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Abstract：
BACKGROUND: Endogeneous and exogeneous sex hormones can impact the frequency and severity of migraine attacks, but the underlying mechanisms are poorly understood. In this study, we investigate the relationship between female sex hormones and Pituitary Adenylate Cyclase-Activating Polypeptide-38 (PACAP-38) concentrations in plasma of women with migraine and healthy controls, aiming to elucidate potential hormonal influences on PACAP dynamics and their relevance to migraine pathophysiology.
METHODS: This analysis is part of a cross-sectional, matched-cohort study. We recruited two groups of women with episodic migraine: one with a regular menstrual cycle (M-RMC) and another undergoing combined oral contraceptive treatment (M-COC). Additionally, we included corresponding age-matched control groups without migraine for both categories (C-RMC and C-COC). For participants with a RMC, the study visits were scheduled during the perimenstrual period (menstrual cycle day 2 ± 2) and periovulatory period (day 13 ± 2). Participants using COC were examined at day 4 ± 2 of the hormone-free interval and between day 7-14 of the hormone intake phase. During these visits, PACAP-38 concentrations in plasma were measured using a commercial Enzyme-linked-immunosorbent assay (ELISA) kit.
RESULTS: The study included 120 women, with 30 participants in each group. Women with migraine and a RMC had significantly higher PACAP-38 plasma concentrations compared to healthy controls at both study visits [day 2 ± 2: M-RMC: 2547.41 pg/ml (IQR 814.27 - 4473.48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 - 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 - 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 - 3038.36), p = 0.028]. In contrast, PACAP-38 levels were comparable between migraine and control groups receiving COC. Women with migraine and a RMC exhibited higher PACAP-38 concentrations during menstruation compared to those using COC during the hormone-free interval.
CONCLUSIONS: Systemic PACAP-38 concentrations in women vary based on the presence of migraine diagnosis and their hormonal status.
METHODS: This analysis is part of a cross-sectional, matched-cohort study. We recruited two groups of women with episodic migraine: one with a regular menstrual cycle (M-RMC) and another undergoing combined oral contraceptive treatment (M-COC). Additionally, we included corresponding age-matched control groups without migraine for both categories (C-RMC and C-COC). For participants with a RMC, the study visits were scheduled during the perimenstrual period (menstrual cycle day 2 ± 2) and periovulatory period (day 13 ± 2). Participants using COC were examined at day 4 ± 2 of the hormone-free interval and between day 7-14 of the hormone intake phase. During these visits, PACAP-38 concentrations in plasma were measured using a commercial Enzyme-linked-immunosorbent assay (ELISA) kit.
RESULTS: The study included 120 women, with 30 participants in each group. Women with migraine and a RMC had significantly higher PACAP-38 plasma concentrations compared to healthy controls at both study visits [day 2 ± 2: M-RMC: 2547.41 pg/ml (IQR 814.27 - 4473.48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 - 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 - 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 - 3038.36), p = 0.028]. In contrast, PACAP-38 levels were comparable between migraine and control groups receiving COC. Women with migraine and a RMC exhibited higher PACAP-38 concentrations during menstruation compared to those using COC during the hormone-free interval.
CONCLUSIONS: Systemic PACAP-38 concentrations in women vary based on the presence of migraine diagnosis and their hormonal status.
摘要：
背景：内源性和外源性性激素可影响偏头痛发作的频率和严重程度，但潜在的机制却知之甚少。在这项研究中,我们研究了女性性激素和垂体腺苷酸环化酶激活多肽-38（PACAP-38）浓度之间的关系偏头痛女性和健康对照，旨在阐明潜在的激素对PACAP动力学的影响及其与偏头痛病理生理学的相关性。
方法：此分析是横截面的一部分，配对队列研究。我们招募了两组患有偶发性偏头痛的女性：一组具有规律的月经周期（M-RMC），另一组接受联合口服避孕药治疗（M-COC）。此外,我们纳入了两个类别(C-RMC和C-COC)均无偏头痛的相应年龄匹配对照组.对于有RMC的参与者，研究访视时间安排在围月经期(月经周期第2±2天)和围排卵期(第13±2天)。使用COC的参与者在无激素间隔的第4±2天以及激素摄入阶段的第7-14天之间进行检查。在这些访问期间,使用商业酶联免疫吸附测定(ELISA)试剂盒测量血浆中的PACAP-38浓度。
结果：该研究包括120名女性，每组30人。在两次研究访问中，与健康对照组相比，患有偏头痛和RMC的妇女的PACAP-38血浆浓度明显更高[第2天±2：M-RMC：2547.41pg/ml（IQR814.27-4473.48）与C-RMC：1129.49pg/ml（IQR257.34-2684.88），p=0.025；第13±2天：M-RMC：3098.89pg/ml（IQR1186.29-4379.47）与C-RMC：1626.89（IQR383.83-3038.36），p=0.028]。相比之下,接受COC的偏头痛组和对照组之间的PACAP-38水平相当。与无激素间隔期间使用COC的女性相比，患有偏头痛和RMC的女性在月经期间表现出更高的PACAP-38浓度。
结论：女性的全身PACAP-38浓度因偏头痛的诊断和激素状态而异。
方法：此分析是横截面的一部分，配对队列研究。我们招募了两组患有偶发性偏头痛的女性：一组具有规律的月经周期（M-RMC），另一组接受联合口服避孕药治疗（M-COC）。此外,我们纳入了两个类别(C-RMC和C-COC)均无偏头痛的相应年龄匹配对照组.对于有RMC的参与者，研究访视时间安排在围月经期(月经周期第2±2天)和围排卵期(第13±2天)。使用COC的参与者在无激素间隔的第4±2天以及激素摄入阶段的第7-14天之间进行检查。在这些访问期间,使用商业酶联免疫吸附测定(ELISA)试剂盒测量血浆中的PACAP-38浓度。
结果：该研究包括120名女性，每组30人。在两次研究访问中，与健康对照组相比，患有偏头痛和RMC的妇女的PACAP-38血浆浓度明显更高[第2天±2：M-RMC：2547.41pg/ml（IQR814.27-4473.48）与C-RMC：1129.49pg/ml（IQR257.34-2684.88），p=0.025；第13±2天：M-RMC：3098.89pg/ml（IQR1186.29-4379.47）与C-RMC：1626.89（IQR383.83-3038.36），p=0.028]。相比之下,接受COC的偏头痛组和对照组之间的PACAP-38水平相当。与无激素间隔期间使用COC的女性相比，患有偏头痛和RMC的女性在月经期间表现出更高的PACAP-38浓度。
结论：女性的全身PACAP-38浓度因偏头痛的诊断和激素状态而异。
