Peripheral levels of inflammatory mediators in migraineurs during headache-free periods

Objectives.-The present study investigated the peripheral inflammatory changes of the trigeminovascular system by measuring the inflammatory mediators leukotriene B-4 (LTB4), prostaglandin E-2 (PGE(2)), and thromboxane B-2 (TXB2) in the nasal fluid, as well as saliva, of patients with migraine. Background,Migraine has been hypothesized to be as a result of changes in the peripheral or central nervous system or both. It is still unclear whether peripheral changes in the trigeminovascular system are involved in the pathogenesis of migraine. Methods.-Participants were 18 subjects, 9 patients with migraine and 9 controls, matched for age and sex. Each subject took part in one experimental session during which nasal lavage fluid and saliva samples were collected. These samples were analyzed by competitive enzyme immunoassay using goat anti-rabbit polyclonal antibody. Results.-With the exception of TXB2, correlational analyses indicated good correlations between results obtained using nasal lavage or saliva (LTB4, r(18) = 0.91; PGE(2), r(18) = 0.95). When comparing inflammatory mediators measured in controls and migraineurs, the LTB4 level was significantly lower in migraineurs, while no differences were found for PGE(2) and TXB2. Conclusions.-The study demonstrated that nasal lavage, a noninvasive method, can be easily used for investigations of pathophysiological mechanisms of migraine. In addition, the results may indicate that there is no peripheral trigeminal sensitization in the headache-free period of migraineurs compared with controls when PGE(2), LTB4, and TXB2 in saliva and nasal lavage samples are measured.