β-Endorphin Level in Lymphocytes of Primary Headaches Patients

Immunological Alterations in Cluster Headache During Remission and Cluster Period. Comparison with Low Back Pain Patients

“…Circulating monocytes may be reduced in number by several mechanisms, including reduced recruitment from lymphoid organs and alterations in turnover; in this context we recall that b-endorphin increases peripheral blood monocyte chemotaxis (10). No data, to our knowledge, are available on serum b-endorphin levels during the remission phase in cluster headache patients, although low peripheral blood mononuclear cell concentrations of b-endorphin have recently been reported (11).…”

“…Immune alterations in cluster headache patients during remission might be related to a chronic central nervous system disorder, possibly at a hypothalamic level (7). This derangement may involve noradrenergic dysfunction and altered b-endorphin production or release at a CNS or peripheral level (19,11). On the other hand, alterations detected during the pain period in both cluster headache patients and low back pain patients appear non-specific, being either pain or stress related and probably mediated via autonomic pathways.…”

β‐Endorphin in Plasma and Monocytes in Juvenile Headache

“…These findings partially coincide with a recent interictal study on adults suffering from primary headache, though a substantial reduction in PBMC ß-endorphin levels was detected in migrainous patients, but not in tension-type headache sufferers. 8 A low PBMC concentration of ß-endorphin is not specific to migraine, however, as this phenomenon is also found in patients with other pathologies, eg, rheumatic disease, 14 and PBMC ß-endorphin levels also rise with age. 15 As for serum 5-HT levels, our finding of normal interictal levels in patients with MwA or ETH are not entirely consistent with results obtained in adults; in tension-type headache there are reports of interictal 5-HT values being normal 16,17 or raised, 18 whereas in migraine some authors have reported a reduction in interictal values of 5-HT.…”

“…18 Following L-5HTP treatment, the increase in serum 5-HT and ß-endorphin levels, though not statistically significant in our patients, nonetheless supports the hypothesis of a PBMC ß-endorphin synthesis controlled by different neurotransmitter paths, particularly the serotoninergic, as already observed in other studies. 9,10,19,20 Other authors have already pointed out that administering a se-rotoninergic drug, such as clomipramine, even for just a week, was able to induce a significant increase in PBMC ß-endorphin, 8 and that L-5HTP caused an increase in plasma ß-endorphin in painful hypoendorphinergic conditions. 21,22 The stimulating effect of serotoninergic drugs on ß-endorphin synthesis was confirmed in the present study using L-5HTP, already used in juvenile migraine prophylaxis, albeit with results that are sometimes better, 23 sometimes similar 24 to the effect of a placebo.…”

“…A reduction in lymphocyte ß-endorphin has recently been observed during the interictal period in adults with migraine and cluster headache. 8 Moreover, ß-endorphin release is known to be controlled by several neurotransmitter systems, and that the serotoninergic system increases ß-endorphin concentration, whereas the dopaminergic and GABAergic systems reduce it. [9][10][11] We, therefore, performed a combined biochemical study (major objective) and an open clinical trial, analyzing both serum serotonin (5-HT) and plasma and PBMC ß-endorphin levels in young patients with different forms of primary headache (migraine without aura [MwA] and episodic tension-type headache [ETH]) during interictal periods before and after treatment with a serotoninergic precursor, L-5-hydroxytryptophan (L-5HTP).…”