1
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Ha WS, Chu MK. Altered immunity in migraine: a comprehensive scoping review. J Headache Pain 2024; 25:95. [PMID: 38844851 PMCID: PMC11157828 DOI: 10.1186/s10194-024-01800-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The pathogenesis of migraine remains unclear; however, a large body of evidence supports the hypothesis that immunological mechanisms play a key role. Therefore, we aimed to review current studies on altered immunity in individuals with migraine during and outside attacks. METHODS We searched the PubMed database to investigate immunological changes in patients with migraine. We then added other relevant articles on altered immunity in migraine to our search. RESULTS Database screening identified 1,102 articles, of which 41 were selected. We added another 104 relevant articles. We found studies reporting elevated interictal levels of some proinflammatory cytokines, including IL-6 and TNF-α. Anti-inflammatory cytokines showed various findings, such as increased TGF-β and decreased IL-10. Other changes in humoral immunity included increased levels of chemokines, adhesion molecules, and matrix metalloproteinases; activation of the complement system; and increased IgM and IgA. Changes in cellular immunity included an increase in T helper cells, decreased cytotoxic T cells, decreased regulatory T cells, and an increase in a subset of natural killer cells. A significant comorbidity of autoimmune and allergic diseases with migraine was observed. CONCLUSIONS Our review summarizes the findings regarding altered humoral and cellular immunological findings in human migraine. We highlight the possible involvement of immunological mechanisms in the pathogenesis of migraine. However, further studies are needed to expand our knowledge of the exact role of immunological mechanisms in migraine pathogenesis.
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Affiliation(s)
- Woo-Seok Ha
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Fukutomi Y, Tanaka H, Sekiya K, Watai K, Hamada Y, Iwata M, Saito A, Okabe K, Sugiyama A, Fukushima T, Oshikawa C, Uetake H, Yoshisue H, Irie T, Kishikawa R. Uncovering a Severe Patient Group With Pollen-Related Extrarespiratory Allergic Symptoms: A Year-Long Diary Survey in Japan. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1495-1506.e7. [PMID: 38382879 DOI: 10.1016/j.jaip.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The most common symptoms of pollen allergy are rhinitis and conjunctivitis. However, in real-world clinical practice, we sometimes encounter patients with pollen allergy suffering from severe extrarespiratory symptoms including skin, gastrointestinal, or flu-like symptoms in relation to exposure to sensitized pollen. OBJECTIVE To elucidate the extrarespiratory symptoms in patients with pollen allergy. METHODS We performed a non-drug-focused prospective study of patients with pollen allergy (n = 384). During the 1-year observational period, they were asked to complete a weekly electronic diary consisting of visual analog scale (VAS) scores to assess all symptoms experienced in various organs over the past week. An association between seasonal pollen levels and seasonal increase in VAS scores was evaluated using a mixed-effects model for repeated measures. A k-means cluster analysis was performed to identify a group of patients experiencing stronger extrarespiratory symptoms. RESULTS In patients sensitized to grass or birch pollen, higher seasonal levels of these pollen grains were associated with higher VAS scores for headache, gastrointestinal symptoms, skin symptoms, and fatigue. A cluster analysis identified a group of severe pollen-allergic patients with higher extrarespiratory symptoms (n = 42). This group was characterized by a higher frequency of comorbid food allergy/atopic dermatitis, higher rate of IgE sensitization to pollens, and higher impaired activity and work productivity. CONCLUSIONS This 1-year survey identified a small but nonnegligible group of patients with pollen-related extrarespiratory symptoms. More attention should be paid to this patient group considering their impaired activity and work productivity.
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Affiliation(s)
- Yuma Fukutomi
- NHO Sagamihara National Hospital, Sagamihara, Japan.
| | | | | | | | - Yuto Hamada
- NHO Sagamihara National Hospital, Sagamihara, Japan
| | - Maki Iwata
- NHO Sagamihara National Hospital, Sagamihara, Japan
| | - Akemi Saito
- NHO Sagamihara National Hospital, Sagamihara, Japan
| | - Koki Okabe
- NHO Fukuoka National Hospital, Fukuoka, Japan
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3
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Lv H, Liu K, Xie Y, Wang Y, Chen S, Liu P, Guan M, Cong J, Xu Y. No causal association between allergic rhinitis and migraine: a Mendelian randomization study. Eur J Med Res 2024; 29:78. [PMID: 38281051 PMCID: PMC10821569 DOI: 10.1186/s40001-024-01682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Allergic rhinitis (AR) and migraine are among the most common public health problems worldwide. Observational studies on the correlation between AR and migraine have reported inconsistent results. This study aimed to investigate the causal relationship of AR with migraine and its subtypes, including migraine with aura (MA) and migraine without aura (MO). METHODS Bidirectional two-sample Mendelian randomization (MR) analysis was performed with publicly available summary-level statistics of large genome-wide association studies to estimate the possible causal effects. The inverse variance-weighted method was selected for primary analysis and was supplemented with the weighted median, weighted mode, and MR-Egger methods. The causal analysis using summary effect estimates (CAUSE) were further performed to verify the causality. Several sensitivity tests, including the leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO tests, were performed to assess the robustness of the results. RESULTS AR did not exhibit a significant causal correlation with the elevated risk of any migraine (odd ratio (OR), 0.816; 95% confidence interval (CI), 0.511-1.302; P = 0.394), MA (OR, 0.690; 95% CI 0.298-1.593; P = 0.384), or MO (OR, 1.022; 95% CI 0.490-2.131; P = 0.954). Consistently, reverse MR analysis did not reveal causal effects of any migraine or its subtypes on AR. Almost all sensitivity analyses supported the robustness of the results. CONCLUSIONS This MR study did not reveal a clear causal association between AR and migraine risk. More research is warranted to reveal the complex association between AR and migraine.
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Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Kunyu Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yulie Xie
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yunfei Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Siyuan Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Peiqiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Mengting Guan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Jianchao Cong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, 430071, Hubei, China.
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Feroz S, Dawood MH, Sohail S, Daniyal M, Zafar A, Shahid UB, Ahmed S. A longitudinal prospective study of septoplasty impact on headache and allergic rhinitis in patients with septal deviation. J Int Med Res 2023; 51:3000605231215168. [PMID: 38000047 PMCID: PMC10676068 DOI: 10.1177/03000605231215168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE To measure the severity of allergic rhinitis (AR) and different types of headaches in patients with septal deviation before and after septoplasty. METHODS This multicentre, prospective, longitudinal, observational study enrolled patients with deviated nasal septum, nasal symptoms and headaches associated with persistent AR lasting at least 2 months without resolution. The nasal obstruction evaluation (NOSE) scale, immunoglobulin-E (Ig-E) levels and visual analogue scale (VAS) for headache pain severity were evaluated before and after septoplasty using Wilcoxon signed-rank test. RESULTS A total of 196 patients were enrolled in the study (102 males; 94 females). A total of 134 patients (68%) were diagnosed with severe AR and 166 (85%) experienced headaches with AR. The majority (100 of 166 patients; 60%) had sinusoidal headaches, while 25% (42 of 166 patients) reported a combination of sinusoidal headache and migraine and 14% (24 of 166 patients) experienced migraines. A comparison of preoperative and postoperative Ig-E levels, NOSE and VAS scores demonstrated that septoplasty significantly improved AR symptoms and headaches. Although there were significant improvements in headaches overall post-septoplasty, only the sinusoidal components improved, while migraine remained unaffected. CONCLUSION Septoplasty improved AR and sinusoidal headaches in patients with septal deviation, but migraines remained unaffected.
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Affiliation(s)
- Shanila Feroz
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Muhammad Hamza Dawood
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Sheza Sohail
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Muhammad Daniyal
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ayesha Zafar
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ukashah Bin Shahid
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
| | - Shamim Ahmed
- United Medical and Dental College, Affiliated with Jinnah Sindh Medical University, Karachi, Pakistan
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Ferretti A, Gatto M, Velardi M, Di Nardo G, Foiadelli T, Terrin G, Cecili M, Raucci U, Valeriani M, Parisi P. Migraine, Allergy, and Histamine: Is There a Link? J Clin Med 2023; 12:jcm12103566. [PMID: 37240671 DOI: 10.3390/jcm12103566] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The relationship between migraines and allergies is controversial. Though they are epidemiologically linked, the underlying pathophysiological connection between them remains unclear. Migraines and allergic disorders have various underlying genetic and biological causes. As per the literature, these conditions are epidemiologically linked, and some common pathophysiological pathways have been hypothesized. The histaminergic system may be the clue to understanding the correlation among these diseases. As a neurotransmitter in the central nervous system with a vasodilatory effect, histamine has a well-documented influence on the allergic response and could be involved in the pathophysiology of migraines. Histamine may influence hypothalamic activity, which may play a major role in migraines or may simply influence their severity. In both cases, antihistamine drugs could prove useful. This review examines whether the histaminergic system, particularly H3 and H4 receptors, may provide a mechanistic link between the pathophysiology of migraines and allergic disorders, two common and debilitating conditions. Identifying their connection could help identify novel therapeutic strategies.
