Beta-Endorphin Levels are Reduced in Peripheral Blood Mononuclear Cells of Cluster Headache Patients

Abstract

Opioid system hypofunction has been postulated in cluster headache (CH) on the basis of reduced opioid levels found in the cerebrospinal fluid (CSF). In this study beta-endorphin levels were monitored in the peripheral blood mononuclear cells of 65 episodic CH patients (32 in remission and 33 in cluster period) and 50 healthy controls. Beta-endorphin levels were significantly lower than controls in CH patients experiencing both phases of the illness (ANOVA, p < 0.0001). The persistence of this abnormality during pain-free remission suggests a primary alteration in the regulation of beta-endorphin in peripheral blood mononuclear cells. We speculate that these findings reflect reduced CNS levels of beta-endorphin in CH.

Successful prophylactic treatment of chronic cluster headache with low-dose levomethadone

“…This view is supported by previous observations of altered ß-endorphin secretion [3], reduced circulating levels of opioidergic peptides [4,5] and changes of the opioidergic receptor availability in the pineal gland in CH patients [6].…”

Gene Expression Profiling in Cluster Headache: A Pilot Microarray Study

“…This emphasizes that gene expression studies in CH preferably would be performed on hypothalamic tissue. However, several other changes have been monitored in peripheral blood during different phases of the CH disease, especially for studies of immunological mechanisms 18–23,46 . Furthermore, the relevance of inflammatory mechanisms in CH pathophysiology has been debated 47–49 …”

Decreased Levels of β-Endorphin in Circulating Mononuclear Leukocytes from Patients with Acute Myocardial Infarction

“…The release of ß-endorphin can be stimulated by interleukin 1, ACTH, ß-adrenergic activation, and polyclonal mitogens such as phytohemagglutinin A [24][25][26]. Previous reports described changes of ß-endorphin levels in circulating leukocytes in different diseases: increased levels of immunoreactive ß-endorphin have been found in peripheral blood mononuclear cells from HIV-positive subjects and patients suffering from hereditary angioneurotic edema [27,28]; decreased levels were measured in subjects suffering from cluster headache, Crohn's disease, and rheumatic diseases [29][30][31]. Normal values of immunoreactive ß-endorphin range from 20 to 40 pg/10 6 cells [27][28][29][30][31].…”