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Sudershan A, Sudershan S, Sharma I, Kumar H, Panjaliya RK, Kumar P. Role of TNF -α in the Pathogenesis of Migraine. Pain Res Manag 2024; 2024:1377143. [PMID: 38213956 PMCID: PMC10781531 DOI: 10.1155/2024/1377143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/12/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Abstract
Background Neurogenic neuroinflammation has a wide role in migraine pathogenesis including the transition from episodic migraine to chronic one. The seed molecule of neurogenic neuroinflammation, i.e., the TNF-α proinflammatory molecule, has gathered a lot of attention. This pleiotropic cytokine is a classical component of inflammatory soup, secreted by the microglial cell, and promotes a wide range of inflammatory reactions. Aim In this review, we aimed to provide a culminating and comprehending glimpse into the TNF-α in association with the migraine. Method A systematic literature survey method with a mixture of keywords was utilized to grasp the different elements that represent the association between TNF-α and migraine. Discussion. Highlighted the probable involvement of the TNF-α with migraine, the complexity of the matter such as activation of NF-KB signaling cascade, autoactivation, sensitization, and increased likelihood of transition cannot be neglected. Being TNF-α as a core node, it becomes the factor for linking diseases such as chronic inflammatory disorders, including COVID-19, and also interaction with other genes to develop severe conditions. Conclusion To this end, TNF-α plays a critical role in chronification, and inhibiting its signaling would likely be a crucial strategy for migraine therapy.
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Affiliation(s)
- Amrit Sudershan
- Department of Human Genetics, Sri Pratap College Srinagar, Cluster University Srinagar, Srinagar 190001, Jammu and Kashmir, India
- Institute of Human Genetics, University of Jammu, Jammu 180006, Jammu & Kashmir, India
| | - Srishty Sudershan
- Department of Zoology, University of Jammu, Jammu 180006, Jammu & Kashmir, India
| | - Isha Sharma
- Institute of Human Genetics, University of Jammu, Jammu 180006, Jammu & Kashmir, India
- Department of Zoology, University of Jammu, Jammu 180006, Jammu & Kashmir, India
| | - Hardeep Kumar
- Department of Neurology, Super Specialty Hospital, Jammu 180006, Jammu and Kashmir, India
| | - Rakesh K. Panjaliya
- Department of Zoology, University of Jammu, Jammu 180006, Jammu & Kashmir, India
| | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu 180006, Jammu & Kashmir, India
- Department of Zoology, University of Jammu, Jammu 180006, Jammu & Kashmir, India
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Sudershan A, Sudershan S, Younis M, Bhagat M, Pushap AC, Kumar H, Kumar P. Enlightening the association between TNF-α -308 G > A and migraine: a meta-analysis with meta-regression and trial sequential analysis. BMC Neurol 2023; 23:159. [PMID: 37085790 PMCID: PMC10120225 DOI: 10.1186/s12883-023-03174-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/21/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Migraine is a complex neurological disorder that is characterized by a "lower threshold of neuronal hyperexcitability" with distinctive periodicity and complex vascular dysfunction. Genetic factors have impacted incredibly on the susceptibility of migraine and one such example is the TNF-α 308G > A. AIM Therefore, we aim to provide a glimpse of the association of the TNF-α 308G > A risk on the susceptibility of migraine. METHOD The pooled odds ratio with the associated 95% of confidence interval were calculated using different genetic models. Heterogeneity was accessed by using Cochran's Q Test and I2 statistics and Begg's and Egger's tests were used for finding the publication bias, tests were two-sided, and a p-value of < 0.05 was considered statistically significant. The Trial Sequential Analysis with Meta-regression Analysis were also utilized to find out the sample size requirement for meta-analysis to avoid type I error and source of heterogeneity respectively. RESULT A total of 13 studies with cases: 7193 and controls: 23,091 were included and after using different genetic models, no overall association with migraine and its clinical subtype migraine with aura was observed (Allele model "OR: 1.28, 95% C.I. [0.96-1.69] and OR: 0.99,95% C.I. [0.69-1.42]) respectively. Interestingly, after sub-grouping using the "ethnicity criteria" in the migraine group, it was observed that the allelic genetic model and the dominant model were found to be significantly associated with the Asian ethnic group (OR: 1.79, 95% C.I. [1.13-2.84], and OR: 1.85, 95% C.I. [1.0927; 3.1580]. CONCLUSION In conclusion, the present meta-analysis has provided evidence that 308G > A increases the risk of migraine only in the Asian population.