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Affiliation(s)
- Alessandro Ferretti
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Mattia Gatto
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Margherita Velardi
- General and Emergency Department, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Giovanni Di Nardo
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Gianluca Terrin
- Department of Mother and Child, Gynecological and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Manuela Cecili
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Umberto Raucci
- General and Emergency Department, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Massimiliano Valeriani
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Pasquale Parisi
- Pediatrics Unit, Neuroscience, Mental Health and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
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Han JH, Lee HJ, Yook HJ, Han K, Lee JH, Park YM. Atopic Disorders and Their Risks of Migraine: A Nationwide Population-Based Cohort Study. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 15:55-66. [PMID: 36693358 PMCID: PMC9880296 DOI: 10.4168/aair.2023.15.1.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE Migraine is a relatively common neurologic disorder. A possible link between atopic disorders and migraine has been suggested. This study investigated atopic disorders and their risks of migraine in the Korean population. METHODS From the Korean National Health Insurance Service database, patients aged ≥ 20 years who underwent health screening between January and December of 2009 were enrolled. To evaluate the risk of migraine, Cox proportional hazards regression analyses were performed. RESULTS In multivariable analysis, the atopic dermatitis group (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.23-1.33), asthma group (aHR, 1.32; 95% CI, 1.30-1.34) and allergic rhinitis group (aHR, 1.45; 95% CI, 1.44-1.46) had significantly increased risks of migraine compared to their respective control groups (P < 0.001). The patients with 1 (aHR, 1.43; 95% CI, 1.42-1.44), 2 (aHR, 1.50; 95% CI, 1.47-1.53), and 3 (aHR, 1.64; 95% CI, 1.43-1.88) atopic disorders had significantly increased risks of migraine compared to the control group (P < 0.001). CONCLUSIONS Our results demonstrate that patients with atopic disorders may have increased risk of migraine and that the larger the number of concomitant atopic disorders, the higher the risk of migraine.
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Affiliation(s)
- Ju Hee Han
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Ji Lee
- Department of Dermatology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwa Jung Yook
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Min Park
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lyu S, Zhang CS, Sun J, Weng H, Xue CC, Guo X, Zhang AL. Chinese herbal medicine for migraine management: A hospital-based retrospective analysis of electronic medical records. Front Med (Lausanne) 2022; 9:936234. [PMID: 36438031 PMCID: PMC9684313 DOI: 10.3389/fmed.2022.936234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background Migraine is a chronic neurological disease causing significant socioeconomic burden and impaired quality of life. Chinese medicine is commonly used for migraine in China. Clinical trials have generated evidence of the effectiveness of Chinese medicine therapies for migraine. However, little is known about how to use these therapies to treat migraine in real-world clinical settings. Methods In this retrospective study, we analyzed data from the electronic medical records (EMRs) of 2,023 migraine patients who attended the Guangdong Provincial Hospital of Chinese Medicine (GPHCM) between July 2018 and July 2020. Results More than three-quarters (77.21%) of the patients were female. Most (78.20%) of the patients were aged between 18 and 50 years, 18.49% were aged above 50 years, and the remaining 3.31% were under 18 years. Sleep disorders were the most documented comorbidity occurring in 27.29% of patients, and more common in females (29.77%) than male (18.87%). Fatigue was the most frequently reported trigger of migraine attacks among all patients (9.39%), while menstruation was the most common trigger for female patients (10.24%). Less than a quarter of patients (21.01%) reported a history of taking analgesic medication for their migraine. The median treatment duration reported by the patients was 10 days. Chinese herbal medicine (CHM) was the predominant treatment for migraine at the hospital (88.48%), while pharmacotherapies were prescribed to 28.97% of the patients. CHM was prescribed more often as a sole treatment (53.58% of patients) than combined with pharmacotherapies (27.39% of patients). Among patients who reported improvements after taking CHM, the most frequently used herbs were fu ling and chuan xiong, the most frequent patented CHM product was tong tian oral solution, and the main herbal formulae were chuan xiong cha tiao san and yi qi cong ming tang. Conclusion CHM formulae, such as chuan xiong cha tiao san and yi qi cong ming tang, patented CHM product tong tian oral solution, and some herbs are potentially effective treatments for migraine. As such, CHM can be used as an alternative to conventional pharmacotherapies for migraine and is worth further evaluation in randomized controlled trials.
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Affiliation(s)
- Shaohua Lyu
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Claire Shuiqing Zhang
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Jingbo Sun
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Heng Weng
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Xinfeng Guo,
| | - Anthony Lin Zhang
- The China Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
- Anthony Lin Zhang,
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Tang SJ, Lee H, Cui T, Lee JM, Ahn JY, Lee S, Kim S. A Comparison of Clinical Features of Youth with and without Rhinitis Signs and Symptoms Who Are Hospitalized for Headache. CHILDREN 2022; 9:children9081241. [PMID: 36010131 PMCID: PMC9406595 DOI: 10.3390/children9081241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022]
Abstract
Headache and allergic rhinitis (AR) are common in children and often co-occur. We investigated the clinical characteristics of pediatric headaches and the association of AR and chronic headaches. We retrospectively reviewed the medical records of patients admitted to our pediatric inpatient and outpatient clinics with complaints of headache between January 2017 and June 2020 for headache-specific history, AR signs and symptoms, allergy skin prick test, inhalant multiple allergen simultaneous test results, laboratory and imaging findings, and medication history. The patients were divided into three subgroups: AR, non-AR, and headache groups, reporting 45.7% patients with headache alone, 13.7% with additional AR, and 31.6% with abnormal imaging findings, suggesting that headache was combined with sinusitis (24.3%) or mastoiditis (7.3%). Furthermore, 6% of the patients had both AR and sinusitis. Body mass index (BMI) differed significantly between the AR and the non-AR and headache groups (p = 0.03). The BMI differed significantly according to headache severity (p ˂ 0.001). The most common allergen was “dust or mites” (41.1%). Acetaminophen (35.9%) was the most commonly used painkiller. The coexistence of AR and headache may indicate that these conditions share a similar pathophysiology. Better management of allergies may facilitate diagnosis, treatment, and prophylaxis of headaches.
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Affiliation(s)
- Si-Jia Tang
- Graduate School, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Heejin Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
| | - Tiantian Cui
- Graduate School, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Sua Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
| | - Saeyoon Kim
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
- Correspondence:
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Biscetti L, De Vanna G, Cresta E, Corbelli I, Gaetani L, Cupini L, Calabresi P, Sarchielli P. Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms. J Neuroinflammation 2021; 18:259. [PMID: 34749743 PMCID: PMC8573865 DOI: 10.1186/s12974-021-02229-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/04/2021] [Indexed: 12/31/2022] Open
Abstract
Several lines of evidence support a role of the immune system in headache pathogenesis, with particular regard to migraine. Firstly, alterations in cytokine profile and in lymphocyte subsets have been reported in headache patients. Secondly, several genetic and environmental pathogenic factors seem to be frequently shared by headache and immunological/autoimmune diseases. Accordingly, immunological alterations in primary headaches, in particular in migraine, have been suggested to predispose some patients to the development of immunological and autoimmune diseases. On the other hand, pathogenic mechanisms underlying autoimmune disorders, in some cases, seem to favour the onset of headache. Therefore, an association between headache and immunological/autoimmune disorders has been thoroughly investigated in the last years. The knowledge of this possible association may have relevant implications in the clinical practice when deciding diagnostic and therapeutic approaches. The present review summarizes findings to date regarding the plausible relationship between headache and immunological/autoimmune disorders, starting from a description of immunological alteration of primary headaches, and moving onward to the evidence supporting a potential link between headache and each specific autoimmune/immunological disease.
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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
| | - Ilenia Corbelli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Lorenzo Gaetani
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Letizia Cupini
- Headache Center, UOC Neurologia-Stroke Unit, Emergency Department, Ospedale S. Eugenio, Rome, Italy
| | - Paolo Calabresi
- Department of Neuroscience, Università Cattolica Sacro Cuore, Rome, Italy
| | - Paola Sarchielli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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10
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Nasal Delivery of Acute Medications for Migraine: The Upper Versus Lower Nasal Space. J Clin Med 2021; 10:jcm10112468. [PMID: 34199479 PMCID: PMC8199675 DOI: 10.3390/jcm10112468] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
The acute treatment of migraine requires effective drugs that are well tolerated and provide rapid and consistent pain relief. Oral tablets are the most commonly used acute treatment for migraine; however, their effectiveness is limited by the rate of gastrointestinal (GI) tract absorption and first-pass hepatic metabolism, and they may not be ideal for patients experiencing GI motility issues. Nasal delivery is an attractive alternative route as it may circumvent GI tract absorption, avoid first-pass metabolism in the liver, and potentially reduce the frequency of GI adverse events. The large surface area and high vascularity within the nose may permit rapid absorption of therapeutics into the systemic circulation, allowing for rapid onset of action. However, the site of drug deposition (upper versus lower nasal cavity) may influence drug pharmacokinetics. Most approved nasal migraine therapies target the lower nasal space where the epithelium is less permeable, and they may be quickly cleared away due to increased ciliary function or dripping from the nose or swallowing, resulting in variable absorption and limited bioavailability. Together with its abundant vascularization, relative mucosal thickness stability, and low clearance rates, the upper nasal space harnesses the benefits of nasal delivery to potentially maximize drug efficacy.
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11
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Altamura C, Corbelli I, de Tommaso M, Di Lorenzo C, Di Lorenzo G, Di Renzo A, Filippi M, Jannini TB, Messina R, Parisi P, Parisi V, Pierelli F, Rainero I, Raucci U, Rubino E, Sarchielli P, Li L, Vernieri F, Vollono C, Coppola G. Pathophysiological Bases of Comorbidity in Migraine. Front Hum Neurosci 2021; 15:640574. [PMID: 33958992 PMCID: PMC8093831 DOI: 10.3389/fnhum.2021.640574] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Despite that it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bidirectional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involves a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.
