Platelet Activation and Platelet-Leucocyte Interaction in Patients with Migraine. Subtype Differences and Influence of Triptans

Abstract

As migraine is the result of an inflammatory mechanism with serotonergic signalling, leucocyte function, platelet function and intercellular communication between those cells is likely to be connected to the final pathway of the disease. We examined P-selectin expression on platelets (platelet activation) and leucocyte-platelet aggregate formation in 72 migraine patients during their attack-free interval and controls using a flow cytometric assay. Patients suffering from migraine without aura had a significantly increased platelet activation and leucocyte-platelet aggregation compared with the control group, unlike the migraine patients with aura. Patients who had taken a triptan within 3 days prior to the investigation showed platelet activation values similar to the control group. The variations in platelet activation patterns of migraine subgroups could indicate different pathomechanisms. Even outside an attack, migraine patients, particularly those without aura, show an increased level of platelet activation which seems to be down-regulated by triptans. This mechanism may account for the triptan-induced increases in headache frequency. The involvement of proinflammatory platelet-leucocyte cross-talk suggests a possible therapeutic strategy using anti-inflammatory drugs.

Migrenli Hastaların Kanında Ortalama Trombosit Hacmi ve Trombosit Sayısının Araştırılması

“…Serotonin plays an important role in the pathogenesis of migraine, 90% of which is contained within platelets and it is released from the platelets depending on the demand (19). Zeller et al evaluated the P-selectin expression on platelets in patients with migraine and found an increase in platelet activation and leucocyte-platelet aggregation formation as compared to healthy controls, especially in migraine patients without auras (20). The levels of platelet activator factor, which play an important role in numerous inflammatory and thrombotic processes and serve as the mediator in phospholipid structure, was seen to increase in patients with migraine during attacks (21).…”

Migraine Modulation and Debut after Percutaneous Atrial Septal Defect Closure: A Review

“…A biochemical theory of migraine implicates vasoactive substances in migraine, such as 5-hydroxytryptamine (serotonin), and there is evidence that serotonin metabolism is impaired in migraineurs (13) and that serotonin released from aggregating platelets may be involved in the vasoconstriction and vasodilation associated with migraine headache (MH) (14). In addition, research implicates altered platelet activity in migraine (14–20). …”

Platelet functions beyond hemostasis

“…Migraine [29] Platelet activation and leukocyte-platelet aggregation were significantly increased during migraine headaches in patients without aura vs. control volunteers in flow cytometry assays, but not in migraine patients with aura. All patients had an increased baseline level of platelet activation, and triptan drugs appeared to downregulate platelet aggregation.…”

“…Given the number and variety of bioactive substances secreted by platelets (Table 1), it is unsurprising that they have been implicated in the development or severity of an array of disorders (Table 2) [11,[24][25][26][27][28][29][30][31][32][33][34][35][36]. Some of these disorders may appear obvious (thrombosis and restenosis) but others may not (psoriasis and migraine).…”