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Affiliation(s)
- Amrit Sudershan
- Institute of Human Genetics, University of Jammu, Jammu & Kashmir, Jammu, India, 180006
- Department of Human Genetics, Sri Pratap College, Cluster University of Srinagar, Jammu & Kashmir, Kashmir, India
| | - Srishty Sudershan
- Department of Zoology, University of Jammu, Jammu and Kashmir, Jammu, India, 180006
| | - Mohd Younis
- Institute of Human Genetics, University of Jammu, Jammu & Kashmir, Jammu, India, 180006
| | - Meenakshi Bhagat
- Department of Zoology, University of Jammu, Jammu and Kashmir, Jammu, India, 180006
| | - Agar Chander Pushap
- Department of Education, Dakshina Bharat Hindi Prachar Sabha, Madras, India, 600017
| | - Hardeep Kumar
- Department of Neurology, Super Specialty Hospital, Jammu and Kashmir, Jammu, India, 180006
| | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu & Kashmir, Jammu, India, 180006.
- Department of Zoology, University of Jammu, Jammu and Kashmir, Jammu, India, 180006.
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Sudershan A, Younis M, Sudershan S, Kumar P. Migraine as an inflammatory disorder with microglial activation as a prime candidate. Neurol Res 2023; 45:200-215. [PMID: 36197286 DOI: 10.1080/01616412.2022.2129774] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
BACKGROUND The lower threshold of neuronal hyperexcitability has been correlated with migraines for decades but as technology has progressed, it has now become conceivable to learn more about the migraine disease. Apart from the "cortical spreading depression" and "activation of the trigeminovascular system", inflammation has been increasingly recognized as a possible pathogenic process that may have the possibility to regulate the disease severity. Microglial cells, the prime candidate of the innate immune cells of central nervous tissue, has been associated with numerous diseases; including cancer, neurodegenerative disorders, and inflammatory disorders. AIM In this review, we have attempted to link the dot of various microglial activation signaling pathways to enlighten the correlation between microglial involvement and the progression of migraine conditions. METHOD A structured survey of research articles and review of the literature was done in the electronic databases of Google Scholar, PubMed, Springer, and Elsevier until 31 December 2021. RESULT & CONCLUSION Of 1136 articles found initially and screening of 1047 records, 47 studies were included for the final review. This review concluded that inflammation and microglial overexpression as the prime candidate, plays an important role in the modulation of migraine and are responsible for the progression toward chronification. Therefore, this increases the possibility of preventing migraine development and chronification by blocking microglia overexpression.
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Affiliation(s)
- Amrit Sudershan
- Institute of Human Genetics, University of Jammu, Jammu and Kashmir 180006, India
| | - Mohd Younis
- Department of Human Genetics and Molecular Biology, Bharathair University, Coimbatore, 641046, India
| | - Srishty Sudershan
- Department of Zoology, University of Jammu, Jammu and Kashmir, 180006, India
| | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu and Kashmir 180006, India.,Department of Zoology, University of Jammu, Jammu and Kashmir, 180006, India
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Biscetti L, De Vanna G, Cresta E, Bellotti A, Corbelli I, Letizia Cupini M, Calabresi P, Sarchielli P. Immunological findings in patients with migraine and other primary headaches: a narrative review. Clin Exp Immunol 2022; 207:11-26. [PMID: 35020858 PMCID: PMC8802184 DOI: 10.1093/cei/uxab025] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/14/2021] [Accepted: 11/24/2021] [Indexed: 12/17/2022] Open
Abstract
Experimental findings suggest an involvement of neuroinflammatory mechanisms in the pathophysiology of migraine. Specifically, preclinical models of migraine have emphasized the role of neuroinflammation following the activation of the trigeminal pathway at several peripheral and central sites including dural vessels, the trigeminal ganglion, and the trigeminal nucleus caudalis. The evidence of an induction of inflammatory events in migraine pathophysiological mechanisms has prompted researchers to investigate the human leukocyte antigen (HLA) phenotypes as well as cytokine genetic polymorphisms in order to verify their potential relationship with migraine risk and severity. Furthermore, the role of neuroinflammation in migraine seems to be supported by evidence of an increase in pro-inflammatory cytokines, both ictally and interictally, together with the prevalence of Th1 lymphocytes and a reduction in regulatory lymphocyte subsets in peripheral blood of migraineurs. Cytokine profiles of cluster headache (CH) patients and those of tension-type headache patients further suggest an immunological dysregulation in the pathophysiology of these primary headaches, although evidence is weaker than for migraine. The present review summarizes available findings to date from genetic and biomarker studies that have explored the role of inflammation in primary headaches.
