Abstract

ObjectivePro-inflammatory cytokines like Interleukin-1 beta (IL-1β) have been implicated in the pathophysiology of migraine and inflammatory pain. The trigeminal ganglion and calcitonin gene-related peptide (CGRP) are crucial components in the pathophysiology of primary headaches. 5-HT1B/D receptor agonists, which reduce CGRP release, and cyclooxygenase (COX) inhibitors can abort trigeminally mediated pain. However, the cellular source of COX and the interplay between COX and CGRP within the trigeminal ganglion have not been clearly identified.Methods and Results1. We used primary cultured rat trigeminal ganglia cells to assess whether IL-1β can induce the expression of COX-2 and which cells express COX-2. Stimulation with IL-1β caused a dose and time dependent induction of COX-2 but not COX-1 mRNA. Immunohistochemistry revealed expression of COX-2 protein in neuronal and glial cells. 2. Functional significance was demonstrated by prostaglandin E2 (PGE2) release 4 hours after stimulation with IL-1β, which could be aborted by a selective COX-2 (parecoxib) and a non-selective COX-inhibitor (indomethacin). 3. Induction of CGRP release, indicating functional neuronal activation, was seen 1 hour after PGE2 and 24 hours after IL-1β stimulation. Immunohistochemistry showed trigeminal neurons as the source of CGRP. IL-1β induced CGRP release was blocked by parecoxib and indomethacin, but the 5-HT1B/D receptor agonist sumatriptan had no effect.ConclusionWe identified a COX-2 dependent pathway of cytokine induced CGRP release in trigeminal ganglia neurons that is not affected by 5-HT1B/D receptor activation. Activation of neuronal and glial cells in the trigeminal ganglion by IL-β leads to an elevated expression of COX-2 in these cells. Newly synthesized PGE2 (by COX-2) in turn activates trigeminal neurons to release CGRP. These findings support a glia-neuron interaction in the trigeminal ganglion and demonstrate a sequential link between COX-2 and CGRP. The results could help to explain the mechanism of action of COX-2 inhibitors in migraine.

Highlights

  • Pro-inflammatory cytokines have been linked to inflammation and pain [1]

  • Functional significance was demonstrated by prostaglandin E2 (PGE2) release 4 hours after stimulation with IL-1b, which could be aborted by a selective COX-2 and a non-selective COX-inhibitor

  • We identified a COX-2 dependent pathway of cytokine induced calcitonin gene-related peptide (CGRP) release in trigeminal ganglia neurons that is not affected by 5-HT1B/D receptor activation

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Summary

Introduction

Pro-inflammatory cytokines have been linked to inflammation and pain [1]. Interleukin-1b (IL-1b), interleukin-6 and tumor necrosis factor-a (TNFa) are known to induce hyperalgesia in rats [2,3,4]. Cytokines seem to play an important role in pathophysiological mechanisms involved in migraine headache. IL-1b and TNFa levels were elevated in jugular vein blood during migraine attacks [5,6]. Plasma levels of IL-6 were increased in patients with migraine compared to healthy controls [7]. Enhanced expression of IL-1b was found in the meninges in an experimental animal model related to migraine [8]

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