Migren hastalarında serum ADMA düzeyi değerleri, ADMA düzeyinin migren alttiplerindeki dağılımı ve kliniğe olan etkisinin araştırılması
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Tarih
2009
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Migren; nörolojik, gastrointestinal ve otonom değişikliklerin çeşitli kombinasyonlarda eşlik ettiği, primer epizodik bir baş ağrısıdır. Strüktürel lezyon olmadan nörovasküler transmisyon bozukluğuna bağlı olduğu düşünülmektedir. Yapılan çalışmalarda ekzojen nitrik oksid salgılayan gliseril trinitratla ve vasküler endotelden nitrik oksid serbestleştiren histamin ile migren karakterinde baş ağrısının geliştiğinin görülmesi, nitrik oksidin altta yatan mekanizmadan sorumlu olabileceğini düşündürtmüştür. Asimetrik dimetilarjinin, nitrik oksid sentazın endojen inhibitörüdür ve migren patofizyolojisinde rol oynayabileceği düşünülmektedir. Çalışmamıza Uluslararası Başağrısı Derneği 2004 tanı kriterlerine göre migren tanısı olan atak arası dönemdeki 100 hasta alındı. Hastalar auralı ve aurasız olmak üzere 2 alt gruba ayrıldı. 42'si (%42) auralı migren, 58'i (%58) aurasız migren olarak sınıflandırıldı. Hastalarla yaş ve cinsiyet olarak uyumlu 100 sağlıklı gönüllü kontrol grubu olarak alındı. Hastalardan ve kontrol grubundan alınan venöz kandan ?high performance liquid chromotography? yöntemi ile serum asimetrik dimetilarjinin, simetrik dimetil arjinin ve L-arjinin değerleri ölçüldü. Asimetrik dimetil arjinin, simetrik dimetilarjinin ve L-arjinin düzeyleri çalışma hastalarında kontrol grubuna göre yüksek bulunurken ( üçünde de p=0.001>), auralı ve aurasız alt grupları arasında fark bulunmadı. Profilaktik tedavi alan ve almayan grubun asimetrik dimetilarjinin düzeyleri arasında da fark saptanmadı .Asimetrik dimetilarjinin düzeyi yaşla, L-arjinin düzeyi ağrı şiddeti ile pozitif ilişkili bulundu (sırasıyla p=0.020, p=0.021). Migrene bağlı kayıp değerlendirme ölçeği ve serum asimetrik dimetilarjinin düzeyleri arasında ilişki bulunmadı. Bizim çalışmamızda serum asimetrik dimetilarjinin değerlerinin migrenli hastalarda kontrol grubuna göre anlamlı derecede yüksek olması, asimetrik dimetilarjinin migren patofizyoloisinde önemli bir rol oynadığını ve gelecekte migren tedavilerinin belirlenmesinde etken olabileceğini göstermiştir.
Abstract
Migraine is a primary episodic headache disorder characterized by various combinations of neurological, gastrointestinal and autonomic changes. It is considered to be a disorder of neurovascular transmission without structural lesions. On the basis of studies in migraine induced by glyceryl trinitrat which is an exogenous nitric oxide donor and histamine which liberates nitric oxide from vascular endothelium, it has been suggested that nitric oxide is a likely candidate responsible molecule. Asymmetrical dimethylarginine is an endogenous inhibitor of nitric oxide synthase and is considered to play an important role in the pathophysiology of migraine. One hunred patients diagnosed as migraine according to the International Headache Society criteria were included in our study. The migraine patients were in the interictal period and classified into two groups as having migraine with aura or migraine without aura. 42(42%) of pateints were diagnosed as migraine with aura and 58(58%) of patients were diagnosed as migraine without aura. The control group consisted of 100 healthy volunteers who were age and gender matched. Serum asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels were measured using the high performance liquid chromotography method. Asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels were found significantly higher in patients with migraine compared to the control group (all comparisons p=0.001>). But there was no statistically significant difference between the patients with and without aura. Subanalysis of the patients with migraine according to having prophylactic therapy or not revealed no difference for the levels of asymmetric dimethylarginine. Asymmetric dimethylarginine levels were associated with age and L-arginine levels were associated with headache severity positively. There was no correlation between the migraine disabilty assesment scale and serum asymmetric dimethylarginine levels. Our study showed that serum asymmetric dimethylarginine levels are significantly higher in patients with migraine compared to the control group which indicates that ADMA plays an important role in the pathophysiology of migraine and may be an important factor in the direction of future migraine therapies.
Abstract
Migraine is a primary episodic headache disorder characterized by various combinations of neurological, gastrointestinal and autonomic changes. It is considered to be a disorder of neurovascular transmission without structural lesions. On the basis of studies in migraine induced by glyceryl trinitrat which is an exogenous nitric oxide donor and histamine which liberates nitric oxide from vascular endothelium, it has been suggested that nitric oxide is a likely candidate responsible molecule. Asymmetrical dimethylarginine is an endogenous inhibitor of nitric oxide synthase and is considered to play an important role in the pathophysiology of migraine. One hunred patients diagnosed as migraine according to the International Headache Society criteria were included in our study. The migraine patients were in the interictal period and classified into two groups as having migraine with aura or migraine without aura. 42(42%) of pateints were diagnosed as migraine with aura and 58(58%) of patients were diagnosed as migraine without aura. The control group consisted of 100 healthy volunteers who were age and gender matched. Serum asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels were measured using the high performance liquid chromotography method. Asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels were found significantly higher in patients with migraine compared to the control group (all comparisons p=0.001>). But there was no statistically significant difference between the patients with and without aura. Subanalysis of the patients with migraine according to having prophylactic therapy or not revealed no difference for the levels of asymmetric dimethylarginine. Asymmetric dimethylarginine levels were associated with age and L-arginine levels were associated with headache severity positively. There was no correlation between the migraine disabilty assesment scale and serum asymmetric dimethylarginine levels. Our study showed that serum asymmetric dimethylarginine levels are significantly higher in patients with migraine compared to the control group which indicates that ADMA plays an important role in the pathophysiology of migraine and may be an important factor in the direction of future migraine therapies.
Açıklama
Anahtar Kelimeler
Asimetrik Dimetilarjinin, Migren, Nitrik Oksid, Asymmetric Dimethylarginine, Migraine, Nitric Oxide
