Dynamic fluctuations of salivary CGRP levels during migraine attacks

Migraine is a complex neurological disorder with significant heterogeneity in its clinical presentation and molecular mechanisms. Calcitonin gene-related peptide (CGRP) has emerged as a key player in migraine pathophysiology, but challenges remain in its utilization as a biomarker. This study aimed...

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Autores: Alpuente, Alicia|||0000-0001-5296-9401, Gallardo López, Victor José|||0000-0002-3042-2007, Asskour, Laila, Caronna, Edoardo|||0000-0001-5525-0267, Torres-Ferrús, Marta|||0000-0003-2856-4134, Pozo-Rosich, Patricia|||0000-0003-0796-4702
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:319983
Acceso en línea:https://ddd.uab.cat/record/319983
https://dx.doi.org/urn:doi:10.1186/s10194-024-01772-9
Access Level:acceso abierto
Palabra clave:Migraine
Salivary CGRP
Biomarker
Endophenotyping
Personalized medicine
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repository_id_str
spelling Dynamic fluctuations of salivary CGRP levels during migraine attacksassociation with clinical variables and phenotypic characterizationAlpuente, Alicia|||0000-0001-5296-9401Gallardo López, Victor José|||0000-0002-3042-2007Asskour, LailaCaronna, Edoardo|||0000-0001-5525-0267Torres-Ferrús, Marta|||0000-0003-2856-4134Pozo-Rosich, Patricia|||0000-0003-0796-4702MigraineSalivary CGRPBiomarkerEndophenotypingPersonalized medicineMigraine is a complex neurological disorder with significant heterogeneity in its clinical presentation and molecular mechanisms. Calcitonin gene-related peptide (CGRP) has emerged as a key player in migraine pathophysiology, but challenges remain in its utilization as a biomarker. This study aimed to investigate salivary CGRP levels during migraine attacks across the frequency spectrum and explore associations with clinical variables. A prospective longitudinal pilot study was conducted, recruiting migraine patients from an outpatient headache clinic. Salivary CGRP levels were measured at interictal, onset, post-2 h of onset and end-of-attack. Using generalized linear mixed models, we explored the effect of CGRP changes over the attack in presence of depressive symptoms (DS), acute attack treatment, and after three-months of erenumab treatment. Finally, patients were classified and compared according to their CGRP phenotype. A total of 44 migraine patients were included (90.9% women), with 80 migraine attacks analyzed. Salivary CGRP levels increased at the onset of migraine attacks. We observed statistically significant interactions between DS and both the linear (Est. [SE]: 19.4 [5.8], p = 0.001) and quadratic terms of time (-19.1 [6.0], p = 0.002). Additionally, a significant three-way interaction within the use of acute treated attack (linear-term: -18.5 [6.2], p = 0.005; quadratic-term: 19.2 [6.8], p = 0.005) was also found. Molecular phenotyping revealed that 72.7% (32/44) of patients presented only CGRP-dependent attacks, while 27.3% (12/44) presented non-CGRP-dependent migraine attacks. Patients with only CGRP-dependent attacks were associated with younger age, shorter disease evolution time, a higher proportion of aura, and fewer monthly headache days (p < 0.05). Exploratory analysis of erenumab treatment effects did not result in changes in CGRP levels during migraine attacks. Our study underscores the dynamic nature of migraine at a molecular level and emphasizes the importance of integrating clinical variables, such as depressive symptoms, in understanding its pathophysiology. The identification of distinct migraine subtypes based on CGRP dependence suggests potential opportunities for personalized treatment approaches. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/319983https://dx.doi.org/urn:doi:10.1186/s10194-024-01772-9reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengMinisterio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI16/01525open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3199832026-06-06T12:50:31Z
dc.title.none.fl_str_mv Dynamic fluctuations of salivary CGRP levels during migraine attacks
association with clinical variables and phenotypic characterization
title Dynamic fluctuations of salivary CGRP levels during migraine attacks