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Affiliation(s)
- Leonardo Biscetti
- Istituto Nazionale di Riposo e Cura dell'Anziano a carattere scientifico, IRCSS-INRCA, Ancona, Italy
| | - Gioacchino De Vanna
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Cresta
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alessia Bellotti
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ilenia Corbelli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - Paolo Calabresi
- Department of Neuroscience, Università Cattolica Sacro Cuore, Rome, Italy.,Neurologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Paola Sarchielli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Hamad N, Alzoubi KH, Swedan SF, Khabour OF, El-Salem K. Association between tumor necrosis factor alpha and lymphotoxin alpha gene polymorphisms and migraine occurrence among Jordanians. Neurol Sci 2021; 42:3625-3630. [PMID: 33433759 DOI: 10.1007/s10072-020-04967-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/05/2020] [Indexed: 12/31/2022]
Abstract
Inflammatory reactions in the body have been shown to contribute to migraine development. Therefore, genes involved in the inflammatory pathways might play a role in the susceptibility and development of migraine. In this study, polymorphisms in tumor necrosis factor alpha (TNFα) and lymphotoxin alpha (LTA) genes were tested for association with migraine. A total of 398 participants (198 migraine patients and 200 controls) were recruited in the study. Serum TNF level was measured using a sandwich ELISA kit. Lymphocytes' and monocytes' counts were obtained from a differential complete blood count profile. Participants' DNA was extracted and genotyped for rs1800629 and rs1799724 in TNFα, and rs909253 in LTA. Controls had a significantly higher mean lymphocyte count (P = 0.018), while the mean monocyte count and serum TNFα levels did not differ between the two groups (P > 0.05). With respect to gene polymorphisms, the rs1800629 and rs1799724 variants showed significant association with migraine in all subjects, and in males and females when analyzed separately (P < 0.001). The rs909253 did not show any statistical difference in frequencies among the two groups (P > 0.05). Having the A allele in rs1800629 was associated with a higher risk of migraine in both male (OR, 95%; CI, G/A = 3.79 [1.87-7.69]; A/A = 14.22 [1.67-121.14]; P < 0.01) and female (OR, 95%; G/A = 2.54 [1.47-4.38]; A/A = 2.52 [1.12-5.69]; P < 0.001) subjects. In conclusion, rs1800629 and rs1799724 in TNFα showed significant association with migraine among the Jordanian population.
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Affiliation(s)
- Nour Hamad
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Samer F Swedan
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Khalid El-Salem
- Department of Neurosciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Li C, Zhu Q, He Q, Wang J, Wang F, Zhang H. Plasma Levels of Cyclooxygenase-2 (COX-2) and Visfatin During Different Stages and Different Subtypes of Migraine Headaches. Med Sci Monit 2017; 23:24-28. [PMID: 28044053 PMCID: PMC5226301 DOI: 10.12659/msm.899269] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background The aim of this study was to determine the plasma levels of cyclooxygenase-2 (COX-2) and visfatin in different stages and different subtypes of migraine headaches compared to a control group to elucidate the pathological mechanisms involved. Material/Methods We recruited a case-control cohort of 182 adult migraine patients and 80 age-matched and gender-matched healthy controls. The migraine patients were divided into two groups: the headache-attack-period group (Group A, n=77) and the headache-free-period group (Group B, n=105). The two groups were further divided into subgroups according to whether they had aura symptoms. Solid phase double antibody sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the plasma levels of COX-2 and visfatin. Statistical analysis was performed using SPSS 17.0. Results The plasma levels of COX-2 and visfatin in the headache-attack-period group were significantly higher than in the headache-free-period group and the control group; there were no significant differences between the headache-free group and the control group. There were no significant differences in plasma levels of COX-2 and visfatin between the subgroups: headache-attack-period with aura subgroup and the headache-attack-period without aura sub group. Conclusions COX-2 and visfatin participated in the pathogenesis of migraine headaches. The presence of aura had no effect on the serum levels of COX-2 and visfatin.
