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Gárate G, Pascual J, Pascual-Mato M, Madera J, Martín MMS, González-Quintanilla V. Untangling the mess of CGRP levels as a migraine biomarker: an in-depth literature review and analysis of our experimental experience. J Headache Pain 2024; 25:69. [PMID: 38684990 PMCID: PMC11057141 DOI: 10.1186/s10194-024-01769-4] [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: 03/18/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Calcitonin gene-related peptide (CGRP) is the most promising candidate to become the first migraine biomarker. However, literature shows clashing results and suggests a methodological source for such discrepancies. We aimed to investigate some of these methodological factors to evaluate the actual role of CGRP as biomarker. METHODS Previous to the experimental part, we performed a literature review of articles measuring CGRP in migraine patients. Using our 399 bio-bank sera samples, we performed a series of experiments to test the validity of different ELISA kits employed, time of sample processing, long-term storage, sampling in rest or after moderate exercise. Analysis of in-house data was performed to analyse average levels of the peptide and the effect of sex and age. RESULTS Literature review shows the high variability in terms of study design, determination methods, results and conclusions obtained by studies including CGRP determinations in migraine patients. CGRP measurements depends on the method and specific kit employed, also on the isoform detected, showing completely different ranges of concentrations. Alpha-CGRP and beta-CGRP had median with IQR levels of 37.5 (28.2-54.4) and 4.6 (2.4-6.4)pg/mL, respectively. CGRP content is preserved in serum within the 24 first hours when samples are stored at 4°C after clotting and immediate centrifugation. Storages at -80°C of more than 6 months result in a decrease in CGRP levels. Moderate exercise prior to blood extraction does not modulate the concentration of the peptide. Age positively correlates with beta-CGRP content and men have higher alpha-CGRP levels than women. CONCLUSIONS We present valuable information for CGRP measurements in serum. ELISA kit suitability should be tested prior to the experiments. Alpha and beta-CGRP levels should be analysed separately as they can show different behaviours even within the same condition. Samples can be processed in a 24-h window if they have been kept in 4°C and should not be stored for more than 6 months at -80°C before assayed. Patients do not need to rest before the blood extraction unless they have performed a high-endurance exercise. For comparative studies, sex and age should be accounted for as these parameters can impact CGRP concentrations.
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Affiliation(s)
- Gabriel Gárate
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain.
| | - Julio Pascual
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain
| | - Marta Pascual-Mato
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain
| | - Jorge Madera
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain
| | - María Muñoz-San Martín
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain
| | - Vicente González-Quintanilla
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla & Universidad de Cantabria, Santander, Spain
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Galiniak S, Biesiadecki M, Rościszewska-Żukowska I, Rachel M. Calcitonin Gene-Related Peptide Level in Cystic Fibrosis Patients. Life (Basel) 2024; 14:565. [PMID: 38792587 PMCID: PMC11122201 DOI: 10.3390/life14050565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Calcitonin gene-related peptide (CGRP) has long been implicated in both the physiology and pathophysiology of the respiratory tract. The objective of our study was to determine the serum concentration of alpha CGRP (αCGRP) in cystic fibrosis (CF) that arises from mutations in the gene responsible for encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Currently, there are not many data in the literature about the role of CGRP in CF. The serum level of αCGRP was estimated using the enzyme-linked immunosorbent assay among 64 patients with CF and 31 healthy controls. The αCGRP concentration in the CF group was 62.51 ± 15.45 pg/mL, while in the control group it was 47.43 ± 8.06 pg/mL (p < 0.001). We also compared the level of αCGRP in CF patients according to the type of CFTR mutation. Homozygotes for ΔF508 had higher αCGRP levels than heterozygotes (67.9 ± 10.2 vs. 54.5 ± 18.3 pg/mL, p < 0.01). The level of this neuropeptide was statistically higher in patients with severe disease than in those with mild CF (p = 0.003) when patients were divided into three groups by spirometry results. αCGRP concentration was not correlated with age, sex, clinical parameters, and pulmonary function test results in the study participants. The results of our study suggest a significant increase in the concentration of αCGRP in the serum of patients with CF compared to the control group. This observation opens interesting possibilities for understanding the role of αCGRP in the context of CF pathophysiology.
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Affiliation(s)
- Sabina Galiniak
- Institute of Medical Sciences, Medical College, Rzeszów University, Warzywna 1a, 35-310 Rzeszów, Poland; (M.B.); (I.R.-Ż.); (M.R.)
| | - Marek Biesiadecki
- Institute of Medical Sciences, Medical College, Rzeszów University, Warzywna 1a, 35-310 Rzeszów, Poland; (M.B.); (I.R.-Ż.); (M.R.)
| | - Iwona Rościszewska-Żukowska
- Institute of Medical Sciences, Medical College, Rzeszów University, Warzywna 1a, 35-310 Rzeszów, Poland; (M.B.); (I.R.-Ż.); (M.R.)
| | - Marta Rachel
- Institute of Medical Sciences, Medical College, Rzeszów University, Warzywna 1a, 35-310 Rzeszów, Poland; (M.B.); (I.R.-Ż.); (M.R.)
