Feasibility of serum CGRP measurement as a biomarker of chronic migraine: a critical reappraisal
Background Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine. Methods We prospectively recruited patients with episodic and chro...
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| Published in | Journal of headache and pain Vol. 19; no. 1; pp. 53 - 8 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Milan
Springer Milan
13.07.2018
Springer Nature B.V BMC |
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| Online Access | Get full text |
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| Abstract | Background
Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.
Methods
We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.
Results
A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.
Conclusions
Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. |
|---|---|
| AbstractList | Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.BACKGROUNDCalcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.METHODSWe prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.RESULTSA total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice.CONCLUSIONSSerum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. BackgroundCalcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.MethodsWe prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.ResultsA total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.ConclusionsSerum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. Abstract Background Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine. Methods We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit. Results A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine. Conclusions Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine. We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit. A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine. Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. Background Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine. Methods We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit. Results A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine. Conclusions Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice. |
| ArticleNumber | 53 |
| Author | Kang, Eun-Suk Cho, Soohyun Chung, Chin-Sang Lee, Mi Ji Lee, Sook-Yeon |
| Author_xml | – sequence: 1 givenname: Mi Ji surname: Lee fullname: Lee, Mi Ji organization: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 2 givenname: Sook-Yeon surname: Lee fullname: Lee, Sook-Yeon organization: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 3 givenname: Soohyun surname: Cho fullname: Cho, Soohyun organization: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 4 givenname: Eun-Suk surname: Kang fullname: Kang, Eun-Suk organization: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 5 givenname: Chin-Sang orcidid: 0000-0002-0049-558X surname: Chung fullname: Chung, Chin-Sang email: cspaul@naver.com organization: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Neuroscience Center, Samsung Medical Center |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30006780$$D View this record in MEDLINE/PubMed |
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| References_xml | – volume: 20 start-page: 566 year: 2000 end-page: 572 ident: CR19 article-title: Prevalence of migraine in Taipei, Taiwan: a population-based survey publication-title: Cephalalgia doi: 10.1046/j.1468-2982.2000.00085.x – volume: 44 start-page: 8 year: 2004 end-page: 19 ident: CR20 article-title: Population-based door-to-door survey of migraine in Japan: the Daisen study publication-title: Headache doi: 10.1111/j.1526-4610.2004.04004.x – volume: 81 start-page: 1191 year: 2013 end-page: 1196 ident: CR2 article-title: Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine publication-title: Neurology doi: 10.1212/WNL.0b013e3182a6cb72 – volume: 64 start-page: 104 year: 2009 end-page: 110 ident: CR7 article-title: Identification of biomarkers associated with migraine with aura publication-title: Neurosci Res doi: 10.1016/j.neures.2009.02.001 – volume: 85 start-page: 538 year: 2009 end-page: 545 ident: CR5 article-title: How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular disease publication-title: Postgrad Med J doi: 10.1136/pgmj.2008.073759 – volume: 16 start-page: 425 year: 2017 end-page: 434 ident: CR13 article-title: Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial publication-title: Lancet Neurol doi: 10.1016/S1474-4422(17)30083-2 – volume: 54 start-page: 987 year: 2014 end-page: 995 ident: CR16 article-title: CGRP and VIP levels as predictors of efficacy of Onabotulinumtoxin type a in chronic migraine publication-title: Headache doi: 10.1111/head.12372 – volume: 26 start-page: 257 year: 2006 end-page: 265 ident: CR3 article-title: Clinical-biochemical correlates of migraine attacks in rizatriptan responders and non-responders publication-title: Cephalalgia doi: 10.1111/j.1468-2982.2005.01016.x – volume: 58 start-page: 78 year: 2018 end-page: 87 ident: CR15 article-title: CGRP and PTX3 as predictors of efficacy of Onabotulinumtoxin type a in chronic migraine: an observational study publication-title: Headache doi: 10.1111/head.13211 – volume: 53 start-page: 1262 year: 2013 end-page: 1277 ident: CR6 article-title: Biomarkers associated with migraine and their potential role in migraine management publication-title: Headache doi: 10.1111/head.12174 – volume: 57 start-page: 47 issue: Suppl 2 year: 2017 end-page: 55 ident: CR10 article-title: The Trigeminovascular pathway: role of CGRP and CGRP receptors in migraine publication-title: Headache doi: 10.1111/head.13081 – ident: CR9 – volume: 377 start-page: 2113 year: 2017 end-page: 2122 ident: CR12 article-title: Fremanezumab for the preventive treatment of chronic migraine publication-title: N Engl J Med doi: 10.1056/NEJMoa1709038 – volume: 372 start-page: 307 year: 2017 end-page: 315 ident: CR18 article-title: Migraine affects 1 in 10 people worldwide featuring recent rise: a systematic review and meta-analysis of community-based studies involving 6 million participants publication-title: J Neurol Sci doi: 10.1016/j.jns.2016.11.071 – volume: 76 start-page: 176 year: 1999 end-page: 183 ident: CR11 article-title: Messenger molecules and receptor mRNA in the human trigeminal ganglion publication-title: J Auton Nerv Syst doi: 10.1016/S0165-1838(99)00024-7 – volume: 58 start-page: 561 year: 2005 end-page: 568 ident: CR17 article-title: No increase of calcitonin gene-related peptide in jugular blood during migraine publication-title: Ann Neurol doi: 10.1002/ana.20605 – volume: 36 start-page: 1334 year: 2016 end-page: 1340 ident: CR4 article-title: The phenotype of migraine with unilateral cranial autonomic symptoms documents increased peripheral and central trigeminal sensitization. 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| Snippet | Background
Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP... Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration... BackgroundCalcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP... Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration... Abstract Background Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum... |
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| SubjectTerms | Adult Biomarker Biomarkers Biomarkers - blood Blood levels Calcitonin Calcitonin gene-related peptide Calcitonin Gene-Related Peptide - blood CGRP Chronic Disease Feasibility Studies Female Follow-Up Studies Headache Headache - blood Headache - diagnosis Headaches Humans Immunoassay Internal Medicine Male Medicine Medicine & Public Health Middle Aged Migraine Migraine Disorders - blood Migraine Disorders - diagnosis Neurology Pain Medicine Patients Peripheral blood Prospective Studies Research Article |
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| Title | Feasibility of serum CGRP measurement as a biomarker of chronic migraine: a critical reappraisal |
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