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Affiliation(s)
- Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Ilenia Corbelli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Bari, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso B Jannini
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberta Messina
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,Headache Clinic, IRCCS-Neuromed, Pozzilli, Italy
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Linxin Li
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Catello Vollono
- Department of Neurology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
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12
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Liu Y, Xing Z, Ma X, Yu L. Association between migraine and vasomotor rhinitis. Int Forum Allergy Rhinol 2021; 11:1378-1380. [PMID: 33713559 DOI: 10.1002/alr.22790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/17/2021] [Accepted: 02/09/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Yan Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Zhimin Xing
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Xin Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Lisheng Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
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13
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Clemow DB, Baygani SK, Hauck PM, Hultman CB. Lasmiditan in patients with common migraine comorbidities: a post hoc efficacy and safety analysis of two phase 3 randomized clinical trials. Curr Med Res Opin 2020; 36:1791-1806. [PMID: 32783644 DOI: 10.1080/03007995.2020.1808780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT1F receptor agonist approved in the United States for the acute treatment of migraine. METHODS In SPARTAN and SAMURAI (double-blind Phase 3 clinical trials), patients with migraine were randomized to oral lasmiditan 50 mg (SPARTAN only), 100mg, 200 mg, or placebo. Lasmiditan increased the proportion of pain-free and most bothersome symptom (MBS)-free patients at 2 h after dose compared with placebo. Most common treatment-emergent adverse events (TEAEs) were dizziness, paraesthesia, somnolence, fatigue, nausea, muscular weakness, and hypoesthesia. Based upon literature review of common migraine comorbidities, Anxiety, Allergy, Bronchial, Cardiac, Depression, Fatigue, Gastrointestinal, Hormonal, Musculoskeletal/Pain, Neurological, Obesity, Sleep, and Vascular Comorbidity Groups were created. Using pooled results, efficacy and TEAEs were assessed to compare patients with or without a given common migraine comorbidity. To compare treatment groups, p-values were calculated for treatment-by-subgroup interaction, based on logistic regression with treatment-by-comorbidity condition status (Yes/No) as the interaction term; study, treatment group, and comorbidity condition status (Yes/No) were covariates. Differential treatment effect based upon comorbidity status was also examined. Trial registration at clinicaltrials.gov: SAMURAI (NCT02439320) and SPARTAN (NCT02605174). RESULTS Across all the Comorbidity Groups, with the potential exception of fatigue, treatment-by-subgroup interaction analyses did not provide evidence of a lasmiditan-driven lasmiditan versus placebo differential treatment effect dependent on Yes versus No comorbidity subgroup for either efficacy or TEAE assessments. CONCLUSIONS The efficacy and safety of lasmiditan for treatment of individual migraine attacks appear to be independent of comorbid conditions.
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Affiliation(s)
- David B Clemow
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Simin K Baygani
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Paula M Hauck
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
| | - Cory B Hultman
- Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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14
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Lovrenčić L, Matak I, Lacković Z. Association of Intranasal and Neurogenic Dural Inflammation in Experimental Acute Rhinosinusitis. Front Pharmacol 2020; 11:586037. [PMID: 33178025 PMCID: PMC7593566 DOI: 10.3389/fphar.2020.586037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background Nasal cavity and sinus disorders, such as allergic rhinitis, rhinosinusitis, or certain anatomical defects, are often associated with transient or ongoing headaches. On the other hand, migraine headache patients often exhibit pain referral over the area of nasal sinuses and typical nasal autonomic symptoms involving congestion and rhinorrhea. Mechanism for convergence of nasal or sinus disorders and headaches is unknown. Herein, we examined the association of sino-nasal inflammatory pain with common preclinical indicators of trigeminovascular system activation such as dural neurogenic inflammation (DNI) and neuronal activation in brainstem nociceptive nuclei. Methods Nasal and paranasal cavity inflammation and pain was induced by formalin (2.5%/10 μl) or capsaicin (0.1%/10 μl) instillation at the border of maxillary sinus and nasal cavity in rats. Quantification of inflammation of nasal mucosa and DNI was performed by spectrophotometric measurement of Evans blue - plasma protein complex extravasation. Pain behavior was quantified by rat grimace scale (RGS). Nociceptive neuronal activation in caudal part of spinal trigeminal nucleus (TNC) was assessed by c-Fos protein immunohistochemistry. Results Capsaicin and formalin administered into rat nasal cavity increased plasma protein extravasation in the nasal mucosa and dura mater. Intensity of plasma protein extravasation in nasal mucosa correlated with extravasation in dura. Similarly, facial pain intensity correlated with nociceptive neuronal c-Fos activation in the TNC. Conclusion Present data show that inflammatory stimuli in deep nasal and paranasal structures provoke distant intracranial changes related to trigeminovascular system activation. We hypothesize that this phenomenon could explain overlapping symptoms and comorbidity of nasal/paranasal inflammatory disorders with migraine.
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Affiliation(s)
- Luka Lovrenčić
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ivica Matak
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Zdravko Lacković
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia
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15
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Charoensanti S, Uthaisangsook S, Padsee N, Srisingh K. Association between Childhood Allergic Diseases and Headache. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0040-1718697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractAllergic disorders and headache are both common in pediatric populations. Chronic allergic disorders may affect sleep leading to chronic daily headaches. Poor controlled allergies may cause neurogenic inflammation that may be a predisposing factor to migraine headaches. We hypothesized that a higher prevalence of headaches may be found in children with allergy compared with those without allergy. Patients with either multiple allergic disorders or with poorly controlled allergic symptoms may be associated with headaches, especially migraine headaches. This study aimed to examine (1) the prevalence of headache in allergic children and (2) the association between allergic diseases and headache. Patients with allergic diseases and nonallergic children as control were recruited in the pediatric outpatient clinic of Naresuan University Hospital between January 2017 and January 2018. A neurological examination was performed by a pediatric neurologist. The questionnaire consisted of the pediatric headache symptom checklist and the items for evaluation of allergy control status. The diagnosis and classification of headache were based on the International Classification of Headache Disorders-3 criteria. The results were analyzed using the Student's t-test, chi-squared tests, odds ratios, and 95% confidence interval. One hundred fifty-five subjects were enrolled in our study, of which 85 subjects (54.8%) were diagnosed with allergic diseases. The allergic group had a significantly higher prevalence of headache than the control group (37 [43.5%] vs. 19 [27.1%], p = 0.035). The allergic group also had a significantly higher prevalence of migraine and probable migraine headache than the control group (23 [27.06%] vs. 7 [10%], p = 0.007). The prevalence of headache did not increase in subjects who had more than one allergic disease. There was no association between the control of allergy and headache. The present study showed that allergic diseases were associated with increased prevalence of headache and migraine in children. However, the control of allergic symptoms and the number of allergic diseases were not associated with headache. The physicians should be aware of headache in allergic patients and give appropriate treatment. Further study would be to identify specific biomarkers for the development of better treatment in these comorbid diseases.
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Affiliation(s)
- Sudarat Charoensanti
- Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Suwannee Uthaisangsook
- Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Nadda Padsee
- Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Klaita Srisingh
- Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
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Turbinate Submucosal Reduction Operation Reduced Migraine Admission among Patients with Chronic Hypertrophic Rhinitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155455. [PMID: 32751116 PMCID: PMC7432356 DOI: 10.3390/ijerph17155455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022]
Abstract
Rhinitis increases migraine risk. Chronic hypertrophic rhinitis can be treated with turbinate submucosal reduction operation. The relationship between migraine and chronic hypertrophic rhinitis after turbinate submucosal reduction operation is still unclear. The goal of this study was to evaluate the correlation between turbinate submucosal reduction operation and subsequent migraine admission in Asian chronic hypertrophic rhinitis patients. We identified patients suffering from chronic hypertrophic rhinitis and receiving turbinate submucosal reduction operation. The control group was selected from patients with chronic hypertrophic rhinitis without operation. The event was migraine admission. The risk factors of migraine admission were established using multivariate Cox proportional hazard regression. The risk of migraine admission after turbinate submucosal reduction operation is represented by a hazard ratio (HR) of 0.858 (95% confidence interval (CI): 0.633–0.962). The higher risk of migraine included depression with HR 4.348 (95% CI: 2.826–6.69), anxiety with HR 3.75 (95% CI: 2.267–6.203), fibromyalgia with HR of 7.326 (95% CI: 3.427–15.661), and asthma with HR 1.969 (95% CI: 1.11–3.491). Our study revealed that turbinate submucosal reduction operation led to a 14.2% reduction in migraine admission. Clinicians should understand the benefit of turbinate submucosal reduction operation and provide suitable treatments for comorbid conditions. Further prospective studies are required to confirm our findings.