- Department of Allergology and Cystic Fibrosis, State Hospital 2 in Rzeszow, Lwowska 60, 35-301 Rzeszów, Poland
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Wong NSQ, Liu C, Lin MTY, Lee IXY, Tong L, Liu YC. Neuropathic Corneal Pain after Coronavirus Disease 2019 (COVID-19) Infection. Diseases 2024; 12:37. [PMID: 38391784 PMCID: PMC10887979 DOI: 10.3390/diseases12020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION This is a case report of a patient with neuropathic corneal pain after coronavirus disease 2019 (COVID-19) infection. METHODS A previously healthy 27-year-old female presented with bilateral eye pain accompanied by increased light sensitivity 5 months after COVID-19 infection. She was diagnosed with neuropathic corneal pain based on clear corneas without fluorescein staining, alongside the presence of microneuromas, dendritic cells, and activated stromal keratocytes identified bilaterally on in vivo confocal microscopy. RESULTS The patient's tear nerve growth factor, substance P, and calcitonin gene-related peptide levels were 5.9 pg/mL, 2978.7 pg/mL, and 1.1 ng/mL, respectively, for the right eye and 23.1 pg/mL, 4798.7 pg/mL, and 1.2 ng/mL, respectively, for the left eye, suggesting corneal neuroinflammatory status. After 6 weeks of topical 0.1% flurometholone treatment, decreased microneuroma size, less extensive dendritic cells, and reduced tear nerve growth factor and substance P levels were observed. The scores on the Ocular Pain Assessment Survey showed an improvement in burning sensation and light sensitivity, decreasing from 80% and 70% to 50% for both. CONCLUSIONS Neuropathic corneal pain is a potential post-COVID-19 complication that warrants ophthalmologists' and neurologists' attention.
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Affiliation(s)
- Natalie Shi Qi Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Chang Liu
- Singapore Eye Research Institute, Singapore 169856, Singapore
| | | | | | - Louis Tong
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore 168751, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yu-Chi Liu
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore 168751, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
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Takizawa T, Ihara K, Uno S, Ohtani S, Watanabe N, Imai N, Nakahara J, Hori S, Garcia-Azorin D, Martelletti P. Metabolic and toxicological considerations regarding CGRP mAbs and CGRP antagonists to treat migraine in COVID-19 patients: a narrative review. Expert Opin Drug Metab Toxicol 2023; 19:951-967. [PMID: 37925645 DOI: 10.1080/17425255.2023.2280221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Migraine pharmacological therapies targeting calcitonin gene-related peptide (CGRP), including monoclonal antibodies and gepants, have shown clinical effect and optimal tolerability. Interactions between treatments of COVID-19 and CGRP-related drugs have not been reviewed. AREAS COVERED An overview of CGRP, a description of the characteristics of each CGRP-related drug and its response predictors, COVID-19 and its treatment, the interactions between CGRP-related drugs and COVID-19 treatment, COVID-19 and vaccination-induced headache, and the neurological consequences of Covid-19. EXPERT OPINION Clinicians should be careful about using gepants for COVID-19 patients, due to the potential drug interactions with drugs metabolized via CYP3A4 cytochrome. In particular, COVID-19 treatment (especially nirmatrelvir packaged with ritonavir, as Paxlovid) should be considered cautiously. It is advisable to stop or adjust the dose (10 mg atogepant when used for episodic migraine) of gepants when using Paxlovid (except for zavegepant). CGRP moncolconal antibodies (CGRP-mAbs) do not have drug - drug interactions, but a few days' interval between a COVID-19 vaccination and the use of CGRP mAbs is recommended to allow the accurate identification of the possible adverse effects, such as injection site reaction. Covid-19- and vaccination-related headache are known to occur. Whether CGRP-related drugs would be of benefit in these circumstances is not yet known.
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Affiliation(s)
- Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Keiko Ihara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Shunsuke Uno
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Seiya Ohtani
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Narumi Watanabe
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Noboru Imai
- Department of Neurology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - David Garcia-Azorin
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Paolo Martelletti
- School of Health Sciences, Unitelma Sapienza University of Rome, Rome, Italy
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Rasmi Y, Jalali L, Khalid S, Shokati A, Tyagi P, Ozturk A, Nasimfar A. The effects of prolactin on the immune system, its relationship with the severity of COVID-19, and its potential immunomodulatory therapeutic effect. Cytokine 2023; 169:156253. [PMID: 37320963 PMCID: PMC10247151 DOI: 10.1016/j.cyto.2023.156253] [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: 01/03/2023] [Revised: 05/01/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023]
Abstract
Prolactin (PRL) is an endocrine hormone secreted by the anterior pituitary gland that has a variety of physiological effects, including milk production, immune system regulation, and anti-inflammatory effects. Elevated levels of PRL have been found in several viral infections, including 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), a viral pathogen that has recently spread worldwide. PRL production is increased in SARS-CoV2 infection. While PRL can trigger the production of proinflammatory cytokines, it also has several anti-inflammatory effects that can reduce hyperinflammation. The exact mechanism of PRL's contribution to the severity of COVID-19 is unknown. The purpose of this review is to discuss the interaction between PRL and SARS-CoV2 infection and its possible association with the severity of COVID-19.
