Baseline tear fluid CGRP is elevated in active cluster headache patients as long as they have not taken attack abortive medication

Kamm, Katharina; Straube, Andreas und Ruscheweyh, Ruth (2020): Baseline tear fluid CGRP is elevated in active cluster headache patients as long as they have not taken attack abortive medication. In: Cephalalgia, Bd. 41, Nr. 1: S. 69-77

Abstract

Background: Calcitonin gene-related peptide plays a key role in cluster headache pathophysiology. It is released from the trigeminal nerve, which also innervates the eye. In this study, we tested if tear fluid calcitonin gene-related peptide measurement detects elevated calcitonin gene-related peptide levels in cluster headache patients compared to controls. Methods: Calcitonin gene-related peptide concentration in tear fluid and plasma of 16 active episodic and 11 chronic cluster headache patients (all outside acute attacks) and 60 controls were assessed using ELISA. Results: Cluster headache patients without use of attack abortive medication in the last 48 h showed significantly elevated tear fluid calcitonin gene-related peptide levels (1.78 +/- 1.57 ng/ml, n = 17) compared to healthy controls (0.79 +/- 0.74 ng/ml,p = 0.003) and compared to cluster headache patients who had used attack abortive medication in the last 48 h (0.84 +/- 1.40 ng/ml, n = 10,p = 0.022). High calcitonin gene-related peptide levels in cluster headache patients were independent of the occurrence of a cluster headache attack in the last 48 hours (no attack: 1.95 +/- 1.65 ng/ml, n = 8;attack: 1.63 +/- 1.59 ng/ml, n = 9,p = 0.82) as long as no acute medication was used. No significant difference in tear fluid calcitonin gene-related peptide levels between episodic (1.48 +/- 1.34 ng/ml) and chronic cluster headache patients (2.21 +/- 1.88 ng/ml,p = 0.364) was detected. In contrast to these results in tear fluid, there were no significant group differences in plasma calcitonin gene-related peptide levels. Conclusion This study shows that active cluster headache patients have increased calcitonin gene-related peptide levels in tear fluid compared to healthy subjects, which are reduced to control levels after intake of attack abortive medication. Calcitonin gene-related peptide measurement in tear fluid is non-invasive, and has the advantage of allowing direct access to calcitonin gene-related peptide released from the trigeminal nerve.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0333-1024
• Sprache: Englisch