Migren ve periferik inflamasyon

Yıl 2017, Cilt: 1 Sayı: 3, 127 - 134, 15.12.2017

Aynur Yılmaz Avcı , Oktay Akalin

https://doi.org/10.30565/medalanya.336902

Cited By: 2

Öz

Amaç: Migren inflamasyon ve  vasküler hastalıklar ile ilişkili olabilen
yaygın bir baş ağrısı türüdür. Biz genç erişkin migren hastalarında C-reaktif
protein ve periferik kandaki bağışık hücre sayısını değerlendirdik.

Hastalar ve Yöntem: Bu olgu-kontrol çalışması,
260 migren hastası (aurasız, 169 olgu, auralı, 91 olgu) ve 260 sağlıklı kontrol
katılımcı (yaş aralığı, 18-50 yıl) olmak üzere 520 kişiyi içermektedir.
Katılımcıların hiçbirinde bilinen bir anemi, vasküler risk faktörü veya
inflamatuar hastalık yoktu. Migren ve kontrol olgularında serum C-reaktif
protein ve tam kan sayımı parametrelerini değerlendirdik.

Bulgular: C-reaktif protein, lökosit, nötrofil,
lenfosit, trombosit sayıları ve ortalama trombosit hacmi migren hastalarında
kontrol grubuna (P <0.001) oranla anlamlı olarak farklıydı. Ancak bu
parametreler, C-reaktif protein hariç, auralı ve aurasız migrenlerde benzerdi.
Lojistik regresyon analizinde migren hastalığı C-reaktif protein seviyesi (OR,
2.36; 95% CI, 1.73 ile 3.23; P< 0.001), ortalama trombosit hacmi (odds ratio
[OR], 2.32; 95% confidence interval [CI], 1.78 - 3.0; P<0.001), ve lökosit
sayısı (OR, 1.61; 95% CI, 1.32 - 1.94; P< 0.001) ile anlamlı olarak
ilişkiliydi. 

Sonuç: Periferik inflamasyonun artmış seviyeleri
migren hastalarında ortaya çıkabilir ve migren patogenezinde rol oynayabilir.           

Anahtar Kelimeler

Tam kan sayımı, C-reaktif protein, başağrısı, lökosit, lenfosit, trombosit

Migraine and peripheral inflammation

Öz

Aim: Migraine is a common
headache disorder that may be associated with inflammation and vascular
diseases. We evaluated C-reactive protein and the number of immune cells in the
peripheral blood of young adult patients with migraine.

Patients and
Methods:
This case–control study included 520 subjects: 260 patients with migraine
(without aura, 169 patients; with aura, 91 patients) and 260 healthy control
subjects (age range, 18–50 years). Participants had no known anemia, vascular
risk factors, or inflammatory diseases. We evaluated serum C-reactive protein
and complete blood count parameters in patients with migraine and control
subjects.

Results: C-reactive protein level,
leukocyte, neutrophillymphocyte, platelet counts and mean platelet volume
significantly differed in patients with migraine compared to controls
(P<0.001). However, with the exception of C-reactive protein, these
parameters were similar in migraine with and without aura. Logistic regression
analysis showed that migraine was significantly associated with C-reactive
protein level (odds ratio [OR], 2.36; 95% confidence interval [CI],
1.73–3.23; P<0.001), MPV (OR, 2.32; 95% CI, 1.78–3.0;
P<0.001), and leukocyte count (OR, 1.61; 95% CI,
1.32–1.94;).

Conclusion: Increased levels of
peripheral inflammation may occur in patients with migraine and may be involved
in the pathogenesis of migraine.

Anahtar Kelimeler

Complete blood count, C-reactive protein, headache, leukocyte, lymphocyte, platelet