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Affiliation(s)
- Yousef Rasmi
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
| | - Ladan Jalali
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
| | - Saliha Khalid
- Department of Bioinformatics and Genetics, School of Engineering and Natural Sciences, Kadir Has University 34083, Cibali Campus Fatih, Istanbul, Turkey
| | - Ameneh Shokati
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Poonam Tyagi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Alpaslan Ozturk
- Department of Medical Biochemistry, Health Sciences University, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Amir Nasimfar
- Department of Pediatric, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Wang K, Fenton BT, Deng Y, Anthony SE, Dao VX, Schindler E, Lipton RB, Guirguis A, Skanderson M, Seng EK, Sico JJ. Calcitonin Gene-Related Peptide Monoclonal Antibodies and Risk of SARS-CoV-2 Infection and Severe COVID-19 Outcomes Among Veterans With Migraine Disorder. JAMA Netw Open 2023; 6:e2326371. [PMID: 37523183 PMCID: PMC10391301 DOI: 10.1001/jamanetworkopen.2023.26371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/15/2023] [Indexed: 08/01/2023] Open
Abstract
Importance Calcitonin gene-related peptide (CGRP), a neuropeptide involved in migraine pathophysiology, is also a key neuroimmune modulator. CGRP antagonists may help mitigate the hyperinflammatory response observed in patients with COVID-19; however, findings from the literature are contradictory, and to date, no study has investigated the safety and effectiveness of CGRP antagonists against COVID-19. Objective To evaluate the association between CGRP monoclonal antibody (mAb) treatment and risk of SARS-CoV-2 infection and sequela hospitalization, requiring supplemental oxygen, use of mechanical ventilation, or death. Design, Setting, and Participants This retrospective cohort study analyzed the electronic health records of US veterans aged 18 to 65 years who were diagnosed with migraine disorder and were at risk of COVID-19 between January 20, 2020, and May 19, 2022. Exposure Initiation of CGRP mAbs. Main Outcomes and Measures The main outcome was cumulative incidence of SARS-CoV-2 infection. Odds of 30-day hospitalization, requiring supplemental oxygen, use of mechanical ventilation, or death were secondary outcomes. Results Among 8 178 652 eligible person-trials (354 294 veterans), 9992 (mean [SD] age, 46.0 [9.5] years; 53.9% male) initiated CGRP mAbs and 8 168 660 (mean [SD] age, 46.6 [10.2] years; 65.7% male) did not initiate CGRP mAbs. Over a 28-month follow-up period, 1247 initiators (12.5%) and 780 575 noninitiators (9.6%) tested positive for SARS-CoV-2. After censoring persons who deviated from treatment, the incidence was 7.4 cases per 1000 person-months among initiators and 6.9 per 1000 person-months among noninitiators. The inverse probability-weighted observational analogs of intention-to-treat and per-protocol hazard ratios were 0.95 (95% CI, 0.89-1.01) and 0.93 (95% CI, 0.86-1.02), respectively. No significant differences in the likelihood of hospitalization (odds ratio [OR], 0.93; 95% CI, 0.62-1.41), requiring supplemental oxygen (OR, 0.77; 95% CI, 0.45-1.30), use of mechanical ventilation (OR, 0.85; 95% CI, 0.26-2.84), or death (OR, 0.67; 95% CI, 0.09-5.23) were observed between CGRP mAb initiators and noninitiators who tested positive for SARS-CoV-2. Conclusions and Relevance In this cohort study, CGRP mAb treatment was not associated with positive SARS-CoV-2 test results or risk of severe COVID-19 outcomes, suggesting that CGRP mAbs may be used for migraine prevention during the COVID-19 pandemic. Given the few events of requiring supplemental oxygen, use of mechanical ventilation, and death, replication analysis in a larger sample of patients later in the course of disease is warranted.