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17
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Association of Diamine oxidase (DAO) variants with the risk for migraine from North Indian population. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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18
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Morkavuk G, Akkaya E, Koc G, Atac G, Leventoglu A. Relationship between white matter lesions and neutrophil–lymphocyte ratio in migraine patients. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_33_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Hemmati S, Rahimi N, Dabiri S, Alaeddini M, Etemad-Moghadam S, Dehpour AR. Inhibition of ovalbumin-induced allergic rhinitis by sumatriptan through the nitric oxide pathway in mice. Life Sci 2019; 236:116901. [DOI: 10.1016/j.lfs.2019.116901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/08/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
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20
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Maurya A, Qureshi S, Jadia S, Maurya M. "Sinus Headache": Diagnosis and Dilemma?? An Analytical and Prospective Study. Indian J Otolaryngol Head Neck Surg 2019; 71:367-370. [PMID: 31559205 PMCID: PMC6737117 DOI: 10.1007/s12070-019-01603-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/17/2019] [Indexed: 10/27/2022] Open
Abstract
To evaluate the type, location, severity of headache and their relation to various nasal and sinus related pathological conditions. All the patients presenting with acute and chronic sinus and nasal infections along with headache were included in the study. The diagnostic confirmation was done with clinical along with radiological and endoscopic evaluation. Various parameters categorized accordingly. Chronic rhinosinusitis/chronic recurrent rhinosinusitis are the most common nasal condition seen in oto-rhino-laryngology OPD which has enormous economic burden and significant morbidity on general population. The headache is the commonest associated symptom which is needed to be given attention. The location, variation, pattern of the headache can guide us towards the correct diagnosis.
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Affiliation(s)
- Ashish Maurya
- Department of E.N.T, Government Medical College, Datia, MP India
| | - Sadat Qureshi
- Department of E.N.T, Peoples Medical College and Research Centre, Bhopal, India
| | - Shalini Jadia
- Department of E.N.T, Peoples Medical College and Research Centre, Bhopal, India
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21
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Malm L. Re-sensitization of desensitized histamine H1 receptors in the human skin takes more than 18 hours. Skin Res Technol 2019; 26:61-66. [PMID: 31423656 DOI: 10.1111/srt.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/28/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is known since the time of testing histamine on pieces of guinea pig's jejunum that histamine receptors can develop insensitivity. The aim was to find evidence for desensitization of histamine H1 receptors in the human skin in vivo and, if found, to study the time for such receptors to regain normal sensitivity. MATERIALS AND METHODS A skin prick test with histamine (10 mg mL-1 ) was set in areas where a large histamine wheal was evoked 2, 6, 18, 24 or 72 hours earlier. A skin prick test with histamine (10 mg mL-1 ) was also set in an area where an allergen wheal was evoked 2 or 6 hours earlier. Heights, diameters and areas were measured on photographs of side views of plaster casts of the evoked skin elevations. RESULTS Histamine wheals, called test wheals, in areas where large histamine wheals were evoked 2, 6 or 18 hours earlier, were smaller than histamine wheals, called initial wheals, in earlier non-stimulated areas. Test wheals from the 18 hours experiment were smaller than test wheals from the 72 hours experiment. Test wheals evoked in areas where allergen wheals were evoked 2 or 6 hours earlier were smaller than corresponding initial wheals. CONCLUSION Histamine-evoked wheals and IgE-mediated allergic wheals reduce the sensitivity of histamine H1 receptors in the human skin. It takes between 18 and 72 hours to restore the sensitivity. Similarities between the development of histamine wheals in the human skin and histaminergic migraine with aura are discussed.
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Affiliation(s)
- Lars Malm
- Otorhinolaryngology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden
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22
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Karaulov AV, Vylegzhanina T, Ovchinnikov A, Chernikova M, Nenasheva N. Triamcinolone Acetonide versus Fluticasone Propionate in the Treatment of Perennial Allergic Rhinitis: A Randomized, Parallel-Group Trial. Int Arch Allergy Immunol 2019; 179:142-151. [PMID: 30879006 DOI: 10.1159/000497160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/22/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Intranasal sprays are recommended as targeted therapy for allergic rhinitis (AR). Triamcinolone acetonide is a nasal corticosteroid preparation indicated for the treatment of seasonal and perennial AR (PAR) in different countries worldwide. OBJECTIVES In order to determine the efficacy of triamcinolone acetonide in the treatment of PAR, the non-inferiority of triamcinolone acetonide to fluticasone propionate was assessed in Russian adults. METHODS In this randomized, double-blind, parallel-group, multicenter, prospective, non-inferiority, phase III clinical trial, a total of 260 patients with persistent PAR were randomized to receive either triamcinolone acetonide or fluticasone propionate nasal sprays for 4 weeks. The efficacy in symptom control was evaluated using the reflective total nasal symptom score (rTNSS) from baseline (day 0) to day 28. Safety was assessed through the reporting of adverse events. RESULTS The rTNSS mean values decreased from baseline to the end of study treatment (day 28) in both groups: -8.2 ± 3.0 in the triamcinolone acetonide arm versus -8.0 ± 2.8 in the fluticasone propionate arm. The mean difference between the groups (triamcinolone acetonide - fluticasone propionate) for rTNSS change from baseline was -0.2 (95% confidence interval -0.89 to 0.54), with an upper confidence limit of 0.54, which is lower than the non-inferiority margin of 0.8. Triamcinolone acetonide was well tolerated, with no difference in adverse event occurrence compared with fluticasone propionate. CONCLUSIONS Triamcinolone acetonide proved to be non-inferior to fluticasone propionate in adult patients with PAR; both treatments decreased rTNSS values and showed a good safety profile.
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Affiliation(s)
- Alexander V Karaulov
- Department of Clinical Immunology and Allergology of I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation,
| | - Tamara Vylegzhanina
- National Research Center Institute of Immunology Federal Medical-Biological Agency of Russia, Moscow, Russian Federation
| | - Andrey Ovchinnikov
- Department of otorhinolaryngology of A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | | | - Nataiya Nenasheva
- Department of Clinical Allergology of Russian Medical Academy of Postdiploma Education, Moscow, Russian Federation
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Wei CC, Lin CL, Shen TC, Chen AC. Children with allergic diseases have an increased subsequent risk of migraine upon reaching school age. J Investig Med 2018; 66:1064-1068. [PMID: 29903897 DOI: 10.1136/jim-2018-000715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 01/15/2023]
Abstract
The association between migraine and allergy has remained a subject of debate for more than a century. To systemically investigate the interaction between children with antecedent allergic diseases and their future risks of migraine on reaching school age, we recruited 16,130 children aged 7-18 with migraine diagnosed between 2000 and 2008, and 64,520 matched controls without a history of migraine. The ORs of migraine were calculated for the association with allergic diseases diagnosed before migraine diagnosis. The allergic diseases included atopic dermatitis, allergic conjunctivitis, allergic rhinitis (AR), and asthma. Children with preceding allergic diseases had a greater subsequent risk of migraine than the controls. Among the four evaluated diseases, AR had the highest adjusted OR (aOR) of 2.17 (95% CI 2.09 to 2.26). Children with all four allergic diseases had the highest aOR of 3.59 (95% CI 2.91 to 4.44). Further, an increasing trend of aORs was observed with more allergic disease-associated medical consulting. Our study indicates that children with allergic diseases are at increased subsequent risk of migraine when they reach school age, and the risk shows a cumulative effect of more allergic diseases and more allergy-related healthcare.
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Affiliation(s)
- Chang-Ching Wei
- Division of Pediatric Allergy, Immunology, and Rheumatology, Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Public Health, China Medical University, Taichung, Taiwan
| | - Te-Chun Shen
- School of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - An-Chyi Chen
- School of Medicine, China Medical University, Taichung, Taiwan
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24
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Benign Headache Management in the Emergency Department. J Emerg Med 2018; 54:458-468. [DOI: 10.1016/j.jemermed.2017.12.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/01/2017] [Indexed: 01/08/2023]
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25
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Jansen-Olesen I, Hougaard Pedersen S. PACAP and its receptors in cranial arteries and mast cells. J Headache Pain 2018; 19:16. [PMID: 29460121 PMCID: PMC5818390 DOI: 10.1186/s10194-017-0822-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/09/2017] [Indexed: 01/03/2023] Open
Abstract
Background In migraineurs pituitary adenylate cyclase activating peptide1–38 (PACAP1–38) is a potent migraine provoking substance and the accompanying long lasting flushing suggests degranulation of mast cells. Infusion of the closely related vasoactive intestinal peptide (VIP) either induces headache or flushing. This implicates the pituitary adenylate cyclase activating peptide type I receptor (PAC1) to be involved in the pathophysiology of PACAP1–38 provoked headaches. Here we review studies characterizing the effects of mainly PACAP but also of VIP on cerebral and meningeal arteries and mast cells. Discussion PACAP1–38, PACAP1–27 and VIP dilate cerebral and meningeal arteries from several species including man. In rat cerebral and meningeal arteries the dilation seems to be mediated preferably via vasoactive intestinal peptide receptor type 1 (VPAC1) receptors while, in human, middle meningeal artery dilation induced via vasoactive intestinal peptide receptor type 2 (VPAC2) receptors cannot be ruled out. PACAP1–38 is a strong degranulator of peritoneal and dural mast cells while PACAP1–27 and VIP only have weak effects. More detailed characterization studies suggest that mast cell degranulation is not mediated via the known receptors for PACAP1–38 but rather via a still unknown receptor coupled to phospholipase C. Conclusion It is suggested that PACAP1–38 might induce migraine via degranulation of dural mast cells via a yet unknown receptor.