spellingShingle Dynamic fluctuations of salivary CGRP levels during migraine attacks
Alpuente, Alicia|||0000-0001-5296-9401
Migraine
Salivary CGRP
Biomarker
Endophenotyping
Personalized medicine
title_short Dynamic fluctuations of salivary CGRP levels during migraine attacks
title_full Dynamic fluctuations of salivary CGRP levels during migraine attacks
title_fullStr Dynamic fluctuations of salivary CGRP levels during migraine attacks
title_full_unstemmed Dynamic fluctuations of salivary CGRP levels during migraine attacks
title_sort Dynamic fluctuations of salivary CGRP levels during migraine attacks
dc.creator.none.fl_str_mv Alpuente, Alicia|||0000-0001-5296-9401
Gallardo López, Victor José|||0000-0002-3042-2007
Asskour, Laila
Caronna, Edoardo|||0000-0001-5525-0267
Torres-Ferrús, Marta|||0000-0003-2856-4134
Pozo-Rosich, Patricia|||0000-0003-0796-4702
author Alpuente, Alicia|||0000-0001-5296-9401
author_facet Alpuente, Alicia|||0000-0001-5296-9401
Gallardo López, Victor José|||0000-0002-3042-2007
Asskour, Laila
Caronna, Edoardo|||0000-0001-5525-0267
Torres-Ferrús, Marta|||0000-0003-2856-4134
Pozo-Rosich, Patricia|||0000-0003-0796-4702
author_role author
author2 Gallardo López, Victor José|||0000-0002-3042-2007
Asskour, Laila
Caronna, Edoardo|||0000-0001-5525-0267
Torres-Ferrús, Marta|||0000-0003-2856-4134
Pozo-Rosich, Patricia|||0000-0003-0796-4702
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Migraine
Salivary CGRP
Biomarker
Endophenotyping
Personalized medicine
topic Migraine
Salivary CGRP
Biomarker
Endophenotyping
Personalized medicine
description Migraine is a complex neurological disorder with significant heterogeneity in its clinical presentation and molecular mechanisms. Calcitonin gene-related peptide (CGRP) has emerged as a key player in migraine pathophysiology, but challenges remain in its utilization as a biomarker. This study aimed to investigate salivary CGRP levels during migraine attacks across the frequency spectrum and explore associations with clinical variables. A prospective longitudinal pilot study was conducted, recruiting migraine patients from an outpatient headache clinic. Salivary CGRP levels were measured at interictal, onset, post-2 h of onset and end-of-attack. Using generalized linear mixed models, we explored the effect of CGRP changes over the attack in presence of depressive symptoms (DS), acute attack treatment, and after three-months of erenumab treatment. Finally, patients were classified and compared according to their CGRP phenotype. A total of 44 migraine patients were included (90.9% women), with 80 migraine attacks analyzed. Salivary CGRP levels increased at the onset of migraine attacks. We observed statistically significant interactions between DS and both the linear (Est. [SE]: 19.4 [5.8], p = 0.001) and quadratic terms of time (-19.1 [6.0], p = 0.002). Additionally, a significant three-way interaction within the use of acute treated attack (linear-term: -18.5 [6.2], p = 0.005; quadratic-term: 19.2 [6.8], p = 0.005) was also found. Molecular phenotyping revealed that 72.7% (32/44) of patients presented only CGRP-dependent attacks, while 27.3% (12/44) presented non-CGRP-dependent migraine attacks. Patients with only CGRP-dependent attacks were associated with younger age, shorter disease evolution time, a higher proportion of aura, and fewer monthly headache days (p < 0.05). Exploratory analysis of erenumab treatment effects did not result in changes in CGRP levels during migraine attacks. Our study underscores the dynamic nature of migraine at a molecular level and emphasizes the importance of integrating clinical variables, such as depressive symptoms, in understanding its pathophysiology. The identification of distinct migraine subtypes based on CGRP dependence suggests potential opportunities for personalized treatment approaches.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/319983
https://dx.doi.org/urn:doi:10.1186/s10194-024-01772-9
url https://ddd.uab.cat/record/319983
https://dx.doi.org/urn:doi:10.1186/s10194-024-01772-9
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI16/01525
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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