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Affiliation(s)
- Kaicheng Wang
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Brenda T. Fenton
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
- Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven
| | - Yanhong Deng
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Sarah E. Anthony
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Vinh X. Dao
- Headache Center of Excellence, VA Minneapolis Health Care System, Minneapolis, Minnesota
| | - Emmanuelle Schindler
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Headache Center of Excellence, VA Connecticut Healthcare System, West Haven
| | - Richard B. Lipton
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Alexander Guirguis
- Headache Center of Excellence, VA Connecticut Healthcare System, West Haven
| | - Melissa Skanderson
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
| | - Elizabeth K. Seng
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Jason J. Sico
- Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Headache Center of Excellence, VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
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Rizzi M, D'Onghia D, Tonello S, Minisini R, Colangelo D, Bellan M, Castello LM, Gavelli F, Avanzi GC, Pirisi M, Sainaghi PP. COVID-19 Biomarkers at the Crossroad between Patient Stratification and Targeted Therapy: The Role of Validated and Proposed Parameters. Int J Mol Sci 2023; 24:ijms24087099. [PMID: 37108262 PMCID: PMC10138390 DOI: 10.3390/ijms24087099] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Clinical knowledge about SARS-CoV-2 infection mechanisms and COVID-19 pathophysiology have enormously increased during the pandemic. Nevertheless, because of the great heterogeneity of disease manifestations, a precise patient stratification at admission is still difficult, thus rendering a rational allocation of limited medical resources as well as a tailored therapeutic approach challenging. To date, many hematologic biomarkers have been validated to support the early triage of SARS-CoV-2-positive patients and to monitor their disease progression. Among them, some indices have proven to be not only predictive parameters, but also direct or indirect pharmacological targets, thus allowing for a more tailored approach to single-patient symptoms, especially in those with severe progressive disease. While many blood test-derived parameters quickly entered routine clinical practice, other circulating biomarkers have been proposed by several researchers who have investigated their reliability in specific patient cohorts. Despite their usefulness in specific contexts as well as their potential interest as therapeutic targets, such experimental markers have not been implemented in routine clinical practice, mainly due to their higher costs and low availability in general hospital settings. This narrative review will present an overview of the most commonly adopted biomarkers in clinical practice and of the most promising ones emerging from specific population studies. Considering that each of the validated markers reflects a specific aspect of COVID-19 evolution, embedding new highly informative markers into routine clinical testing could help not only in early patient stratification, but also in guiding a timely and tailored method of therapeutic intervention.
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Affiliation(s)
- Manuela Rizzi
- Department of Health Sciences, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Davide D'Onghia
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Stelvio Tonello
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Rosalba Minisini
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Donato Colangelo
- Department of Health Sciences, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Mattia Bellan
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Luigi Mario Castello
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Francesco Gavelli
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Gian Carlo Avanzi
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Pier Paolo Sainaghi
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
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Al-Keilani MS, Awad S, Hammouri HM, Al Shalakhti T, Almomani BA, Dahabreh MM, Ajlony MJ. Evaluation of serum VIP and aCGRP during pulmonary exacerbation in cystic fibrosis: A longitudinal pilot study of patients undergoing antibiotic therapy. PLoS One 2023; 18:e0284511. [PMID: 37146001 PMCID: PMC10162560 DOI: 10.1371/journal.pone.0284511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 04/02/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Objective monitoring of improvement during treatment of pulmonary exacerbation can be difficulty in children when pulmonary function testing cannot be obtained. Thus, the identification of predictive biomarkers to determine the efficacy of drug treatments is of high priority. The major aim of the current study was to investigate the serum levels of vasoactive intestinal peptide (VIP) and alpha calcitonin gene related peptide (aCGRP) of cystic fibrosis pediatric patients during pulmonary exacerbation and post-antibiotic therapy, and possible associations of their levels with different clinicopathological parameters. METHODS 21 patients with cystic fibrosis were recruited at onset of pulmonary exacerbation. Serum was collected at time of admission, three days post-antibiotic therapy, and two weeks post-antibiotic therapy (end of antibiotic therapy). Serum VIP and aCGRP levels were measured using ELISA. RESULTS Overall least square means of serum aCGRP level but not VIP changed from time of exacerbation to completion of antibiotic therapy (p = 0.005). Serum VIP was significantly associated with the presence of diabetes mellitus (p = 0.026) and other comorbidities (p = 0.013), and with type of antibiotic therapy (p = 0.019). Serum aCGRP level was significantly associated with type of antibiotic therapy (p = 0.012) and positive Staphylococcus aureus microbiology test (p = 0.046). CONCLUSION This study could only show significant changes in serum aCGRP levels following treatment of pulmonary exacerbations. Future studies with larger sample size are required to investigate the clinical importance of VIP and aCGRP in cystic fibrosis patients.