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Affiliation(s)
- Inger Jansen-Olesen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Neurology, Danish Headache Center, Glostrup Research Institute, Nordre Ringvej 69, 2600, Glostrup, Denmark.
| | - Sara Hougaard Pedersen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Attenuation of serotonin-induced itch by sumatriptan: possible involvement of endogenous opioids. Arch Dermatol Res 2018; 310:165-172. [DOI: 10.1007/s00403-018-1809-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/23/2017] [Accepted: 01/12/2018] [Indexed: 02/03/2023]
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Asociación de polimorfismos de diaminoxidasa e histamina N metiltransferasa con la presencia, discapacidad y severidad de migraña en un grupo de madres mexicanas de niños alérgicos. Neurologia 2017; 32:500-507. [DOI: 10.1016/j.nrl.2016.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/23/2016] [Accepted: 02/27/2016] [Indexed: 02/03/2023] Open
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Meza-Velázquez R, López-Márquez F, Espinosa-Padilla S, Rivera-Guillen M, Ávila-Hernández J, Rosales-González M. Association of diamine oxidase and histamine N-methyltransferase polymorphisms with presence of migraine in a group of Mexican mothers of children with allergies. NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2016.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Yuan H, Silberstein SD. Histamine and Migraine. Headache 2017; 58:184-193. [PMID: 28862769 DOI: 10.1111/head.13164] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Histamine is an ancient "tissue amine" preceding multicellular organisms. In the central nervous system (CNS), its fibers originate solely from the tuberomammillary nucleus and travel throughout the brain. It is mainly responsible for wakefulness, energy homeostasis, and memory consolidation. Recently, several studies suggest a potential role of histamine in migraine pathogenesis and management. METHODS Narrative review of current literature regarding histamine and migraine. RESULTS Histamine plays a crucial role in migraine pathogenesis: sustaining the neurogenic inflammation pathway. Interaction between mast cells (MC) and calcitonin-gene related protein (CGRP) results in sensitization of trigeminal afferents and trigeminal ganglia (TG). Histamine binds with differing affinities to four different histaminergic G-protein coupled receptors, activating protein kinases, or triggering calcium release with subsequent mode of actions. Histamine 1 receptor (H1 R) and histamine 2 receptor (H2 R) antagonists are frequently used for the treatment of allergy and gastric acid secretion, respectively, but their antagonism is probably ineffective for migraine. Histamine 3 receptor (H3 R) and histamine 4 receptor (H4 R) have a threefold higher affinity than H1 R/H2 R for histamine and are found almost exclusively on neurons and immune tissues, respectively. H3 R acts as an autoreceptor or as a heteroreceptor, lowering the release of histamine and other neurotransmitters. This is a potential target for anti-nociception and anti-neurogenic inflammation. To date, several small clinical trials using low dose histamine or Nα -methylhistamine have demonstrated migraine prophylactic efficacy, probably via H3 R or other undetermined pathways. CONCLUSION The histamine system interacts with multiple regions in the CNS and may hypothetically modulate the migraine response. Low dose histamine may be a promising option for migraine prevention.
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Affiliation(s)
- Hsiangkuo Yuan
- Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA, USA
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Güvenc IA, Acar M, Muluk NB, Kucukcan NE, Cingi C. Is There An Association between Migraine and Allergic Rhinitis? EAR, NOSE & THROAT JOURNAL 2017. [DOI: 10.1177/014556131709600604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We conducted a prospective study to evaluate nasal signs and symptoms and to perform allergen-specific immunoglobulin E (IgE) testing to investigate the relationship between migraine and allergic rhinitis. Our study group consisted of 40 patients diagnosed with migraine—22 men and 18 women, aged 21 to 38 years (mean: 25.7). We compared their findings with a control group of 40 healthy adults—15 men and 25 women, aged 19 to 36 years (mean: 25.1). Allergen-specific IgE measurements were obtained with six groups of allergens: fungi, grass pollens, tree pollens, wild herbs, house dust mite 1, and house dust mite 2. We found no significant difference between the migraine patients and the controls in the incidence of nasal signs and symptoms (i.e., discharge, congestion, itching, and sneezing) or inferior turbinate signs (i.e., color and edema). According to the IgE assays, 14 migraine patients (35.0%) were sensitized to one or more allergens, compared with 11 of the controls (27.5%); the difference was not statistically significant. Sensitization was highest for the grass pollens panel in both groups. Even though we did not find an association between migraine and allergic rhinitis, the recent literature supports a correlation between migraine and atopy. The two conditions share common neural pathways and common mediators, and they can be linked statistically in patients and their families. A pathophysiologic association between the two conditions seems more likely than an etiologic association. In this regard, future efforts could be focused on the determination of atopy in migraine patients and the therapeutic implications of this diagnosis.
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Affiliation(s)
| | - Mustafa Acar
- ENT Department, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Nuray Bayar Muluk
- ENT Department, Kırıkkale University Medical Faculty, Kırıkkale, Turkey
| | | | - Cemal Cingi
- ENT Department, Eskisehir Osmangazi University Medical Faculty, Eskisehir
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Turan MO, Susuz ÇÇ, Turan PA. Presence of Headache and Migraine in Asthma Patients. Turk Thorac J 2017; 18:47-51. [PMID: 29404159 DOI: 10.5152/turkthoracj.2017.16008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 03/05/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Migraine is a diseases characterized with severe headaches, with neurological and systemic findings. The purpose of this study is to investigate the prevalence of migraine and to examine whether there is a relationship between atopic disorders, parental history and migraine in asthma patients. MATERIAL AND METHODS A total of 288 asthma outpatients, who had the diagnosis by an early or late test of reversibility showing a reversible airway obstruction according to hospital database were included. The presence of headache, atopic symptoms and parental history about asthma, atopic disorders and migraine were asked. The patients with headache were consultated by neurology department and investigated about the presence of migraine. The diagnosis of migraine headache was made if patients fulfilled the International Headache Society (IHS) criteria. RESULTS 60.4% of patients described a headache. There were 94 patients (32.6%) with headaches meeting the IHS criteria for migraine. Only 12 patients had migraine with aura. There were atopic symptoms in 86.8% of patients. According to parental history, there were asthma in 47.9%, atopic symptoms in 39.6% and migraine in 22.2% of parents. Patients with atopic symptoms were found to have significantly high rate of headaches (65.3%) "p=0.007". The prevalence of migraine was significantly high in patients with parental atopic symptoms (54%) "p=0.002". Multiple logistic regression analysis identified that gender, parental history of asthma, allergia and migraine, and smoking were independent risk factors for presence of migraine in asthmatics. CONCLUSION There is a high prevalence of migraine headaches in patients with asthma. The coexistence of asthma and headaches may be related with a similar pathophysiological mechanism; parental history, common genetic compounds and smoking may play role in this mechanism. The headaches in asthma patients, atopic symptoms and family history should be questioned, and clinicians should be careful about the presence of migraine.
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Affiliation(s)
- Muzaffer Onur Turan
- Department of Chest Diseases, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Abstract
Since the 1950s food safety hazards have been categorized simply as (micro) biological, chemical or physical hazards with no clear differentiation between those that cause acute and chronic harm. Indeed international risk assessment methods, including hazard analysis critical control point (HACCP) use these criteria. However, the spectrum of food related illness continues to grow now encompassing food allergy and intolerance, obesity, type 2 diabetes, stroke, heart disease, cancer as well as food poisoning, foodborne illness and food contamination. Therefore over a half-century later is this the time to redefine the spectrum of what constitutes food related illness? This paper considers whether such "redefinition" of food related intoxicating and infectious agents would provide more targeted policy instruments and lead to better risk assessment and thus mitigation of such risk within the food supply chain.
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Affiliation(s)
- Louise Manning
- a Royal Agricultural University, School of Agriculture, Food and the Environment , Cirencester , United Kingdom
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Bektas H, Karabulut H, Doganay B, Acar B. Allergens might trigger migraine attacks. Acta Neurol Belg 2017; 117:91-95. [PMID: 27141872 DOI: 10.1007/s13760-016-0645-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 04/21/2016] [Indexed: 11/30/2022]
Abstract
Migraine is a common primary headache disorder. The mechanisms underlying the onset of a migraine attack are not completely understood. Environmental changes and a number of other factors could induce migraine attacks. The aim of this study was to investigate the relationship between the frequency of migraine attacks and allergens. Migraine patients without aura, and healthy individuals similar in age and gender without a history of headache and allergy were prospectively included in the study. The duration of migraine, the frequency of migraine attacks, the medication history, and the symptoms during attacks were questioned. Migraine disability assessment score (MIDAS) and visual analog scale (VAS) scores were obtained. Allergen extracts including dust, fungi, insect, animal epithelium, pollens, and food allergens were applied for allergy tests. 49 migraine patients and 49 healthy individuals were enrolled in the study. There was no significant difference in terms of age and gender. The median migraine disease duration, the number of attacks in a month, and the duration of attacks were, respectively, 5.5 years (1-44), 4 (1-10) day/month, and 24 (4-72) h. The mean MIDAS grade was 2.45 ± 0.14 (1-4), and mean VAS score was 7.89 ± 0.27 (4-10). The positivity of allergy tests was 55.1 % (27/49) in the migraine group and 32.7 % (16/49) in the control group (p < 0.05). The allergy tests were positive for house dust, red birch, hazel tree, olive tree, nettle, and wheat. The frequency of migraine attacks was higher in allergy-test-positive patients than in negative ones in the migraine group (p = 0.001). The migraine patients who had frequent attacks should be examined for allergies.
