Impact of migraine attacks on the blood-brain barrier

• Published in: Chinese medical journal Vol. 123; no. 18; pp. 2559 - 2561
• Main Authors: Gao, Hong-Mei, Li, Le, Zhang, Ke-Ling, Chen, Xu-Hui, Tian, Shu-Qing, Zhang, Zhong-Ling
• Format: Journal Article
• Language: English
• Published: China Department of Neurology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China 20.09.2010
• Subjects: Adult; Blood-Brain Barrier - metabolism; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Matrix Metalloproteinase 9 - blood; Middle Aged; Migraine Disorders - physiopathology; MMP; Young Adult; 偏头痛; 基质金属蛋白酶-9; 晚期阶段; 水平度; 皮层扩散性抑制; 血脑屏障; 酶联免疫吸附法; blood-brain barrier; matrix metalloproteinase 9; migraine
• ISSN: 0366-6999; 2542-5641; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2010.18.012

Background Cortical spreading depression can cause migraine attack, and up-regulate matrix metalloproteinase-9 （MMP-9） expression in animal. This study aimed to determine the impact on the structure and function of the blood-brain barrier by measuring plasma MMP-9 levels in patients at the acute and late stages of migraine attacks in order to elucidate the pathological mechanisms involved. Methods We recruited a case-control cohort of 38 adult migraine patients and 20 age- and gender-matched healthy control subjects. Five milliliter blood samples were collected at the acute and late stages of migraine （days 1-7）, and also from the control subjects. Solid phase double antibody sandwich enzyme-linked immunosorbent assay was used to determine plasma MMP-9 levels. Statistical analysis was performed using the SAS version 9.1. Results Initial plasma MMP-9 levels of migraine patients were significantly higher than those of controls （（12.612±0.016） μg/L vs. （6.069±0.023）μg/L, respectively, P 〈0.05）. High MMP-9 expression was observed during days 1-6 of migraine attacks, with highest expression occurring on day 3 （（17.524±0.035） μg/L）. During attacks, MMP-9 levels were similar in migraine patients with and without aura （P 〉0.05）; in addition, levels were not correlated with degree of headache pain （P 〉0.05）. Conclusions We hypothesize that migraine could lead to increased plasma MMP-9 levels resulting in blood-brain barrier damage. MMP-9 levels increase during days 1-6 of migraine attacks, peaking on day 3. Therefore, MMP-9 could be used as a biological marker to guide treatment of migraine attacks.