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Affiliation(s)
- Maha S Al-Keilani
- Department of Clinical Pharmacy, College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Samah Awad
- Department of Pediatrics and Neonatology, College of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Hanan M Hammouri
- Department of Mathematics and Statistics, College of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Tala Al Shalakhti
- Department of Pediatrics and Neonatology, College of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basima A Almomani
- Department of Clinical Pharmacy, College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Muna M Dahabreh
- Department of Respiratory Medicine, Royal London Hospital Barts NHS Trust, London, United Kingdom
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Gallardo VJ, Shapiro RE, Caronna E, Pozo‐Rosich P. The relationship of headache as a symptom to
COVID
‐19 survival: A systematic review and meta‐analysis of survival of 43,169 inpatients with
COVID
‐19. Headache 2022; 62:1019-1028. [PMID: 36053077 PMCID: PMC9539239 DOI: 10.1111/head.14376] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Víctor J. Gallardo
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine Universitat Autònoma de Barcelona Barcelona Spain
| | - Robert E. Shapiro
- Department of Neurological Sciences, Larner College of Medicine University of Vermont Burlington Vermont USA
| | - Edoardo Caronna
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine Universitat Autònoma de Barcelona Barcelona Spain
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Barcelona Spain
| | - Patricia Pozo‐Rosich
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine Universitat Autònoma de Barcelona Barcelona Spain
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Barcelona Spain
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Al-Kuraishy HM, Al-Gareeb AI, Alexiou A, Mukerjee N, Al-Hamash SMJ, Al-Maiahy TJ, Batiha GES. 5-HT/CGRP pathway and Sumatriptan role in Covid-19. Biotechnol Genet Eng Rev 2022:1-26. [PMID: 36042570 DOI: 10.1080/02648725.2022.2108996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/21/2022] [Indexed: 12/27/2022]
Abstract
Coronavirus disease 2019 (Covid-19) is a pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). In Covid-19, there is uncontrolled activation of immune cells with a massive release of pro-inflammatory cytokines and the development of cytokine storm. These inflammatory changes induce impairment of different organ functions, including the central nervous system (CNS), leading to acute brain injury and substantial changes in the neurotransmitters, including serotonin (5-HT) and calcitonin gene-related peptide (CGRP), which have immunomodulatory properties through modulation of central and peripheral immune responses. In Covid-19, 5-HT neurotransmitters and CGRP could contribute to abnormal and atypical vascular reactivity. Sumatriptan is a pre-synaptic 5-HT (5-HT1D and 5-HT1B) agonist and inhibits the release of CGRP. Both 5-HT and CGRP seem to be augmented in Covid-19 due to underlying activation of inflammatory signaling pathways and hyperinflammation. In virtue of its anti-inflammatory and antioxidant properties with inhibition release of 5-HT and CGRP, Sumatriptan may reduce Covid-19 hyperinflammation. Therefore, Sumatriptan might be a novel potential therapeutic strategy in managing Covid-19. In conclusion, Sumatriptan could be an effective therapeutic strategy in managing Covid-19 through modulation of 5-HT neurotransmitters and inhibiting CGRP.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyah University, Baghdad, Iraq
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, Australia
- AFNP Med, Wien, Austria
| | - Nobendu Mukerjee
- Department of Microbiology, Ramakrishna Mission Vivekananda Centenary College, Kolkata, India
- Department of Health Sciences, Novel Global Community Educational Foundation, Hebersham, NSW, Australia
| | | | - Thabat J Al-Maiahy
- Department of Gynecology and Obstetrics, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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11
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Neuronal-Immune Cell Units in Allergic Inflammation in the Nose. Int J Mol Sci 2022; 23:ijms23136938. [PMID: 35805946 PMCID: PMC9266453 DOI: 10.3390/ijms23136938] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Immune cells and immune-derived molecules, endocrine glands and hormones, the nervous system and neuro molecules form the combined tridirectional neuroimmune network, which plays a significant role in the communication pathways and regulation at the level of the whole organism and local levels, in both healthy persons and patients with allergic rhinitis based on an allergic inflammatory process. This review focuses on a new research paradigm devoted to neuronal-immune cell units, which are involved in allergic inflammation in the nose and neuroimmune control of the nasal mucociliary immunologically active epithelial barrier. The categorization, cellular sources of neurotransmitters and neuropeptides, and their prevalent profiles in constituting allergen tolerance maintenance or its breakdown are discussed. Novel data on the functional structure of the nasal epithelium based on a transcriptomic technology, single-cell RNA-sequencing results, are considered in terms of neuroimmune regulation. Notably, the research of pathogenesis and therapy for atopic allergic diseases, including recently identified local forms, from the viewpoint of the tridirectional interaction of the neuroimmune network and discrete neuronal-immune cell units is at the cutting-edge.
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12
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Ouerdane Y, Khlidj Y, Attia MS, Korissi R. Calcitonin gene-related peptide: A biomarker for stroke in SARS-CoV-2 infection? Med Hypotheses 2022; 162:110807. [PMID: 35228771 PMCID: PMC8864889 DOI: 10.1016/j.mehy.2022.110807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/11/2022] [Accepted: 02/10/2022] [Indexed: 11/03/2022]
Abstract
COVID-19 infection was mainly associated with respiratory symptoms, but lately, ischemic stroke (IS) has been reported in several cases. The incidence of IS in SARS-CoV-2 infection is increasing, and its mechanism is still not fully understood. Calcitonin gene-related peptide (CGRP) -the abundantly expressed protein in the peripheral and central nervous system- showed low expression in SARS-CoV-2 patients. This peptide is strongly implicated in regulating cerebral blood flow (CBF) and improving neurological deficits after cerebral arterial occlusion. We assume that a possible interplay between the low circulating levels of CGRP may affect CBF, thus worsening the symptoms of IS in SARS-CoV-2 patients.
