Altered serum levels of kynurenine metabolites in patients affected by cluster headache

The Journal of Headache and Pain

Research Article

Maurizio Simmaco¹  Luana Lionetto¹  Matilde Capi¹  Francesca Perugino²  Andrea Negro³  Paolo Martelletti⁴  Martina Curto⁵  Maria Adele Giamberardino⁶  Francesco Fazio⁷  Ferdinando Nicoletti⁸ 

[1] Advanced Molecular Diagnostics, IDI-IRCCS, Rome, Italy;Department of Molecular Medicine, Sant’Andrea Medical Center, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy;Department of Molecular Medicine, Sant’Andrea Medical Center, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy;Advanced Molecular Diagnostics, IDI-IRCCS, Rome, Italy;Department of Molecular Medicine, Sant’Andrea Medical Center, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy;Regional referral headache center, Sant’Andrea Hospital, Rome, Italy;Department of Psychiatry, Harvard Medical School, Boston, MA, USA;Department of Molecular Medicine, Sant’Andrea Medical Center, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy;Regional referral headache center, Sant’Andrea Hospital, Rome, Italy;Headache Center and Geriatrics Clinic, Department of Medicine and Science of Aging, “G. D’Annunzio” University, Chieti, Italy;IRCCS Neuromed, Pozzilli, Italy;IRCCS Neuromed, Pozzilli, Italy;Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy;

关键词: Kynurenine;    Cluster headache;    Glutamate;    Pain;    NMDA receptors;   

DOI  :  10.1186/s10194-016-0620-2

 received in 2016-01-24, accepted in 2016-03-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe reported efficacy of memantine in the treatment of patients with cluster headache (CH) suggests that NMDA receptors are involved in mechanisms of nociceptive sensitization within the trigeminal system associated with CH. NMDA receptors are activated or inhibited by neuroactive compounds generated by tryptophan metabolism through the kynurenine pathway. In the accompanying manuscript, we have found that serum levels of all kynurenine metabolites are altered in patients with chronic migraine. Here, we have extended the study to patients affected by episodic or chronic CH as compared to healthy controls.MethodWe assessed serum levels of kynurenine (KYN), kynurenic Acid (KYNA), anthranilic acid (ANA), 3-hydroxy-anthranilic acid (3-HANA), 3-hydroxykynurenine (3-HK), xanthurenic acid (XA), quinolinic acid (QUINA), tryptophan (Trp) and 5-hydroxyindolacetic acid (5-HIAA) by means of a liquid chromatography/tandem mass spectrometry (LC/MS-MS) method in 21 patients affected by CH (15 with episodic and 6 with chronic CH), and 35 age-matched healthy subjects. Patients with psychiatric co-morbidities, systemic inflammatory, endocrine or neurological disorders, and mental retardation were excluded.ResultsLC/MS-MS analysis of kynurenine metabolites showed significant reductions in the levels of KYN (-36 %), KYNA (-34 %), 3-HK (-51 %), 3-HANA (-54 %), XA (-25 %), 5-HIAA (-39 %) and QUINA (-43 %) in the serum of the overall population of patients affected by CH, as compared to healthy controls. Serum levels of Trp and ANA were instead significantly increased in CH patients (+18 % and +54 %, respectively). There was no difference in levels of any metabolite between patients affected by episodic and chronic CH, with the exception of KYN levels, which were higher in patients with chronic CH.ConclusionThe reduced levels of KYNA (an NMDA receptor antagonist) support the hypothesis that NMDA receptors are overactive in CH. A similar reduction in KYNA levels was shown in the accompanying manuscript in patients affected by chronic migraine. The reduced levels of XA, a putative analgesic compound, may contribute to explain the severity of pain attacks in CH. These data, associated with the data reported in the accompanying manuscript, supports a role for the kynurenine pathway in the pathophysiology of chronic headache disorders.

【 授权许可】

CC BY   
© Curto et al. 2016