Krekora Jan, Fila Michal, Mitus-Kenig Maria, Pawlowska Elzbieta, Ciupinska Justyna, Blasiak Janusz
2nd Department of Cardiology, Medical University of Lodz, 92-213 Lodz, Poland.
Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
Int J Mol Sci. 2025 Jul 10;26(14):6634. doi: 10.3390/ijms26146634.
The prevalence of stroke in patients with migraine is higher than in the general population, suggesting certain shared mechanisms of pathogenesis. Migrainous infarction is a pronounced example of the migraine-stroke connection. Some cases of migraine with aura may be misdiagnosed as stroke, with subsequent mistreatment. Therefore, it is important to identify these shared mechanisms of pathogenesis contributing to the migraine-stroke connection to improve diagnosis and treatment. Sirtuins (SIRTs) are a seven-member family of NAD-dependent histone deacetylases that can epigenetically regulate gene expression. Sirtuins possess antioxidant properties, making them a first-line defense against oxidative stress, which is important in the pathogenesis of migraine and stroke. Mitochondrial localization of SIRT2, SIRT3, and SIRT4 supports this function, as most reactive oxygen and nitrogen species are produced in mitochondria. In this narrative review, we present arguments that sirtuins may link migraine with stroke through their involvement in antioxidant defense, mitochondrial quality control, neuroinflammation, and autophagy. We also indicate mediators of this involvement that can be, along with sirtuins, therapeutic targets to ameliorate migraine and prevent stroke.
偏头痛患者中风的患病率高于普通人群，提示存在某些共同的发病机制。偏头痛性脑梗死是偏头痛与中风关联的一个显著例子。一些伴有先兆的偏头痛病例可能被误诊为中风，进而导致后续的错误治疗。因此，识别这些导致偏头痛与中风关联的共同发病机制对于改善诊断和治疗至关重要。沉默调节蛋白（SIRTs）是一个由七个成员组成的NAD依赖性组蛋白脱乙酰酶家族，可通过表观遗传方式调节基因表达。沉默调节蛋白具有抗氧化特性，使其成为对抗氧化应激的一线防御，而氧化应激在偏头痛和中风的发病机制中起着重要作用。SIRT2、SIRT3和SIRT4的线粒体定位支持了这一功能，因为大多数活性氧和氮物种是在线粒体中产生的。在这篇叙述性综述中，我们提出了一些观点，即沉默调节蛋白可能通过参与抗氧化防御、线粒体质量控制、神经炎症和自噬将偏头痛与中风联系起来。我们还指出了这种参与的介质，它们与沉默调节蛋白一起可以成为改善偏头痛和预防中风的治疗靶点。