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13
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Özkan E, Celebi Ö, Keskin Ö, Gursoy A, Gürsoy-Özdemir Y. Is Persistent Post-COVID Headache Associated With Protein-Protein Interactions Between Antibodies Against Viral Spike Protein and CGRP Receptor?: A Case Report. FRONTIERS IN PAIN RESEARCH 2022; 3:858709. [PMID: 35434707 PMCID: PMC9011137 DOI: 10.3389/fpain.2022.858709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background After the acute pandemic of coronavirus disease 2019 (COVID-19), a wide variety of symptoms are identified under the term post-COVID syndrome, such as persistent headache. Post-COVID headache can be presented in a broad spectrum like headache attributed to systemic infection, chronification of already existing primary headache, or long-lasting, and also late-onset new daily persistent headache. Still, little is known about the pathophysiology of post-COVID headache, but activation of the trigeminovascular system may be one of the players. Case Report Here, we present a case with a severe, long-lasting post-COVID headache and its sudden cessation with calcitonin gene-related peptide (CGRP) monoclonal antibody treatment. Conclusion In our previous protein mimicry study, we have pointed at mimicry of virus spike protein and CGRP receptors. This mechanism may enlighten the current, common, and yet unsolved post-COVID headache cases.
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Affiliation(s)
- Esra Özkan
- Koç University Research Center for Translational Medicine, Istanbul, Turkey
| | - Özlem Celebi
- Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey
| | - Özlem Keskin
- College of Engineering, Chemical and Biological Engineering, Koç University, Istanbul, Turkey
| | - Attila Gursoy
- Department of Computer Science and Engineering, College of Engineering, Koç University, Istanbul, Turkey
| | - Yasemin Gürsoy-Özdemir
- Koç University Research Center for Translational Medicine, Istanbul, Turkey
- Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey
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14
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González-Menacho J, Villas-Roca M, Castañé H, Joven J, Camps J, Iftimie S. Can COVID-19 vaccines relieve severe tension-type headache and migraine? Med Hypotheses 2022; 161:110812. [PMID: 35221450 PMCID: PMC8863372 DOI: 10.1016/j.mehy.2022.110812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/17/2022] [Accepted: 02/10/2022] [Indexed: 11/06/2022]
Abstract
Chronic headache is a frequent disorder that can cause a significant deterioration in the quality of life of the affected person. The COVID-19 pandemic is compelling all countries to develop a complete vaccination protocol for the entire population. In this article, we present 8 clinical cases of patients suffering chronic headache which resolved completely or partially after vaccination. Five patients had migraine, 2 had a post-viral headache typical of COVID-19, and one had a headache induced by sexual activity. Resolution was complete in 3 cases, almost complete in 2 others, and a great improvement was observed in the other 3. We hypothesize that the administration of vaccines for COVID-19 can produce an improvement or the disappearance of symptoms in our patients by inhibiting synthesis of pro-inflammatory cytokines.
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15
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Al-Kuraishy HM, Al-Gareeb AI, Butnariu M, Batiha GES. The crucial role of prolactin-lactogenic hormone in Covid-19. Mol Cell Biochem 2022; 477:1381-1392. [PMID: 35147901 PMCID: PMC8831165 DOI: 10.1007/s11010-022-04381-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 12/15/2022]
Abstract
Prolactin (PRL) is a peptide hormone secreted from anterior pituitary involved in milk production in the females and regulation of sex drive in both sexes. PRL has pro-inflammatory and anti-inflammatory functions. High PRL serum level or hyperprolactinemia is associated with different viral infections. In coronavirus disease 2019 (Covid-19), which caused by positive-sense single-strand RNA virus known as severe acute respiratory distress syndrome coronavirus type 2 (SARS-CoV-2), PRL serum level is increased. PRL in Covid-19 may exacerbate the underlying inflammatory status by induction release of pro-inflammatory cytokines. However, PRL through its anti-inflammatory effects may reduce the hyperinflammatory status in Covid-19. The underlying mechanism of increasing PRL in Covid-19 is poorly understood. Therefore, in this review we try to find the potential anti-inflammatory or pro-inflammatory role of PRL in Covid-19. As well, this review was aimed to discuss the underlying causes and mechanisms for Covid-19-induced hyperprolactinemia.
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Affiliation(s)
| | - Ali I Al-Gareeb
- College of Medicine, Al-Mustansiriyah University, P.O. Box 14132, Baghdad, Iraq
| | - Monica Butnariu
- Chemistry & Biochemistry Discipline, Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" From Timisoara, Calea Aradului 119, 300645, Timis, Romania.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, AlBeheira, 22511, Egypt.