Kaynakça

• 1. Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001;41(7):646–57.
• 2. Waeber C, Moskowitz MA. Migraine as an inflammatory disorder. Neurology. 2005;64(10 Suppl 2):S9–S15.
• 3. Bolay H, Reuter U, Dunn AK, Huang Z, Boas DA, Moskowitz MA. Intrinsic brain activity triggers trigeminal meningeal afferents in migraine model. Nat Med. 2002;8(2):136–42.
• 4. Moskowitz MA. The neurobiology of vascular head pain. Neurology. 1984;16(2):157–168.
• 5. Markowitz S, Saito K, Moskowitz MA. Neurogenically mediated leakage of plasma protein occurs from blood vessels in dura mater but not brain. J Neurosci. 1987;7(12):4129–36.
• 6. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extrecerebral circulation of humans during migraine headache. Ann Neurol. 1990;28(2):183–7.
• 7. Kemper RH, Meijer WJ, Korf J, Ter Horst GJ. Migraine and function of the immune system: a meta-analysis of clinical literature published between 1966 and 1999. Cephalalgia. 2001;21(5):549–57.
• 8. Sarchielli P, Alberti A, Baldi A, Coppola F, Rossi C, Pierguidi L, et al. Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache. 2006;46(2):200–7.
• 9. Bassuk SS, Rifai N, Ridker PM. High-sensitivity C-reactive protein: clinical importance. Curr Probl Cardiol. 2004;29(8):439–93.
• 10. Emerging Risk Factors Collaboration, Kaptoge S, Di Angelantonio E, Pennells L, Wood AM, White IR, Gao P, et al. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med. 2012;367(14):1310–20. 11. Vanmolkot FH, de Hoon JN. Increased C-reactive protein in young adult patients with migraine. Cephalalgia. 2007;27(7):843–846.
• 12. Yilmaz Avci A, Lakadamyali H, Arikan S, Benli US, Kilinc M. High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients. J Headache Pain. 2015;16:9.
• 13. Phillipson M, Kubes P. The neutrophil in vascular inflammation. Nat Med. 2011;17(11):1381–90.
• 14. Soehlein O. Multiple roles for neutophils in atherosclerosis. Circ Res. 2012;110(6):875–88.
• 15. Libby P, Nahrendorf M, Swirski FK. Leukocytes link local and systemic inflammation in ischemic cardiovascular disease: an expanded “Cardiovascular Continuum.” J Am Coll Cardiol. 2016;67(9):1091–103.
• 16. Lahoute C, Herbin O, Mallat Z, Tedgui A. Adaptive immunity in atherosclerosis: mechanisms and future therapeutic targets. Nat Rev Cardiol. 2011;8(6):348–58.
• 17. Kaplan ZS, Jackson SP. The role of platelets in atherothrombosis. Hematology Am Soc Hematol Educ Program. 2011;2011:51–81.
• 18. Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest. 2005;115(12):3378–84.
• 19. Danese E, Montagnana M, Lippi G. Platelets and migraine. Thromb Res. 2014;134(1):17–22.
• 20. Zeller JA, Frahm K, Baron R, Stingele R, Deuschl G. Platelet-leukocyte interaction and platelet activation in migraine: a link to ischemic stroke? J Neurol Neurosurg Psychiatry. 2004;75(7):984–7.
• 21. Forcelini CM, Dantas DC, Luz C, Santin R, Stein AT, Barros HM, Barea LM. Analysis of leukocytes in medication-overuse headache, chronic migraine, and episodic migraine. Headache. 2011;51(8):1228–38.
• 22. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(suppl 1):9–160.
• 23. Cseh A, Farkas KM, Derzbach L, Muller K, Vasarhelyi B, Szalay B, Treszi A, Farkas V. Lymphocyte subsets in pediatric migraine. Neurol Sci. 2013;34(7):1151–5.
• 24. Leone M, Biffi M, Leoni F, Bussone G. Leukocyte subsets and cortisol serum levels in patients with migraine without aura and chronic tension-type headache. Cephalalgia. 1994;14(2):139–42.
• 25. Gilman-Sachs A, Robbins L, Baum L. Flow cytometric analysis of lymphocyte subsets in peripheral blood of chronic headache patients. Headache. 1989;29(5):290–4.
• 26. Karabulut KU, Egercioglu TU, Uyar M, Ucar Y. The change of neutrophils/lymphocytes ratio in migraine attacks: a case-controlled study. Ann Med Surg. 2016;27(10):52–6.
• 27. Rathod KS, Kapil V, Velmurugan S, Khambata RS, Siddique U, Khan S, Van Eijl S, Gee LC, Bansal J, Pitrola K, Shaw C, D'Acquisto F, Colas RA, Marelli-Berg F, Dalli J, Ahluwalia A. Accelerated resolution of inflammation underlies sex differences in inflammatory responses in humans. J Clin Invest. 2017;127(1):169–82.
• 28. Zhou P, Meng Z, Liu M, Ren X, Zhu M, He Q, et al. The associations between leukocyte, erythrocyte or platelet, and metabolic syndrome in different genders of Chinese. Medicine. 2016;95(44):e5189.
• 29. Nelson KB, Richardson AK, He J, Lateef TM, Khoromi S, Merikangas KR. Headache and biomarkers predictive of vascular disease in a representative sample of US children. Arch Pediatr Adolesc Med. 2010;164(4):358–62.
• 30. Pradalier A, Abuaf N, Launay JM, Vincent D. Platelet size and volume distribution measured by automated platelet analyzer. Cephalalgia. 1992;12(5):321–2.
• 31. Peatfield RC, Gawel MJ, Guthrie DL, Pearson TC, Glover V, Littlewood J, et al. Platelet size: no correlation with migraine or monoamine oxidase activity. J Neurol Neurosurg Psychiatry. 1982;45(9):826–9.
• 32. Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Matowicka-Karna J, Radziwon P, Lipska A. Platelet count, mean platelet volume and thrombocytopoietic indices in healthy women and men. Thromb Res. 2006;118(2):199–204.
• 33. Bain BJ. Platelet count and platelet size in males and females. Scand J Haematol. 1985;35(1):77–9.
• 34. Varol S, Akıl E, Çevik MU, Çelepkolu T, Yücel Y, Tanrıverdi MH, Aluçlu MU, Uzar E. Migrenli hastaların kanında ortalama trombosit hacmi ve trombosit sayısının araştırılması. Turk J Neurol. 2013;23(2):90–2.
• 35. McCabe DJ, Harrison P, Sidhu PS, Brown MM, Machin SJ. Circulating reticulated platelets in the early and late phases after ischaemic stroke and transient ischaemic attack. Br J Haematol. 2004;126(6):861–9.
• 36. Gudmundsson LS, Aspelund T, Scher AI, Thorgeirsson G, Johannsson M, Launer LJ, et al. C-reactive protein in migraine sufferers similar to that of non-migraineurs: the Reykjavik Study. Cephalalgia. 2009;29(12):1301–10.