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Affiliation(s)
- Hesna Bektas
- Department of Neurology, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Hayriye Karabulut
- Department of ENT, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Beyza Doganay
- Department of Biostatistics, Ankara University Medical Faculty, Ankara, Turkey
| | - Baran Acar
- Department of ENT, Kecioren Training and Research Hospital, Ankara, Turkey
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Aupiais C, Wanin S, Romanello S, Spiri D, Moretti R, Boizeau P, Massano D, Zuccotti GV, Crichiutti G, Kanagarajah L, Houdouin V, Alberti C, Titomanlio L. Association Between Migraine and Atopic Diseases in Childhood: A Potential Protective Role of Anti-Allergic Drugs. Headache 2017; 57:612-624. [PMID: 28160287 DOI: 10.1111/head.13032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Migraine is a common cause of headache in childhood. Several studies have investigated the association between migraine and atopic diseases, mostly in the adult population. OBJECTIVE This study aimed to investigate this association in children. METHODS A case-control study was conducted across 3 European tertiary care hospitals between June 2014 and August 2014. Cases (n = 229) were children aged 6-18 years consulting for a migraine episode. Controls in the same age range (n = 406) were consulting for a minor injury and did not have a history of recurrent headache. Logistic regression analyses tested the effect of atopic diseases and anti-allergic therapies on occurrence of migraine. RESULTS Children with migraine were more likely to have persistent asthma compared to absence of asthma (odds ratio [OR]: 4.57, 95% confidence interval [CI]: 2.04-10.24) and less likely to have been treated by inhaled or nasal corticosteroid (OR: 0.34, 95% CI: 0.15-0.76) or antihistamine therapy (OR: 0.33, 95% CI: 0.18-0.60). The median number of monthly migraine episodes was higher in children with persistent asthma (3; interquartile [IQR]: 1-4; range: 0.5-10) compared to children with intermittent asthma (2; IQR: 1-3; range: 0.1-4) or non-asthmatic children (2; IQR: 1-3; range: 0.1-12) (P < .01). CONCLUSION Persistent childhood asthma was associated with increased risk of migraine and higher frequency of migraine attacks. History of anti-asthmatic or anti-allergic therapies was associated with decreased risk of migraine in children and adolescents. The role of these therapies on the pathogenesis and occurrence of migraine needs to be further elucidated because of the huge potential impact in terms of public health.
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Affiliation(s)
- Camille Aupiais
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France
| | - Stephanie Wanin
- Pediatric Pneumology and Allergic Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France
| | - Silvia Romanello
- Pediatric Migraine and Neurovascular Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1141, Paris, France
| | - Daniele Spiri
- Department of Pediatrics, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Raffaella Moretti
- Department of Pediatrics, Azienda ospedaliero-universitaria Santa Maria della Misericordia di Udine, Italy
| | - Priscilla Boizeau
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France
| | - Davide Massano
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Crichiutti
- Department of Pediatrics, Azienda ospedaliero-universitaria Santa Maria della Misericordia di Udine, Italy
| | | | - Veronique Houdouin
- Pediatric Pneumology and Allergic Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France
| | - Corinne Alberti
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 and CIC-EC 1426, Paris, France
| | - Luigi Titomanlio
- Pediatric Migraine and Neurovascular Diseases Unit, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1141, Paris, France.,Department of Pediatric Emergency Care,Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, Université Paris Diderot, Sorbonne Paris-Cité, Paris, France
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Wang IC, Tsai JD, Shen TC, Lin CL, Li TC, Wei CC. Allergic Conjunctivitis and the Associated Risk of Migraine Among Children: A Nationwide Population-based Cohort Study. Ocul Immunol Inflamm 2016; 25:802-810. [PMID: 27382919 DOI: 10.1080/09273948.2016.1178303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the risk of migraine in children with allergic conjunctivitis (AC). METHODS In this population-based cohort study, 309 138 children with AC and 309 138 non-AC controls were included between 2000 and 2007. By 2008 end, the incidences of migraine in both cohorts, and the AC-to-non-AC cohort hazard ratios (HRs) were measured. RESULTS The incidence of migraine during the study period was 1.92-fold higher in the AC cohort than in the non-AC cohort. The risk was greater for boys with AC and children aged <6 years. The mean time-interval between physician-diagnosed AC to physician-diagnosed migraine was 3.67 years (SD = 2.19).The risk of migraine development in the AC cohort increased with follow-up time and was highest during 4-5 years after AC diagnosis. The children with AC more likely had migraine without than with aura. CONCLUSIONS Children with AC had a higher incidence and subsequent risk of migraine.
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Affiliation(s)
- I-Chung Wang
- a Children's Hospital of China Medical University Hospital , Taichung , Taiwan
| | - Jeng-Dau Tsai
- b Department of Pediatrics , Chung Shan Medical University Hospital , Taichung , Taiwan.,c Institute of Medicine, Chung Shan Medical University , Taichung , Taiwan
| | - Te-Chun Shen
- d Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine , China Medical University Hospital , Taichung , Taiwan.,e School of Medicine, China Medical University , Taichung , Taiwan
| | - Cheng-Li Lin
- f Management Office for Health Data, China Medical University Hospital , Taichung , Taiwan.,g Institute of Biostatistics, China Medical University , Taichung , Taiwan
| | - Tsai-Chung Li
- g Institute of Biostatistics, China Medical University , Taichung , Taiwan
| | - Chang-Ching Wei
- a Children's Hospital of China Medical University Hospital , Taichung , Taiwan.,e School of Medicine, China Medical University , Taichung , Taiwan
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Abstract
Allergic rhinitis and migraine remain on the list of the most common diseases affecting adults. Migraines and headaches due to allergic rhinitis are easily confused because the symptoms of both conditions often overlap. Both may occur with sinus headache, nasal congestion, and lacrimation and may worsen with weather changes and exposure to allergens. No precise clinical definition exists for what constitutes a sinus headache, which has always been a diagnostic dilemma. Contrary to popular belief, headache is not a typical symptom of rhinitis. Some studies have shown that up to 90 % of sinus headaches are actually migraines. Nevertheless, patients with self-diagnosed sinus headache self-treat or are treated by primary care physicians and/or otolaryngologists with medications for rhinosinusitis, ignoring the neurogenic causes of the symptoms when most of these patients fulfill diagnostic criteria for chronic migraine. Chronic migraine affects 2 % of the general population and has a significant socioeconomic impact on society, incurring health care costs and diminishing quality of life; therefore, the proper diagnosis and treatment of these headache patients should be a priority.
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Affiliation(s)
- Anna Gryglas
- Department of Neurology, Gromkovski Voivodship Hospital, Department of Social Pediatrics, Wroclaw Medical University, Wroclaw, Poland.
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Abstract
Comorbid conditions frequently occur in pediatric headaches and may significantly affect their management. Comorbidities that have been associated with pediatric headaches include attention-deficit or hyperactivity disorder, autism, developmental disabilities, depression, anxiety, epilepsy, obesity, infantile colic, atopic disorders, inflammatory bowel disease, and irritable bowel syndrome. The goal of this article is to review these comorbidities associated with pediatric headache, thereby empowering child neurologists to identify common triggers and tailor management strategies that address headache and its comorbidities.
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38
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Wang IC, Tsai JD, Lin CL, Shen TC, Li TC, Wei CC. Allergic rhinitis and associated risk of migraine among children: a nationwide population-based cohort study. Int Forum Allergy Rhinol 2015; 6:322-7. [PMID: 26446370 DOI: 10.1002/alr.21654] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/09/2015] [Accepted: 08/26/2015] [Indexed: 02/03/2023]
Affiliation(s)
- I-Chung Wang
- Children's Hospital; China Medical University Hospital; Taichung Taiwan
| | - Jeng-Dau Tsai
- Department of Pediatrics; Chung Shan Medical University Hospital; Taichung Taiwan
- Institute of Medicine; Chung Shan Medical University; Taichung Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data; China Medical University Hospital; Taichung Taiwan
- Institute of Biostatistics; China Medical University; Taichung Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine; China Medical University Hospital; Taichung Taiwan
- College of Medicine; China Medical University; Taichung Taiwan
| | - Tsai-Chung Li
- Institute of Biostatistics; China Medical University; Taichung Taiwan
| | - Chang-Ching Wei
- Children's Hospital; China Medical University Hospital; Taichung Taiwan
- College of Medicine; China Medical University; Taichung Taiwan
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Friedman BW, Cabral L, Adewunmi V, Solorzano C, Esses D, Bijur PE, Gallagher EJ. Diphenhydramine as Adjuvant Therapy for Acute Migraine: An Emergency Department-Based Randomized Clinical Trial. Ann Emerg Med 2015; 67:32-39.e3. [PMID: 26320523 DOI: 10.1016/j.annemergmed.2015.07.495] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/09/2015] [Accepted: 07/14/2015] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE More than 1 million patients present to US emergency departments (EDs) annually seeking care for acute migraine. Parenteral antihistamines have long been used in combination with antidopaminergics such as metoclopramide to treat acute migraine in the ED. High-quality data supporting this practice do not exist. We determine whether administration of diphenhydramine 50 mg intravenously+metoclopramide 10 mg intravenously results in greater rates of sustained headache relief than placebo+metoclopramide 10 mg intravenously. METHODS This was a randomized, double-blind, clinical trial comparing 2 active treatments for acute migraine in an ED. Eligible patients were adults younger than 65 years presenting with an acute moderate or severe headache meeting International Classification of Headache Disorders-2 migraine criteria. Patients were stratified according to presence or absence of allergic symptoms. The primary outcome was sustained headache relief, defined as achieving a headache level of mild or none within 2 hours of medication administration and maintaining this level of relief without use of any additional headache medication for 48 hours. Secondary efficacy outcomes included mean improvement on a 0 to 10 verbal scale between baseline and 1 hour, the frequency with which subjects indicated they would want the same medication the next time they present to the ED with migraine, and the ED throughput time. Sample size calculation using a 2-sided α of .05, a β of .20, and a 15% difference between study arms determined the need for 374 patients. An interim analysis was conducted when data were available for 200 subjects. RESULTS Four hundred twenty patients were approached for participation. Two hundred eight eligible patients consented to participate and were randomized. At the planned interim analysis, the data and safety monitoring board recommended that the study be halted for futility. Baseline characteristics were comparable between the groups. Fourteen percent (29/208) of the sample reported allergic symptoms. Of patients randomized to diphenhydramine, 40% (40/100) reported sustained relief at 48 hours, as did 37% (38/103) of patients randomized to placebo (95% confidence interval [CI] for difference of 3%: -10% to 16%). One hour after medication administration, patients randomized to diphenhydramine improved by a mean of 5.1 on the 0 to 10 scale versus 4.8 for those randomized to placebo (95% CI for difference of 0.3: -0.6 to 1.1). Eighty-five percent (84/99) of the patients in the diphenhydramine arm reported they would want the same medication combination during a subsequent ED visit, as did 76% (77/102) of those who received placebo (95% CI for difference of 9%: -2% to 20%). Median ED length of stay was 122 minutes (interquartile range 84 to 180 minutes) in the diphenhydramine group and 139 minutes (interquartile range 90 to 235 minutes) in the placebo arm. Rates of adverse effects, including akathisia, were comparable between the groups. CONCLUSION Intravenous diphenhydramine, when administered as adjuvant therapy with metoclopramide, does not improve migraine outcomes.