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16
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Hiroki CH, Sarden N, Hassanabad MF, Yipp BG. Innate Receptors Expression by Lung Nociceptors: Impact on COVID-19 and Aging. Front Immunol 2021; 12:785355. [PMID: 34975876 PMCID: PMC8716370 DOI: 10.3389/fimmu.2021.785355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
The lungs are constantly exposed to non-sterile air which carries harmful threats, such as particles and pathogens. Nonetheless, this organ is equipped with fast and efficient mechanisms to eliminate these threats from the airways as well as prevent pathogen invasion. The respiratory tract is densely innervated by sensory neurons, also known as nociceptors, which are responsible for the detection of external stimuli and initiation of physiological and immunological responses. Furthermore, expression of functional innate receptors by nociceptors have been reported; however, the influence of these receptors to the lung function and local immune response is poorly described. The COVID-19 pandemic has shown the importance of coordinated and competent pulmonary immunity for the prevention of pathogen spread as well as prevention of excessive tissue injury. New findings suggest that lung nociceptors can be a target of SARS-CoV-2 infection; what remains unclear is whether innate receptor trigger sensory neuron activation during SARS-CoV-2 infection and what is the relevance for the outcomes. Moreover, elderly individuals often present with respiratory, neurological and immunological dysfunction. Whether aging in the context of sensory nerve function and innate receptors contributes to the disorders of these systems is currently unknown. Here we discuss the expression of innate receptors by nociceptors, particularly in the lungs, and the possible impact of their activation on pulmonary immunity. We then demonstrate recent evidence that suggests lung sensory neurons as reservoirs for SARS-CoV-2 and possible viral recognition via innate receptors. Lastly, we explore the mechanisms by which lung nociceptors might contribute to disturbance in respiratory and immunological responses during the aging process.
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Affiliation(s)
- Carlos H. Hiroki
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nicole Sarden
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mortaza F. Hassanabad
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bryan G. Yipp
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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17
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Abstract
Purpose of Review Headache is a common symptom of COVID-19 with emerging literature being published on the subject. Although it may seem unspecific, scientific evidence has allowed a better definition of this headache type, revealing relevant associations with other COVID-19 symptoms and prognoses. We therefore sought to highlight the most remarkable findings concerning headache secondary to COVID-19, specifically focusing on epidemiology, characteristics, pathophysiology, and treatments. Recent Findings The real prevalence of headache as a symptom of COVID-19 is still unclear ranging from 10 to 70%. Headache mainly has a tension-type-like phenotype, although 25% of individuals present with migraine-like features that also occur in patients without personal migraine history. This finding suggests that a likely pathophysiological mechanism is the activation of the trigeminovascular system. SARS-CoV-2 neurotropism can occur by trans-synaptic invasion through the olfactory route from the nasal cavity, leading to anosmia which has been associated with headache. SARS-CoV-2 protein has been found not only in olfactory mucosa and bulbs but also in trigeminal branches and the trigeminal ganglion, supporting this hypothesis. However, other mechanisms such as brain vessels inflammation due to SARS-CoV-2 damage to the endothelium or systemic inflammation in the context of cytokine storm cannot be ruled out. Interestingly, headache has been associated with lower COVID-19 mortality. No specific treatment for COVID-19 headache is available at present. Summary Studies show that investigating COVID-19 headache represents an opportunity not only to better understand COVID-19 in general but also to advance in the knowledge of both secondary and primary headaches. Future research is therefore warranted.
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18
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Khodabakhsh P, Asgari Taei A, Mohseni M, Bahrami Zanjanbar D, Khalili H, Masoumi K, Haji Abbas Shirazi A, Dargahi L. Vasoactive Peptides: Role in COVID-19 Pathogenesis and Potential Use as Biomarkers and Therapeutic Targets. Arch Med Res 2021; 52:777-787. [PMID: 34134920 PMCID: PMC8179120 DOI: 10.1016/j.arcmed.2021.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/28/2021] [Accepted: 05/27/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND The ongoing outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as the latest threat to global health, causes overwhelming effects for the public healthcare systems worldwide. Of note, in addition to the respiratory complications, some patients with coronavirus disease 2019 (COVID-19) also develop serious cardiovascular injuries. Vasoactive peptides play an important role in a wide range of physiological and pathological conditions. AIM With the urgent need for exploring the specific therapeutic targets and biomarkers for the emerging COVID-19, the general aim of this review is to discuss the potentials of the vasoactive peptides including Angiotensin II (Ang II), vasoactive intestinal peptide (VIP), endothelin-1 (ET-1), calcitonin gene-related peptide (CGRP), natriuretic peptides, substance P (SP) and bradykinin (BK) as therapeutic targets and/or prognostic indicators for the COVID-19 pandemic. CONCLUSION Based on various observations some authors conclude that the assessment of vasoactive peptides shall be considered a routine part of COVID-19 patient monitoring, and they can serve as potential therapeutic targets for the disease management.
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Affiliation(s)
- Pariya Khodabakhsh
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran,Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afsaneh Asgari Taei
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moein Mohseni
- Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Dorsa Bahrami Zanjanbar
- Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hasti Khalili
- Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Kimia Masoumi
- Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | | | - Leila Dargahi
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Iannone LF, Geppetti P, Chiarugi A, De Cesaris F. COVID-19 pneumonia during long-term migraine prophylaxis with fremanezumab: a case report. Intern Emerg Med 2021; 16:2309-2311. [PMID: 34118012 PMCID: PMC8196929 DOI: 10.1007/s11739-021-02787-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Luigi Francesco Iannone
- Headache Center and Clinical Pharmacology, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | - Pierangelo Geppetti
- Headache Center and Clinical Pharmacology, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | - Alberto Chiarugi
- Headache Center and Clinical Pharmacology, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | - Francesco De Cesaris
- Headache Center and Clinical Pharmacology, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy.
