Comparative Analysis of CGRP, VIP and  PACAP-38 Levels in Migraine with and  Without Aura: A Case-control Study.

IF 1.8 Q4 NEUROSCIENCES

Annals of Neurosciences Pub Date : 2025-05-31 DOI:10.1177/09727531251340156

N Sreevani, B Ramesh, K Maheshkumar, J Thanalakshmi

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Abstract

Background: Migraine pathophysiology involves the release of vasoactive neuropeptides following trigeminovascular system activation. While calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) have been individually studied in migraine, their combined role in differentiating migraine subtypes remains unclear.

Purpose: The aim of this study was to evaluate serum levels of CGRP, VIP and PACAP-38 in patients with migraine with aura (MA) and without aura (MO) compared to healthy controls (HC), and assess their potential as diagnostic biomarkers.

Methods: This case-control study included 296 participants (266 females, 30 males) divided into three groups: MA (n = 101), MO (n = 98) and HC (n = 97). Serum neuropeptide levels were measured using enzyme-linked immunosorbent assay (ELISA) under standardised conditions. Clinical characteristics were assessed using attack frequency and Headache Impact Test-6 (HIT-6) scores.

Results: All three neuropeptides were significantly elevated in migraine patients compared to controls (p < .001). CGRP levels were highest in MA (45.6 ± 8.2 pg/mL), followed by MO (38.4 ± 7.8 pg/mL) and HC (28.3 ± 6.4 pg/mL). Similar patterns were observed for VIP (MA: 186.4 ± 24.6, MO: 165.8 ± 22.4, HC: 142.3 ± 20.8 pg/mL) and PACAP-38 (MA: 248.6 ± 32.4, MO: 228.5 ± 30.6, HC: 195.4 ± 28.2 pg/mL). MA patients showed marginally higher attack frequency (4.8 ± 2.3 vs. 4.2 ± 2.1 per month, p = .06) and HIT-6 scores (64.8 ± 6.2 vs 62.4 ± 5.8, p = .08) compared to MO patients.

Conclusion: The significant elevation of all three neuropeptides, particularly in MA patients, suggests their potential utility as biomarkers for migraine diagnosis and subtype differentiation. These findings support the neurogenic inflammation hypothesis in migraine pathophysiology and may have implications for targeted therapeutic approaches.

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有先兆和 无先兆偏头痛患者CGRP、VIP和 PACAP-38水平的比较分析：一项病例对照研究。

背景：偏头痛的病理生理涉及三叉神经系统激活后血管活性神经肽的释放。虽然降钙素基因相关肽（CGRP）、血管活性肠肽（VIP）和垂体腺苷酸环化酶激活多肽-38 （PACAP-38）在偏头痛中的单独研究，但它们在偏头痛亚型区分中的联合作用尚不清楚。目的：本研究的目的是评估有先兆（MA）和无先兆（MO）偏头痛患者与健康对照组（HC）的血清CGRP、VIP和PACAP-38水平，并评估其作为诊断生物标志物的潜力。方法：纳入病例对照研究296例（女性266例，男性30例），分为MA组（101例）、MO组（98例）和HC组（97例）。在标准化条件下，采用酶联免疫吸附试验（ELISA）测定血清神经肽水平。临床特征评估采用发作频率和头痛影响测试-6 （HIT-6）评分。结果：与对照组相比，偏头痛患者的所有三种神经肽均显著升高（p < 0.001）。CGRP水平在MA组最高（45.6±8.2 pg/mL），其次是MO组（38.4±7.8 pg/mL）和HC组（28.3±6.4 pg/mL）。VIP （MA: 186.4±24.6,MO: 165.8±22.4,HC: 142.3±20.8 pg/mL）和PACAP-38 （MA: 248.6±32.4,MO: 228.5±30.6,HC: 195.4±28.2 pg/mL）的变化规律相似。MA患者的发作频率（每月4.8±2.3次比4.2±2.1次，p = 0.06）和HIT-6评分（64.8±6.2比62.4±5.8,p = 0.08）略高于MO患者。结论：所有三种神经肽的显著升高，特别是在MA患者中，表明它们作为偏头痛诊断和亚型分化的生物标志物的潜在效用。这些发现支持偏头痛病理生理学中的神经源性炎症假说，并可能对靶向治疗方法产生影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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