Abstract
Objective: Aim of this study was to investigate whether functional polymorphisms in the IL-1 family (IL-1α, IL-1β and IL-1RN), and TNF-α genes may influence the response to oral nonsteroidal anti-inflammatory drugs (NSAIDs) administration during migraine attacks. Background At present, frontline therapies in migraine acute treatment include NSAIDs and triptans. However, a significant portion of treated patients do not obtain consistent pain relief. Several studies suggested a role for proinflammatory cytokines in the pathophysiology of migraine. Design/Methods: 313 consecutive patients (96 men, 217 women) with episodic migraine without aura (IHCD-II criteria) were recruited at the Headache Center, Department of Neuroscience, University of Torino, Italy. During the first visit, migraineurs were prescribed NSAIDs and were given a headache diary in order to record the clinical response in three consecutive migraine attacks. A positive response was defined by having a decrease of ≥2 points in a 4-point scale intensity of pain, after 120 minutes NSAIDs administration, in at least two attacks out of three. Patients were genotyped for functional polymorphisms in the following genes: IL-1α (-889 C>T), IL-1β (-511 C>T), IL-1β (+3953 C>T), IL-1RN (VNTR), and TNF-α (-308 G>A). Results: Migraine patients carrying the A allele of the TNF-α promoter -308 A/G polymorphism showed a significant association with a lack of efficacy after NSAIDs administration in migraine attacks compared to the G allele (p Conclusions: Our study showed that a functional polymorphism in the TNF-α gene modulates the clinical response to NSAIDs administration in acute migraine attacks. Patients with a higher production of the active cytokine during stress showed a significantly lower anti-migraine effects. Additional studies are needed to further deepen these findings. Disclosure: Dr. Rubino has nothing to disclose. Dr. De Martino has nothing to disclose. Dr. Negro has nothing to disclose. Dr. Gallone has nothing to disclose. Dr. Fenoglio has nothing to disclose. Dr. Vacca has nothing to disclose. Dr. Govone has nothing to disclose. Dr. Savi has nothing to disclose. Dr. Pinessi has nothing to disclose. Dr. Rainero has nothing to disclose.
Published Version
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