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20
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Abobaker A, Darrat M. Letter to the Editor From Abobaker and Darrat: "Circulating Levels of Calcitonin Gene-Related Peptide Are Lower in COVID-19 Patients". J Endocr Soc 2021; 5:bvab052. [PMID: 34396020 PMCID: PMC8083661 DOI: 10.1210/jendso/bvab052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Anis Abobaker
- York Teaching Hospital NHS Foundation Trust, Scarborough, YO12 6QL, UK
| | - Milad Darrat
- Regional Centre For Diabetes and Endocrinology, Royal Victoria Hospital, Belfast, BT12 6BA, UK
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21
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Bolay H, Karadas Ö, Oztürk B, Sonkaya R, Tasdelen B, Bulut TDS, Gülbahar Ö, Özge A, Baykan B. HMGB1, NLRP3, IL-6 and ACE2 levels are elevated in COVID-19 with headache: a window to the infection-related headache mechanism. J Headache Pain 2021; 22:94. [PMID: 34384355 PMCID: PMC8358545 DOI: 10.1186/s10194-021-01306-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Background and aim Pathogenesis of COVID-19 -related headache is unknown, though the induction of the trigeminal neurons through inflammation is proposed. We aimed to investigate key systemic circulating inflammatory molecules and their clinical relations in COVID-19 patients with headache. Methods This cross-sectional study enrolled 88 COVID-19 patients, hospitalized on a regular ward during the second wave of the pandemic. Clinical characteristics of COVID-19 patients were recorded, and laboratory tests were studied. Results The mean ages of 48 COVID-19 patients with headache (47.71 ± 10.8) and 40 COVID-19 patients without headache (45.70 ± 12.72) were comparable. COVID-19 patients suffered from headache had significantly higher serum levels of HMGB1, NLRP3, ACE2, and IL-6 than COVID-19 patients without headache, whereas CGRP and IL-10 levels were similar in the groups. Angiotensin II level was significantly decreased in the headache group. COVID-19 patients with headache showed an increased frequency of pulmonary involvement and increased D- dimer levels. Furthermore, COVID-19 was more frequently associated with weight loss, nausea, and diarrhea in patients with headache. Serum NLRP3 levels were correlated with headache duration and hospital stay, while headache response to paracetamol was negatively correlated with HMGB1 and positively associated with IL-10 levels. Conclusion Stronger inflammatory response is associated with headache in hospitalized COVID-19 patients with moderate disease severity. Increased levels of the circulating inflammatory and/or nociceptive molecules like HMGB1, NLRP3, and IL-6 may play a role in the potential induction of the trigeminal system and manifestation of headache secondary to SARS-CoV-2 infection.
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Affiliation(s)
- Hayrunnisa Bolay
- Department of Neurology and Algology, Neuropsychiatry Center, Neuroscience and Neurotechnology Center (NÖROM), Gazi University Hospital, Medical Faculty, Besevler, 06510, Ankara, Turkey.
| | - Ömer Karadas
- Neurology Department, University of Health Science, Gülhane School of Medicine, Ankara, Turkey
| | - Bilgin Oztürk
- Neurology Department, University of Health Science, Gülhane School of Medicine, Ankara, Turkey
| | - Riza Sonkaya
- Neurology Department, University of Health Science, Gülhane School of Medicine, Ankara, Turkey
| | - Bahar Tasdelen
- Department of Biostatistics and Medical Informatics, Mersin University, Medical Faculty, Mersin, Turkey
| | - Tuba D S Bulut
- Department of Medical Biochemistry, Gazi University, Medical Faculty, Ankara, Turkey
| | - Özlem Gülbahar
- Department of Medical Biochemistry, Gazi University, Medical Faculty, Ankara, Turkey
| | - Aynur Özge
- Department of Neurology and Algology, Mersin University, Medical Faculty, Mersin, Turkey
| | - Betül Baykan
- Istanbul Faculty of Medicine, Department of Neurology, Headache Center, Istanbul University, Istanbul, Turkey
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22
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Ochoa-Callejero L, García-Sanmartín J, Villoslada-Blanco P, Íñiguez M, Pérez-Matute P, Pujadas E, Brody R, Oteo JA, Martínez A. Response to Letter to the Editor from Abobaker and Darrat: "Circulating levels of Calcitonin Gene-Related Peptide Are Lower in COVID-19 Patients". J Endocr Soc 2021; 5:bvab053. [PMID: 34396021 PMCID: PMC8083267 DOI: 10.1210/jendso/bvab053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | | | - María Íñiguez
- Infectious Diseases, Microbiota, and Metabolism Unit (CIBIR), Logroño, Spain
| | | | - Elisabet Pujadas
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rachel Brody
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - José A Oteo
- Infectious Diseases, Microbiota, and Metabolism Unit (CIBIR), Logroño, Spain.,Infectious Diseases Department, Hospital Universitario San Pedro, Logroño, Spain
| | - Alfredo Martínez
- Oncology Area, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
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