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Affiliation(s)
- Benjamin W Friedman
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
| | - Lisa Cabral
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Victoria Adewunmi
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Clemencia Solorzano
- Pharmacy Department, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - David Esses
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Polly E Bijur
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - E John Gallagher
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
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Flores-Clemente C, Osorio-Espinoza A, Escamilla-Sánchez J, Leurs R, Arias JM, Arias-Montaño JA. A single-point mutation (Ala280Val) in the third intracellular loop alters the signalling properties of the human histamine H₃ receptor stably expressed in CHO-K1 cells. Br J Pharmacol 2014; 170:127-35. [PMID: 23713487 DOI: 10.1111/bph.12257] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/02/2013] [Accepted: 05/10/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE An alanine to valine exchange at amino acid position 280 (A280V) in the third intracellular loop of the human histamine H₃ receptor was first identified in a patient suffering from Shy-Drager syndrome and later reported as a risk factor for migraine. Here, we have compared the pharmacological and signalling properties of wild-type (hH₃ R(WT)) and A280V mutant (hH₃ R(A280V)) receptors stably expressed in CHO-K1 cells. EXPERIMENTAL APPROACH The hH₃ R(A280V) cDNA was created by overlapping extension PCR amplification. Receptor expression and affinity were assessed by radioligand (N-α-[methyl-³H]-histamine) binding to cell membranes, and receptor function by the inhibition of forskolin-induced cAMP accumulation and stimulation of ERK1/2 phosphorylation in intact cells, as well as stimulation of [³⁵S]-GTPγS binding to cell membranes. KEY RESULTS Both receptors were expressed at similar levels with no significant differences in their affinities for H₃ receptor ligands. Upon activation the hH₃ RWT was significantly more efficacious to inhibit forskolin-induced cAMP accumulation and to stimulate [³⁵S]-GTPγS binding, with no difference in pEC50 estimates. The hH₃ RWT was also more efficacious to stimulate ERK1/2 phosphorylation, but this difference was not significant. The inverse agonist ciproxifan was more efficacious at hH3 RWT to reduce [³⁵S]-GTPγS binding but, for both receptors, failed to enhance forskolin-induced cAMP accumulation. CONCLUSIONS AND IMPLICATIONS The A280V mutation reduces the signalling efficacy of the human H₃ receptor. This effect may be relevant to the pathophysiology of disorders associated with the mutation.
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Affiliation(s)
- Cecilia Flores-Clemente
- Departamento de Fisiología, Biofísica y Neurociencias, Centro de Investigación y de Estudios Avanzados (Cinvestav) del IPN, México
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Kneipp SM, Beeber LL, Linnan LA. Headache and Health-Related Job Loss among Disadvantaged Women. J Nurse Pract 2014; 10:316-324. [PMID: 24936154 DOI: 10.1016/j.nurpra.2014.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rosario D, Pinto G. Role of Gender and Serum Immunoglobulin E (IGE) levels on Severity of Migraine. J Clin Diagn Res 2014; 8:57-8. [PMID: 24701482 DOI: 10.7860/jcdr/2014/7516.4007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 12/09/2013] [Indexed: 11/24/2022]
Abstract
AIM Migraine headache is a common disorders. Several studies have reported that migraine headache is more common in patients with allergy. AIM of this study is to determine if the allergic sensitization is associated with the prevalence, frequency, and disability of migraine headaches. MATERIALS AND METHODS The study was conducted during the period August 2013. During this period 100 patients of either gender who were diagnosed with migraine were selected and total serum Immunoglobulin E (IGE) levels were estimated. Prevalence of migraine headache and degree of allergic sensitization was estimated in these patients. Severity of migraine was assessed using the MIDAS score. Statistical Analysis : Descriptive tables were generated showing the demographic and clinical characteristics of participants stratified by age and sex. Differences between subject groups were assessed by chi-square test. Correlation between severity of migraine and IgE levels was calculated using Pearson correlation. RESULTS A total of 100 patients with migraine who presented to the outpatient department where studied. Prevalence of migraine was found to be higher in females compared to males. At the younger age group IgE levels were higher. Patients with higher levels of IgE had more severe headaches compared to those with lower levels of IgE. Patients with higher levels of IgE required a longer duration of treatment compared to those with lower levels of IgE. CONCLUSION Prevalence of migraine is high among females. Younger age and female sex are other contributory factors as prevalence of migraine is higher in these groups. Degree of allergic sensitisation determines the severity and frequency of headaches in those whom allergic rhinitis is a risk factor as evidenced by higher levels of IgE.
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Affiliation(s)
- David Rosario
- P.G. Resident, Department of Ear, Nose and Throat, Father Muller Medical College , Mangalore, India
| | - George Pinto
- Professor and H.O.D., Department of Ear, Nose and Throat, Father Muller Medical College , Mangalore, India
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Mehle ME. What do we know about rhinogenic headache? The otolaryngologist’s challenge. Otolaryngol Clin North Am 2014; 47:255-64. [PMID: 24680492 DOI: 10.1016/j.otc.2013.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Sinus headache is a common presenting complaint in the otolaryngology office. Although most patients with this presentation are found to have migraine headache, many do not, and others fail therapy. This review focuses on the current understanding of nonneoplastic rhinogenic headache: headaches that are caused or exacerbated by nasal or paranasal sinus disease or anatomy. The literature regarding this topic is reviewed, along with a review of surgical series seeking to correct these abnormalities and the outcomes obtained with intervention. Suggestions are provided regarding patient diagnosis and management, and options for intervention are reviewed.
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Affiliation(s)
- Mark E Mehle
- Northeast Ohio Medical University, 4209 Ohio 44, Rootstown, OH 44272, USA; Private Practice, ENT and Allergy Health Services, 25761 Lorain Road, 3rd Floor, North Olmsted, OH 44070, USA.
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Ozturk A, Degirmenci Y, Tokmak B, Tokmak A. Frequency of migraine in patients with allergic rhinitis. Pak J Med Sci 2013; 29:528-31. [PMID: 24353570 PMCID: PMC3809225 DOI: 10.12669/pjms.292.3148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 11/09/2012] [Accepted: 01/20/2012] [Indexed: 11/15/2022] Open
Abstract
Objectives: Allergic rhinitis (AR) is an IgE mediated disease which is released by activation of mast cells and basophils, and often leads to sinus headache. Histamine which is the key mediator in the pathogenesis of AR, also plays an important role in the pathogenesis of migraine with nitric oxide (NO). Aim of our study was to investigate the frequency of migraine in patients with AR. Methodology: Headache assessment and neurological examination was performed on patients diagnosed as AR in the outpatient ear nose and throat clinic with age-matched controls. Participants with headache were classified according to the International Headache Society criteria, and migraine frequency was investigated in the patients with AR and control groups. Results: Migraine headache was detected in 50% of the patients with AR. Among these, 95% were migraine without aura, and 5% were migraine with aura. Migraine frequency in the control group was 18.75% in the control group, and all was migraine without aura. Migraine frequency in the patients with AR was four times higher when compared with the control group. Conclusion: While a histamine and IgE associated common mechanism is responsible in the pathogenesis of AR and migraine, not only sinus headache but also migraine headache should be kept in mind. Headache assessment of the patients with AR, and in case of headache existence, referral of these patients to neurology outpatient clinics for differential diagnosis and, to maintain appropriate therapy should not be forgotten.
