Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine
Background: Plasma calcitonin gene-related peptide (CGRP) plays a key role in the migraine pathophysiology. This study aimed to investigate its role in predicting diagnosis and outcome of pharmacotherapy in pediatric migraine.Methods: We prospectively recruited 120 subjects, who never took migraine-...
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doaj-1d084ec8d95b4a88bf0432ee766ff4a02020-11-25T00:41:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-01-011010.3389/fneur.2019.00010419067Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric MigrainePi-Chuan Fan0Pi-Chuan Fan1Pi-Chuan Fan2Pi-Chuan Fan3Ping-Hung Kuo4Ming Tatt Lee5Ming Tatt Lee6Ming Tatt Lee7Shu-Hui Chang8Lih-Chu Chiou9Lih-Chu Chiou10Lih-Chu Chiou11Lih-Chu Chiou12Department of Pediatrics, National Taiwan University Hospital, Taipei, TaiwanClinical Center for Neuroscience and Behavior, National Taiwan University Hospital, Taipei, TaiwanDepartment of Pediatrics, College of Medicine, National Taiwan University, Taipei, TaiwanGraduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanGraduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, TaiwanGraduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, TaiwanFaculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, MalaysiaDepartment of Epidemiology, College of Public Health, National Taiwan University, Taipei, TaiwanClinical Center for Neuroscience and Behavior, National Taiwan University Hospital, Taipei, TaiwanGraduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, TaiwanGraduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, TaiwanGraduate Institute of Acupuncture Sciences, China Medical University, Taichung, TaiwanBackground: Plasma calcitonin gene-related peptide (CGRP) plays a key role in the migraine pathophysiology. This study aimed to investigate its role in predicting diagnosis and outcome of pharmacotherapy in pediatric migraine.Methods: We prospectively recruited 120 subjects, who never took migraine-preventive agents in a pediatric clinic, including 68 patients with migraine, 30 with non-migraine headache (NM), and 22 non-headache (NH) age-matched controls. Short-term therapeutic response was measured for at least 2 weeks after the start of therapy. Responders were defined with >50% headache reduction. Plasma CGRP concentrations were measured by ELISA.Results: In the migraine group, more patients required acute therapy, as compared to the NM group (62/68, 91% vs. 5/30, 15%, p = 0.001). The mean plasma CGRP level in migraineurs either during (291 ± 60 pg/ml) or between (240 ± 48) attacks was higher than in NM patients (51 ± 5 pg/ml, p = 0.006 and 0.018, respectively) and NH controls (53 ± 6 pg/ml, p = 0.016 and 0.045, respectively). Forty-seven patients (69%) needed preventive treatments and had higher plasma CGRP levels (364 ± 62 pg/ml, n = 47) than those not (183 ± 54 pg/ml, n = 21) (p = 0.031). Topiramate responders had higher plasma CGRP levels than non-responders (437 ± 131 pg/ml, n = 14 vs. 67 ± 19 pg/ml, n = 6, p = 0.021). Survival curves of plasma CGRP levels also showed those with higher CGRP levels responded better to topiramate. Differences were not found in the other preventives.Conclusion: The plasma CGRP level can differentiate migraine from non-migraine headache. It may also serve as a reference for the therapeutic strategy since it is higher in patients requiring migraine prevention and responsive to short-term topiramate treatment. These results are clinically significant, especially for the young children who cannot clearly describe their headache symptoms and may provide new insights into the clinical practice for the diagnosis and treatment of pediatric migraine.https://www.frontiersin.org/article/10.3389/fneur.2019.00010/fullpediatric migrainecalcitonin gene-related peptideplasma biomarkeranti-migraine drugstopiramate |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Ping-Hung Kuo Ming Tatt Lee Ming Tatt Lee Ming Tatt Lee Shu-Hui Chang Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou |
spellingShingle |
Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Ping-Hung Kuo Ming Tatt Lee Ming Tatt Lee Ming Tatt Lee Shu-Hui Chang Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine Frontiers in Neurology pediatric migraine calcitonin gene-related peptide plasma biomarker anti-migraine drugs topiramate |
author_facet |
Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Pi-Chuan Fan Ping-Hung Kuo Ming Tatt Lee Ming Tatt Lee Ming Tatt Lee Shu-Hui Chang Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou Lih-Chu Chiou |
author_sort |
Pi-Chuan Fan |
title |
Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine |
title_short |
Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine |
title_full |
Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine |
title_fullStr |
Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine |
title_full_unstemmed |
Plasma Calcitonin Gene-Related Peptide: A Potential Biomarker for Diagnosis and Therapeutic Responses in Pediatric Migraine |
title_sort |
plasma calcitonin gene-related peptide: a potential biomarker for diagnosis and therapeutic responses in pediatric migraine |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-01-01 |
description |
Background: Plasma calcitonin gene-related peptide (CGRP) plays a key role in the migraine pathophysiology. This study aimed to investigate its role in predicting diagnosis and outcome of pharmacotherapy in pediatric migraine.Methods: We prospectively recruited 120 subjects, who never took migraine-preventive agents in a pediatric clinic, including 68 patients with migraine, 30 with non-migraine headache (NM), and 22 non-headache (NH) age-matched controls. Short-term therapeutic response was measured for at least 2 weeks after the start of therapy. Responders were defined with >50% headache reduction. Plasma CGRP concentrations were measured by ELISA.Results: In the migraine group, more patients required acute therapy, as compared to the NM group (62/68, 91% vs. 5/30, 15%, p = 0.001). The mean plasma CGRP level in migraineurs either during (291 ± 60 pg/ml) or between (240 ± 48) attacks was higher than in NM patients (51 ± 5 pg/ml, p = 0.006 and 0.018, respectively) and NH controls (53 ± 6 pg/ml, p = 0.016 and 0.045, respectively). Forty-seven patients (69%) needed preventive treatments and had higher plasma CGRP levels (364 ± 62 pg/ml, n = 47) than those not (183 ± 54 pg/ml, n = 21) (p = 0.031). Topiramate responders had higher plasma CGRP levels than non-responders (437 ± 131 pg/ml, n = 14 vs. 67 ± 19 pg/ml, n = 6, p = 0.021). Survival curves of plasma CGRP levels also showed those with higher CGRP levels responded better to topiramate. Differences were not found in the other preventives.Conclusion: The plasma CGRP level can differentiate migraine from non-migraine headache. It may also serve as a reference for the therapeutic strategy since it is higher in patients requiring migraine prevention and responsive to short-term topiramate treatment. These results are clinically significant, especially for the young children who cannot clearly describe their headache symptoms and may provide new insights into the clinical practice for the diagnosis and treatment of pediatric migraine. |
topic |
pediatric migraine calcitonin gene-related peptide plasma biomarker anti-migraine drugs topiramate |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00010/full |
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