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Pathogenesis of chronic cluster headache and bouts: role of tryptamine, arginine metabolism and α1-agonists

  • New Findings About The Pathophysiology And Therapy Of Cluster Headache
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Abstract

The aim of this study was to explore the possible role of tryptamine in the pathogenesis of chronic cluster headache along with that of adrenaline and noradrenaline (α-agonists) together with arginine metabolism in the origin of cluster bouts. Plasma levels of tyramine, tryptamine, serotonin, 5-hydroxyindolacetic acid, noradrenalin, adrenalin and the markers of arginine metabolism such as arginine, homoarginine, citrulline, ADMA and NMMA, were measured in 23 chronic cluster headache patients (10 chronic cluster ab initio and 13 transformed from episodic cluster) and 28 control subjects. The plasma levels of tyramine, tryptamine, noradrenalin and adrenalin were found several times higher in chronic cluster headache patients compared to controls, whereas the plasma levels of arginine, homoarginine and citrulline were significantly lower. No differences were found in the plasma levels of serotonin, 5-hydroxyindolacetic, ADMA and NMMA between chronic cluster headache patients and control subjects. These results provide support for a role of tryptamine in the pathogenesis of chronic cluster headache and, in particular, in the duration of the cluster bouts. In addition, the low levels of the nitric oxide substrates together with the high levels of noradrenalin and adrenalin suggest an activation of endothelial TAAR1 receptors followed by the release of nitric oxide in the circulation that may constitute the final step of the physiopathology of cluster crisis.

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Authors and Affiliations

  1. Research and Innovation (R&I) s.r.l., Padua, Italy

    G. D’Andrea, A. Bolner & A. Leon

  2. C. Besta Neurological Institute IRCCS Foundation, Milan, Italy

    G. Bussone & P. Di Fiore

  3. Neurology Department, Headache Center, Vicenza Hospital, Vicenza, Italy

    F. Perini & E. Galloni

  4. Mass Spectrometry and Metabolomic Laboratory, Institute of Pediatric Research IRP Città della Speranza, Padua, Italy

    A. Gucciardi

  5. Neurology Department, Headache Center, Asti Hospital, Asti, Italy

    M. Aguggia & G. Saracco

  6. Women’s and Children’s Health Department, University of Padova, Padua, Italy

    G. Giordano

Authors
  1. G. D’Andrea
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  2. G. Bussone
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  3. P. Di Fiore
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  4. F. Perini
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  5. A. Gucciardi
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  6. A. Bolner
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  7. M. Aguggia
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  8. G. Saracco
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  9. E. Galloni
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  10. G. Giordano
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  11. A. Leon
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Correspondence to G. D’Andrea.

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The authors declare that they have no conflict of interest with the publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship and/or publication of the article. The research was partially funded by the F.I.CEF Charity (Italian Headache Foundation).

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D’Andrea, G., Bussone, G., Di Fiore, P. et al. Pathogenesis of chronic cluster headache and bouts: role of tryptamine, arginine metabolism and α1-agonists. Neurol Sci 38 (Suppl 1), 37–43 (2017). https://doi.org/10.1007/s10072-017-2862-4

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  • DOI: https://doi.org/10.1007/s10072-017-2862-4

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