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Plasma Levels and the Correlation of ICAM-1and IL-6of Migraineurs

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Tutor: HeQiu
School: Dalian Medical University
Course: Neurology
Keywords: Migraine,Intercellular adhesion molecule-1,Interleukin-6,Inflammatory cytokines
CLC: R747.2
Type: Master's thesis
Year:  2013
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BackgroundMigraine is one of the common diseases in Neurology. Its main clinicalmanifestation is a recurrent pulsatile headache,unilateral or bilateral.It has a highcrowd incidence and prevalence,and tens of millions of people are suffering frommigraine which brings serious burden to the patients,their family and the wholesociety.Scholars at home and abroad have made a lot of research on migraine,but itspathogenesis remains unclear. Therefore, it’s one of the diseases with whosetherapeutic effect many neurology experts are not satisfied.The trigeminal vascular response theory gets a widespread concern by researchersin recent years which shows some factors activate the trigeminal vascularsystem.Neuropeptides such as substance P and calcitonin gene-related peptide(CGRP)released from trigeminal peripheral axons and subsequent enhanced vascularpermeability,vasodilatation,edema and mast cell degranulation induce neurogenicinflammation which is an important pathophysiological mechanism of migraine.Its coreis gene expression and regulation.There are animal studies show up-regulation ofnuclear factor kappa B (NF-κB) when migraine occur.NF-κB induces inducible nitricoxide synthase (iNOS) and generates nitric oxide (NO), then up-regulatescyclooxygenase-2(COX-2), tumor necrosis factor-α(TNF-α) and matrixmetalloproteinase-9(MMP-9).On the other hand,the release of neuropeptides such as substance P and CGRP in peripheral nerve endings can cause the release ofpro-inflammatory cytokines TNF-alpha,interleukin-1(interleukin-1,IL-1),et al.Many studies have shown that plasma levels of TNF-alpha,IL-1and CGRP inmigraineurs are higher than healthy people.The study about the correlation betweenmigraine and other inflammatory cytokines like IL-6and IL-10are rare,and there areno study about plasma levels of ICAM-1in migraine at home.So more study aboutplasma levels and correlations of these cytokines in migraine is necessary.We selected ICAM-1and IL-6,by case-control association analysis,measuredplasma levels of the two cytokines in the migraineurs in the stage of attack and thehealthy controls and investigated the correlations.Our aim is to show the important roleof cytokines in the pathogenesis of migraine and provide the theoretical basis forprevention and treatment of migraine.MethodsBy case-control association analysis, the subjects of migraine group areconsecutively enrolled with a total of59cases,with the number of migraine with auragroup21and migraine without aura group38,male23and female36,13-45yearsold.The controls matche by age and sex are recruited with a total of39cases,male14and female25,15-48years old.The plasma levels of ICAM-1and IL-6are measuredusing ELISA.The data is done using SPSS17.0.We use median and interquartile rangeto describe the measurement data and Kolmogonov-Smirnov Z test to analyze thedifferences.The correlation analysis is done using Spearman rank correlation analysis,P<0.05is as statistical criteria,P<0.01is statistical significant.Results1.In migraine groups,ICAM-1and IL-6content both are significantly higher thanthe healthy control group,the difference are statistically significant (Z=3.405,P=0.000;Z=1.969,P=0.001,respectively);With aura migraine headache group(MA)the ICAM-1content is significantly higher than that of migraine without aura group(MO),the difference is statistically significant(Z=3.115,P=0.000),and IL-6contentin the difference between the two groups was not statistically significant (Z=1.042,P=0.228);Plasma levels of ICAM-1and IL-6in MA or MO are all higher than that of the controls(Z=3.519,P=0.000;Z=2.803,P=0.000;Z=2.044,P=0.000;Z=1.738,P=0.005,respectively).2.Spearman rank correlation analysis shows that ICAM-1and IL-6are positivelycorrelated (r=1,P=0.000).Conclusion1.Circulating levels of ICAM-1and IL-6in migraineurs are significantly high,prompting that ICAM-1and IL-6may be involved in the pathogenesis of migraineattacks and have effects on happening and development of the migraine.2.ICAM-1activities in MA are significantly higher than that in MO,shows thecytokine maybe correlated with the mechanism of the aura.3.There is significantly positive correlation between ICAM-1levels and IL-6activities,prompting that the two cytokines may interact with each other and getcascade effect in the neurogenic inflammation.4.Circulating levels of ICAM-1and IL-6in migraineurs are significantly highwhich further prove that migraine is a kind of neurogenic inflammatory disease.
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