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Affiliation(s)
- Ayhan Ozturk
- Ayhan Ozturk, Associate Professor, Duzce University School of Medicine, Neurology Department, Duzce, Turkey
| | - Yildiz Degirmenci
- Yildiz Degirmenci, Assistant Professor, Duzce University School of Medicine, Neurology Department, Duzce, Turkey
| | - Burcu Tokmak
- Burcu Tokmak, Specialist, Cerkezkoy Hospital, Ear Nose Throat Department, Tekirdag, Turkey
| | - Abdurrahman Tokmak
- Abdurrahman Tokmak, Specialist, Cerkezkoy Hospital, Ear Nose Throat Department, Tekirdag, Turkey
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Chronic rhinitis and its association with headache frequency and disability in persons with migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Cephalalgia 2013; 34:336-48. [DOI: 10.1177/0333102413512031] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background Rhinitis is a comorbidity of migraine, but its relationship to migraine headache frequency and headache-related disability is unknown. Objectives To determine if rhinitis and its subtypes are associated with an increased frequency and associated disability of migraine. Methods The AMPP Study is a longitudinal study of individuals with “severe” headache from the US population. Respondents meeting ICHD-2 criteria for migraine in 2008 were identified and the presence of rhinitis was determined using the European Community Respiratory Health Survey (ECRHS). Those with rhinitis were subtyped as allergic, non-allergic, mixed and unclassified based on a rhinitis questionnaire. The primary outcome measures were categories of headache-day frequency and headache-related disability as measured by the Migraine Disability Assessment Scale (MIDAS). Logistic regression for ordered categories was used for modeling each outcome separately, adjusted for sociodemographics profile, headache features, headache treatments and comorbidities. Results The AMPP Study questionnaire was mailed to 17,892 persons and returned by 60.1% of respondents. Among the migraine sample ( n = 5849), 66.8% had rhinitis with mixed rhinitis as the most common form. The presence of rhinitis of any type was associated with headache frequency after adjusting for sociodemographic variables only (OR 1.33; 95% CI 1.16, 1.53) and in the fully adjusted model (OR 1.25; 95% CI 1.05–1.49). Headache-related disability (MIDAS category) was associated with rhinitis after adjusting for sociodemographic features (OR 1.30; 95% CI 1.17–1.46), but lost significance in the fully adjusted model (OR 1.10; 95% CI 0.96–1.26). Mixed rhinitis was associated with an increased headache frequency category in the model adjusted for sociodemographics (OR 1.45; 95% CI 1.24–1.70) and in that adjusted for all covariates (OR 1.28; 95% CI 1.05–1.57). The odds ratio for MIDAS categories were similarly increased in both models for the mixed rhinitis group. Conclusions The frequency and disability of migraine are higher in persons with rhinitis, particularly those with mixed rhinitis. These results, however, should be considered preliminary until confirmed in future studies because of the modest questionnaire response rate in this study.
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Pavone P, Rizzo R, Conti I, Verrotti A, Mistretta A, Falsaperla R, Pratico AD, Grosso G, Pavone L. Primary headaches in children: clinical findings on the association with other conditions. Int J Immunopathol Pharmacol 2013; 25:1083-91. [PMID: 23298498 DOI: 10.1177/039463201202500425] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the present study is to report on the frequency of some comorbidities in primary headaches in childhood. Two hundred and eighty children (175 males and 105 females; ratio 1.7:1), aged 4 to 14 years, affected by primary headaches were consecutively enrolled in this study. In direct interviews, parents and children gave information about the association of their headaches with different conditions including asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight, affections some time associated in the literature to headache as comorbidities . In addition, anxiety and depression, attention deficit/hyperactivity disorder, tics, learning disabilities and obsessive-compulsive disorders, using psycho-diagnostic scales were evaluated. Two hundred and eighty children matched for age, sex, race and socio-economic status, were used as controls. No significant association of primary headaches was found with asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight. Overall behavioral disorders were more common in children who experienced headache than in controls. A significant association of primary headache was found with anxiety and depression (p value < 0.001), but not with the other psychiatric disorders. Primary headaches in children are not associated with most of the psychiatric and systemic conditions herein investigated. On the contrary, there was a significant association with anxiety and depression, as frequently reported in adults.
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Affiliation(s)
- P Pavone
- Department of Pediatrics and Pediatric Emergency, University Hospital Policlinico-Vittorio Emanuele, Catania, Italy.
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Abstract
Migraine and allergy are both common diseases. Many patients suffer from both, and the vast majority of patients with "sinus headache" complaints are found to have migraine, making migraine identification important to allergists. This review addresses the possibility that allergy and migraine are comorbid conditions, focusing on epidemiology, shared biochemical pathways, and underlying mechanisms. Therapeutic implications of this possible relationship have been the subject of several recent studies, making a review of this association timely and prudent.
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Migraine-asthma comorbidity and risk of hypertensive disorders of pregnancy. J Pregnancy 2012; 2012:858097. [PMID: 22934185 PMCID: PMC3425816 DOI: 10.1155/2012/858097] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 06/16/2012] [Indexed: 12/26/2022] Open
Abstract
Background. To evaluate the association of migraine and asthma and to estimate the risk of hypertensive disorders of pregnancy in relation to maternal comorbid migraine and asthma. Methods. Reproductive age women (N = 3.731) were interviewed during early pregnancy. At the time of interview, we ascertained participants' migraine and asthma status. From medical records, we collected information to allow the diagnosis of pregnancy-induced hypertension (PIH) and preeclampsia. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression procedures. Results. After adjusting for confounders, migraineurs had 1.38-fold increased odds of asthma as compared with nonmigraineurs (95% CI 1.09–1.38). The odds of hypertensive disorders of pregnancy were highest among women with comorbid migraine-asthma. The ORs for PIH preeclampsia and the two disorders combined were 2.53 (95% CI 1.39–4.61), 3.53 (95% CI 1.51–8.24), and 2.64 (95% CI 1.56–4.47), respectively, for women with comorbid migraine-asthma as compared with those who had neither disorder. Conclusion. These findings confirm prior reports and extend the literature by documenting particularly high odds of pregnancy-induced hypertension and preeclampsia among women with comorbid migraine-asthma. Increased knowledge about the prevalence and sequelae of comorbidities during pregnancy may lead to improved symptom management and perinatal outcomes.
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Lateef T, Cui L, Nelson K, Nakamura E, Merikangas K. Physical comorbidity of migraine and other headaches in US adolescents. J Pediatr 2012; 161:308-13.e1. [PMID: 22381023 PMCID: PMC4408276 DOI: 10.1016/j.jpeds.2012.01.040] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 11/30/2011] [Accepted: 01/19/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the pattern and extent to which other physical conditions are comorbid with migraine and other headaches in youth in a representative sample of the US population. STUDY DESIGN The National Comorbidity Survey-Adolescent Supplement is a face-to-face survey of adolescents aged 13-18 years in the continental US. Sufficient information to assess the International Headache Society's criteria for migraine with and without aura over the past 12 months was available in the diagnostic module. A caretaker/parental self-administered report was used to assess a broad range of other physical conditions. The sample for these analyses was 6843 adolescents with systematic caretaker/parent reports. RESULTS Adolescents with any headaches reported higher rates of other neurologic conditions, including epilepsy (OR, 2.02; 95% CI, 1.04-3.94), persistent nightmares (OR, 2.28; 95% CI, 1.34-3.87), and motion sickness (OR, 1.6; 95% CI, 1.07-2.4), as well as abdominal complaints (OR, 2.36; 95% CI, 1.59-3.51). Asthma (OR, 2.22; 95% CI, 1.26-3.92) and seasonal allergies (OR, 1.66; 95% CI, 1.12-2.48) were more common in adolescents with migraines than in adolescents with nonspecific headaches. CONCLUSION Adolescent migraine is associated with inflammatory conditions such as asthma and seasonal allergies, as well as with epilepsy, persistent nightmares, and motion sickness. Our findings suggest that comorbid medical conditions should be evaluated comprehensively in determining treatment options in youth with headache. Such comorbidity also could be an important source of the clinical and etiologic heterogeneity in migraine.
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Affiliation(s)
- T.M. Lateef
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
- Children’s National Medical Center, Washington, D.C
| | - L. Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - K.B. Nelson
- Children’s National Medical Center, Washington, D.C
- National Institute of Neurological Disorders and Stroke and, Department of Neurology
| | - E.F. Nakamura
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - K.R. Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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Millán-Guerrero RO, Baltazar-Rodríguez LM, Cárdenas-Rojas MI, Ramírez-Flores M, Isais-Millán S, Delgado-Enciso I, Caballero-Hoyos R, Trujillo-Hernández B. A280V polymorphism in the histamine H3 receptor as a risk factor for migraine. Arch Med Res 2011; 42:44-7. [PMID: 21376262 DOI: 10.1016/j.arcmed.2011.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 01/13/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Activation of histamine H3 receptors blocks the release of peptides responsible for headache. Our objective was to investigate the association between the genotypes of A280V polymorphism in the H3 receptor and migraine risk. METHODS We evaluated the frequency of the genotypes of A280V, polymorphism A280V and allelic variants of H3 receptor in 147 migraine patients and 186 healthy controls using a PCR-RLFP method. RESULTS V allele frequency was 6.46% and 2.68% for the cases and controls, respectively (p = 0.02) (OR 2.67; 95% CI 1.20-5.93). The frequency of V/V + V/A genotypes was 12.92% in migraine patients, significantly higher when compared to the 3.22% frequency in the control group (p = 0.001) (OR 4.45; 95% CI 1.7-11.46). CONCLUSIONS The results of this study suggest that V-allele genotypes in the H3 receptor gene are related to migraine risk in the Mexican population. We propose the hypothesis that the V-allele genotypes in the H3 receptor gene increase the population of inactive receptors, enhancing the inhibition of the negative feedback mechanism on the H3 receptor and increasing histamine release, which correlates with migraine attacks in susceptible patients. The case-control study reinforces the role of histamine in migraine pathogenesis.
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Affiliation(s)
- Rebeca O Millán-Guerrero
- Department of Neurology, Unidad de Investigación Médica en Epidemiología Clínica, Hospital General de Zona UMF No. 1 IMSS, Colima, México.
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