1. Clinical relevance of depressed kynurenine pathway in episodic migraine patients: potential prognostic markers in the peripheral plasma during the interictal period
- Author
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Dániel Veréb, Gábor Kecskeméti, János Tajti, Edina Katalin Cseh, Tamás Janáky, Ferenc Tömösi, Aliz Nyári, László Vécsei, Tamás Körtési, and Bernadett Tuka
- Subjects
Adult ,medicine.medical_specialty ,Kynurenine pathway ,Kynurenic Acid ,Melatonin ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Kynurenic acid ,Tandem Mass Spectrometry ,Internal medicine ,medicine ,Humans ,Ictal ,Xanthurenic acid ,Episodic migraine ,Kynurenine ,030304 developmental biology ,0303 health sciences ,business.industry ,Interictal-ictal periods ,Aura-without aura ,Clinical features ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Anesthesiology and Pain Medicine ,Endocrinology ,chemistry ,Migraine ,Medicine ,Pituitary Adenylate Cyclase-Activating Polypeptide ,Female ,Neurology (clinical) ,Serotonin ,business ,Plasma tryptophan metabolites: kynurenine-serotonin-melatonin pathways ,030217 neurology & neurosurgery ,medicine.drug ,Research Article - Abstract
Background Altered glutamatergic neurotransmission and neuropeptide levels play a central role in migraine pathomechanism. Previously, we confirmed that kynurenic acid, an endogenous glutamatergic antagonist, was able to decrease the expression of pituitary adenylate cyclase-activating polypeptide 1–38, a neuropeptide with known migraine-inducing properties. Hence, our aim was to reveal the role of the peripheral kynurenine pathway (KP) in episodic migraineurs. We focused on the complete tryptophan (Trp) catabolism, which comprises the serotonin and melatonin routes in addition to kynurenine metabolites. We investigated the relationship between metabolic alterations and clinical characteristics of migraine patients. Methods Female migraine patients aged between 25 and 50 years (n = 50) and healthy control subjects (n = 34) participated in this study. Blood samples were collected from the cubital veins of subjects (during both the interictal/ictal periods in migraineurs, n = 47/12, respectively). 12 metabolites of Trp pathway were determined by neurochemical measurements (UHPLC-MS/MS). Results Plasma concentrations of the most Trp metabolites were remarkably decreased in the interictal period of migraineurs compared to healthy control subjects, especially in the migraine without aura (MWoA) subgroup: Trp (p p p p p p Conclusions Our results suggest that there is a widespread metabolic imbalance in migraineurs, which manifests in a completely depressed peripheral Trp catabolism during the interictal period. It might act as trigger for the migraine attack, contributing to glutamate excess induced neurotoxicity and generalised hyperexcitability. This data can draw attention to the clinical relevance of KP in migraine.
- Published
- 2020