Polyamines serum levels in episodic and chronic migraine

ABSTRACT

Background: Previous studies focused on food as the trigger of a migraine attack did not consider polyamines as possible activators and sensitizers of the trigeminal-vascular system through their interaction with NMDA glutamate receptors. Therefore, this study aimed to assess serum levels of nine polyamines and to evaluate their role as possible triggers and crisis maintainers in episodic and chronic migraine patients.

Materials and methods: The study included 50 patients with episodic migraine (EM), 50 patients with chronic migraine (CM) and 50 healthy controls (HC). Serum levels of nine polyamines have been determined by Liquid Chromatography tandem Mass Spectrometry. Specifically, agmatine, spermidine, spermine, putrescine, cadaverine, arginine, ornithine, citrulline and lysine levels were studied.

Results: Agmatine serum levels resulted reduced in EC patients with respect to CM and HC. Compared to HC subjects, serum levels of spermine and spermidine were statistically significantly increased both in CM and EM patients.

Conclusions: The authors suggest that alterations of polyamines levels might contribute to the understanding of migraine external activation and help to clarify the potential role of NMDA receptor polyamines site antagonists in migraine treatment.

KEYWORDS:

• Polyamines
• episodic migraine
• chronic migraine
• NMDA receptors
• spermine
• spermidine
• agmatine

Article highlights

• The hyperactivity of NMDA receptors is involved in migraine pathophysiology

• Polyamines interact with the NMDA glutamate receptors both as agonists and as antagonists

• Spermine and spermidine have been shown to hyperactivate the NMDA receptors, while agmatine antagonizes them.

• The serum levels of spermine, spermidine and agmatine are significantly modified in both chronic and episodic migraine, compared to healthy controls.

Authors contributions

All Authors were involved in the conception and design, in the analysis and interpretation of the data, in the drafting of the paper or revising it critically for intellectual content, and in the final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.