Increase in plasma calcitonin gene-related peptide from the extracerebral circulation during nitroglycerin-induced cluster headache attack

Publisher Website
Google Scholar
Abstract
Lood was collected from the external jugular vein homolateral to the pain side of 30 male cluster headache patients; 18 men were in an active and 12 in a remission one. Plasma levels of CGRP and SP were determined using sensitive radioimmunoassays for each peptide. CGRP-like immunoreactivity (CGRP-LI) was found to be augmented in patients in an active period and became elevated further at the peak of the provoked attack. A complete reversal occurred both after spontaneous and sumatriptan-induced remission. On the contrary, nitroglycerin neither provoked a cluster headache attack nor altered CGRP-LI in the patients in a remission period. The augmented levels of CGRP-LI measured before and after nitroglycerin administration, when the provoked attack reached the maximum intensity, suggest an activation of the trigeminovascular system during the active period of cluster headache. Moreover, the clinical and biochemical actions showed by sumatriptan stress the involvement of serotonin in cluster headache mechanisms. ∗Corresponding author: M. Fanciullacci, Istituto di Clinica Medica IV, Centro Cefalee, Viale Pieraccini 18, 50139 Firenze, Italy. Tel.: (39) 55-435922; FAX: (39) 55-430731. (Received 9 February 1994; revision received 21 April 1994; accepted 27 April 1994.) © Lippincott-Raven Publishers....