Department of Neurology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, Berlin, 10117, Germany.
Clinician Scientist Program, Berlin Institute of Health at Charité (BIH), Berlin, Germany.
J Headache Pain. 2024 Jun 11;25(1):98. doi: 10.1186/s10194-024-01804-4.
Endogeneous and exogeneous sex hormones can impact the frequency and severity of migraine attacks, but the underlying mechanisms are poorly understood. In this study, we investigate the relationship between female sex hormones and Pituitary Adenylate Cyclase-Activating Polypeptide-38 (PACAP-38) concentrations in plasma of women with migraine and healthy controls, aiming to elucidate potential hormonal influences on PACAP dynamics and their relevance to migraine pathophysiology.
This analysis is part of a cross-sectional, matched-cohort study. We recruited two groups of women with episodic migraine: one with a regular menstrual cycle (M-RMC) and another undergoing combined oral contraceptive treatment (M-COC). Additionally, we included corresponding age-matched control groups without migraine for both categories (C-RMC and C-COC). For participants with a RMC, the study visits were scheduled during the perimenstrual period (menstrual cycle day 2 ± 2) and periovulatory period (day 13 ± 2). Participants using COC were examined at day 4 ± 2 of the hormone-free interval and between day 7-14 of the hormone intake phase. During these visits, PACAP-38 concentrations in plasma were measured using a commercial Enzyme-linked-immunosorbent assay (ELISA) kit.
The study included 120 women, with 30 participants in each group. Women with migraine and a RMC had significantly higher PACAP-38 plasma concentrations compared to healthy controls at both study visits [day 2 ± 2: M-RMC: 2547.41 pg/ml (IQR 814.27 - 4473.48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 - 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 - 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 - 3038.36), p = 0.028]. In contrast, PACAP-38 levels were comparable between migraine and control groups receiving COC. Women with migraine and a RMC exhibited higher PACAP-38 concentrations during menstruation compared to those using COC during the hormone-free interval.
Systemic PACAP-38 concentrations in women vary based on the presence of migraine diagnosis and their hormonal status.
内源性和外源性性激素会影响偏头痛发作的频率和严重程度，但潜在机制尚不清楚。本研究旨在探讨女性偏头痛患者与健康对照组之间血浆中垂体腺苷酸环化酶激活肽-38（PACAP-38）浓度与女性性激素之间的关系，以阐明潜在的激素对 PACAP 动力学的影响及其与偏头痛病理生理学的相关性。
这是一项横断面、匹配队列研究的分析部分。我们招募了两组偏头痛女性患者：一组为有规律月经周期的患者（M-RMC），另一组为服用复方口服避孕药的患者（M-COC）。此外，我们还为这两组患者（C-RMC 和 C-COC）招募了相应年龄的健康对照组。对于有 RMC 的患者，研究访问安排在围经期（月经周期第 2 天±2 天）和排卵前期（第 13 天±2 天）。服用 COC 的患者在激素无抑制期的第 4 天±2 天和激素摄入期的第 7-14 天接受检查。在此期间，使用商业酶联免疫吸附试验（ELISA）试剂盒测量血浆中的 PACAP-38 浓度。
该研究共纳入 120 名女性，每组 30 名参与者。在两次研究访问中，偏头痛且有 RMC 的女性的 PACAP-38 血浆浓度明显高于健康对照组 [第 2 天±2 天：M-RMC：2547.41pg/ml（IQR 814.27-4473.48）比 C-RMC：1129.49pg/ml（IQR 257.34-2684.88），p=0.025；第 13 天±2 天：M-RMC：3098.89pg/ml（IQR 1186.29-4379.47）比 C-RMC：1626.89pg/ml（IQR 383.83-3038.36），p=0.028]。相比之下，接受 COC 的偏头痛和对照组女性的 PACAP-38 水平相当。有 RMC 的偏头痛女性在月经期间的 PACAP-38 浓度高于在激素无抑制期服用 COC 的女性。
女性偏头痛患者和激素状态不同，其系统性 PACAP-38 浓度也不同。
