Background

Increasing evidence suggests that vasoactive neuropeptides such as pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38), substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide are involved in the pathophysiology of migraine in adults, but their role in pediatric migraineurs remains unclear. We prospectively investigated plasma levels of these vasoactive neuropeptides in pediatric migraine patients without aura and compared the results with those of age-matched healthy controls.

Methods

Thirty-eight children aged 6–18 years with migraine without aura and 20 age-matched control subjects were included in the study. Neuropeptides in plasma samples from the controls, and in either the ictal or interictal periods in pediatric migraine without aura, were measured using ELISA.

Results

PACAP-38 and vasoactive intestinal peptide levels in both ictal and interictal plasma were higher in the patients with pediatric migraine without aura than in the controls (p < 0.001), although calcitonin gene-related peptide and substance P levels remained unchanged. Otherwise, no significant difference was determined between ictal and interictal periods in terms of all neuropeptide levels.

Conclusions

This study demonstrates increased plasma PACAP-38 and vasoactive intestinal peptide levels, but not calcitonin gene-related peptide and substance P levels, in pediatric patients with migraine during both attack and attack-free periods. The study findings suggest that PACAP-38 and vasoactive intestinal peptide may be implicated in the pathophysiology of migraine, particularly in pediatric migraineurs.

中文翻译：

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儿童偏头痛发作期和非发作期血管活性神经肽的血浆水平。

背景

越来越多的证据表明血管活性神经肽，如垂体腺苷酸环化酶激活多肽-38 (PACAP-38)、P 物质、降钙素基因相关肽和血管活性肠肽参与成人偏头痛的病理生理，但它们在儿童偏头痛中的作用偏头痛患者仍不清楚。我们前瞻性地研究了这些血管活性神经肽在没有先兆的小儿偏头痛患者中的血浆水平，并将结果与​​年龄匹配的健康对照者进行了比较。

方法

研究包括 38 名 6-18 岁无先兆偏头痛儿童和 20 名年龄匹配的对照受试者。使用 ELISA 测量来自对照的血浆样品中的神经肽，以及无先兆的小儿偏头痛发作期或发作期的神经肽。

结果

 尽管降钙素基因相关肽和 P 物质水平保持不变，但无先兆小儿偏头痛患者的发作期和发作间期血浆中的 PACAP-38 和血管活性肠肽水平均高于对照组（p < 0.001）。否则，就所有神经肽水平而言，在发作期和间歇期之间没有确定显着差异。

结论

该研究表明，在发作期和未发作期的儿童偏头痛患者中，血浆 PACAP-38 和血管活性肠肽水平升高，但降钙素基因相关肽和 P 物质水平升高。研究结果表明，PACAP-38 和血管活性肠肽可能与偏头痛的病理生理学有关，尤其是小儿偏头痛患者。