伴或不伴先兆偏头痛患者降钙素基因相关肽、血管活性肠肽及垂体腺苷酸环化酶激活肽-38水平的比较分析：一项病例对照研究

Comparative Analysis of CGRP, VIP and  PACAP-38 Levels in Migraine with and  Without Aura: A Case-control Study.

作者信息

Sreevani N, Ramesh B, Maheshkumar K, Thanalakshmi J

机构信息

Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai, Tamil Nadu, India.

Department of Biochemistry, TRR Institute of Medical Sciences, Patancheru, Telangana, India.

出版信息

Ann Neurosci. 2025 May 31:09727531251340156. doi: 10.1177/09727531251340156.

DOI:10.1177/09727531251340156

PMID:40458768

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12126456/

Abstract

BACKGROUND

Migraine pathophysiology involves the release of vasoactive neuropeptides following trigeminovascular system activation. While calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) have been individually studied in migraine, their combined role in differentiating migraine subtypes remains unclear.

PURPOSE

The aim of this study was to evaluate serum levels of CGRP, VIP and PACAP-38 in patients with migraine with aura (MA) and without aura (MO) compared to healthy controls (HC), and assess their potential as diagnostic biomarkers.

METHODS

This case-control study included 296 participants (266 females, 30 males) divided into three groups: MA ( = 101), MO ( = 98) and HC ( = 97). Serum neuropeptide levels were measured using enzyme-linked immunosorbent assay (ELISA) under standardised conditions. Clinical characteristics were assessed using attack frequency and Headache Impact Test-6 (HIT-6) scores.

RESULTS

All three neuropeptides were significantly elevated in migraine patients compared to controls ( < .001). CGRP levels were highest in MA (45.6 ± 8.2 pg/mL), followed by MO (38.4 ± 7.8 pg/mL) and HC (28.3 ± 6.4 pg/mL). Similar patterns were observed for VIP (MA: 186.4 ± 24.6, MO: 165.8 ± 22.4, HC: 142.3 ± 20.8 pg/mL) and PACAP-38 (MA: 248.6 ± 32.4, MO: 228.5 ± 30.6, HC: 195.4 ± 28.2 pg/mL). MA patients showed marginally higher attack frequency (4.8 ± 2.3 vs. 4.2 ± 2.1 per month, = .06) and HIT-6 scores (64.8 ± 6.2 vs 62.4 ± 5.8, = .08) compared to MO patients.

CONCLUSION

The significant elevation of all three neuropeptides, particularly in MA patients, suggests their potential utility as biomarkers for migraine diagnosis and subtype differentiation. These findings support the neurogenic inflammation hypothesis in migraine pathophysiology and may have implications for targeted therapeutic approaches.

摘要

背景

偏头痛的病理生理学涉及三叉神经血管系统激活后血管活性神经肽的释放。虽然降钙素基因相关肽（CGRP）、血管活性肠肽（VIP）和垂体腺苷酸环化酶激活多肽-38（PACAP-38）已分别在偏头痛中进行了研究，但它们在区分偏头痛亚型中的联合作用仍不清楚。

目的

本研究的目的是评估有先兆偏头痛（MA）和无先兆偏头痛（MO）患者与健康对照（HC）相比血清中CGRP、VIP和PACAP-38的水平，并评估它们作为诊断生物标志物的潜力。

方法

本病例对照研究包括296名参与者（266名女性，30名男性），分为三组：MA组（n = 101）、MO组（n = 98）和HC组（n = 97）。在标准化条件下使用酶联免疫吸附测定（ELISA）测量血清神经肽水平。使用发作频率和头痛影响测试-6（HIT-6）评分评估临床特征。

结果

与对照组相比，偏头痛患者的所有三种神经肽均显著升高（P <.001）。MA组中CGRP水平最高（45.6±8.2 pg/mL），其次是MO组（38.4±7.8 pg/mL）和HC组（28.3±6.4 pg/mL）。VIP（MA组：186.4±24.6，MO组：165.8±22.4，HC组：142.3±20.8 pg/mL）和PACAP-38（MA组：248.6±32.4，MO组：228.5±30.6，HC组：195.4±28.2 pg/mL）也观察到类似模式。与MO组患者相比，MA组患者的发作频率略高（4.8±2.3次/月对4.2±2.1次/月，P =.06），HIT-6评分略高（64.8±6.2对62.4±5.8，P =.08）。