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Affiliation(s)
- Chao Li
- Department of Neurology, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China (mainland)
| | - Qiushi Zhu
- Department of Neurosurgery, Liaocheng Center Hospital, Liaocheng, Shandong, China (mainland)
| | - Qiu He
- Department of Neurology, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China (mainland)
| | - Junwei Wang
- Department of Neurology, The Fourth Hospital of Chongqing, Chongqing, China (mainland)
| | - Fengzhi Wang
- Department of Neurology, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China (mainland)
| | - Hemin Zhang
- Department of Neurology, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China (mainland)
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Zhang LM, Dong Z, Yu SY. Migraine in the era of precision medicine. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:105. [PMID: 27127758 DOI: 10.21037/atm.2016.03.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Migraine is a common neurovascular disorder in the neurologic clinics whose mechanisms have been explored for several years. The aura has been considered to be attributed to cortical spreading depression (CSD) and dysfunction of the trigeminovascular system is the key factor that has been considered in the pathogenesis of migraine pain. Moreover, three genes (CACNA1A, ATP1A2, and SCN1A) have come from studies performed in individuals with familial hemiplegic migraine (FHM), a monogenic form of migraine with aura. Therapies targeting on the neuropeptids and genes may be helpful in the precision medicine of migraineurs. 5-hydroxytryptamine (5-HT) receptor agonists and calcitonin gene-related peptide (CGRP) receptor antagonists have demonstrated efficacy in the acute specific treatment of migraine attacks. Therefore, ongoing and future efforts to find new vulnerabilities of migraine, unravel the complexity of drug therapy, and perform biomarker-driven clinical trials are necessary to improve outcomes for patients with migraine.
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Affiliation(s)
- Lv-Ming Zhang
- 1 Department of Neurology, Aerospace Center Hospital/Aerospace Clinical Medical College Affiliated to Peking University, Beijing 100049, China ; 2 Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhao Dong
- 1 Department of Neurology, Aerospace Center Hospital/Aerospace Clinical Medical College Affiliated to Peking University, Beijing 100049, China ; 2 Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
| | - Sheng-Yuan Yu
- 1 Department of Neurology, Aerospace Center Hospital/Aerospace Clinical Medical College Affiliated to Peking University, Beijing 100049, China ; 2 Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
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Chen H, Ji CX, Zhao LL, Kong XJ, Zeng XT. Association Between Polymorphisms of DRD2, COMT, DBH, and MAO-A Genes and Migraine Susceptibility: A Meta-Analysis. Medicine (Baltimore) 2015; 94:e2012. [PMID: 26632697 PMCID: PMC5058966 DOI: 10.1097/md.0000000000002012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Some epidemiological studies have investigated the relationship between genetic polymorphisms of DRD2, COMT, DBH, and MAO-A and migraine susceptibility, but the results are still inconsistent. Thus, our aim was to further assess the association through a meta-analysis.We examined 5 single nucleotide polymorphisms (SNPs) in 4 genes, including DRD2 rs1799732 and rs6275, DBH rs7239728, MAI-A-VNTR, and COMT rs4680, and performed a meta-analysis of 11 published case-control studies including 3138 cases and 4126 controls. Odd ratios (ORs) with 95% confidence intervals (95% CIs) were used to evaluate the association between the 5 genetic polymorphisms and migraine susceptibility.There was no significant relationship between migraine susceptibility and 4 genetic polymorphisms of DRD2 rs1799732 and rs6275, DBH rs7239728, and MAO-A-VNTR. Nevertheless, decreased risk of migraine was observed to be in association with COMT rs4680 polymorphism in overall analysis (AA vs. GG + GA: OR = 0.76, 95% CI = 0.60-0.97, PHet > 0.642, I = 0), and in Caucasian group after subgroup analysis (AA vs. GG + GA: OR = 0.75, 95% CI = 0.58-0.96, PHet > 0.433, I = 0).Studied polymorphisms of DRD2, DBH, and MAO-A genes may not be associated with migraine susceptibility. However, COMT rs4680 polymorphism may decrease the risk of migraine, especially in Caucasians. The failure to evaluate environmental influence and provide adjusted effect size estimates highlights the need for additional studies in a large number to take these factors into consideration, thus better elucidating the role of the genes tested in migraine.
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Affiliation(s)
- Hu Chen
- From Department of Scientific Research, Cangzhou Central Hospital, Cangzhou, Hebei Province, China (HC); Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China (C-XJ, HC); Department of Human Resources, Cangzhou Central Hospital, Cangzhou, Hebei Province, China (L-LZ); Central Laboratory, Cangzhou Central Hospital, Cangzhou, Hebei Province, China (X-JK); and Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China (X-TZ)
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