Procalcitonin is a partial agonist of CGRP on the CGRP receptor, and together with CGRP appears to play a role in migraine. Studies presented at EAN 2020 suggest that both procalcitonin and micro RNAs might be biomarkers for migraine.
The link between procalcitonin levels and chronic migraine
Procalcitonin might be a biomarker of chronic migraine
Neurogenic inflammation plays a key role in migraine pathophysiology, said Clara Dominguez Vivero from Santiago de Compostela, Spain, and many inflammatory biomarkers are increased in migraine, including procalcitonin.1
Procalcitonin is codified by the same gene as calcitonin gene-related peptide (CGRP) — Calcitonin Related Polypeptide Alpha (CALCA), which is located on chromosome 11 — and has a partial agonist effect on the CGRP receptor.1
Procalcitonin may therefore be a potential biomarker of migraine.
To investigate this possibility, Dr Dominguez Vivero and her colleagues compared plasma procalcitonin levels in 17 patients with chronic migraine and 70 healthy controls. They found:
- increased procalcitonin levels during interictal periods in patients with chronic migraine
- a correlation between procalcitonin and CGRP levels
Dr Dominguez Vivero concluded that procalcitonin may be a potential biomarker of chronic migraine and suggested that the increased procalcitonin levels reflect the role of inflammation in the chronification of chronic migraine.
The link between micro RNA levels and migraine
CGRP plays a role in trigeminal system activation
CGRP plays a role in neurogenic inflammation and vasodilation and CGRP receptors are located in the trigeminovascular system in sites involved in migraine pathogenesis.2,3
Infusing CGRP can trigger a migraine attack in people with migraine,4,5 and prolonged triptan exposure can increase CGRP levels,6 said Chiara Demartini of the University of Pavia, Italy.
Migraine attacks are associated with changes in micro RNAs, which have a regulatory role by targeting specific mRNAs. These changes are sustained during pain-free periods,7 said Dr Demartini, so micro RNAs might be markers for migraine?
Micro RNAs might be biomarkers of chronic migraine
Dr Demartini and her colleagues therefore investigated plasma CGRP levels and the expression of micro RNAs miR-34a-5p and mir-382-5p (which are modulated in several diseases) in peripheral blood mononuclear cells in people with migraine and medication overuse. Thirty subjects had episodic migraine and 27 subjects had chronic migraine.
Both micro RNAs were found to be downregulated in all subjects after 2 months of migraine medication discontinuation regardless of disease status.
Further regression analysis will now be made to assess the relationship between these potential biomarkers and clinical variables, concluded Dr Demartini.
Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.