些研究报告称，一些促炎细胞因子（如 IL-6 和 TNF-α）在发作间期水平升高。抗炎细胞因子的结果各不相同，如 TGF-β 增加和 IL-10 减少。体液免疫的其他改变包括趋化因子、黏附分子和基质金属蛋白酶水平升高；补体系统激活；以及 IgM 和 IgA 增加。细胞免疫的改变包括辅助性 T 细胞增加、细胞毒性 T 细胞减少、调节性 T 细胞减少和自然杀伤细胞亚群增加。偏头痛与自身免疫和过敏性疾病的显著共病性也被观察到。
我们的综述总结了关于人类偏头痛中体液和细胞免疫改变的发现。我们强调了免疫机制可能参与偏头痛的发病机制。然而，需要进一步的研究来扩大我们对免疫机制在偏头痛发病机制中的确切作用的认识。
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