A blood test to determine appropriate treatment for migraine might be a significant step closer thanks to researchers at Johns Hopkins University.
In their small study, scientists found that measuring a protein called adiponectin (ADP) before and after migraine treatment indicates which headache sufferers obtained relief from treatment.
Fat tissue secretes ADP, a hormone that modulates several of the pain pathways involved in migraine. ADP is also involved in the body in a number of other ways, including sugar metabolism, insulin regulation, immunity and inflammation, as well as obesity, which is a risk factor for migraine.
For the study, B. Lee Peterlin, DO, and her colleagues collected blood over an approximate two-year period from 20 women during an acute migraine attack. Blood was taken before treatment with either sumatriptan/naproxen sodium or a placebo and then again at 30, 60 and 120 minutes after treatment. Eleven women received the drug, and nine received the placebo.
Peterlin and her colleagues examined total adiponectin levels and two ADP subtypes, low-molecular-weight (LMW) and high-molecular-weight (HMW) adiponectin, which circulate in the blood. LMW has anti-inflammatory properties, the researchers noted, while HMW has inflammatory properties
In all 20 participants, when levels of LMW increased, the severity of pain decreased. In contrast, when the ratio HMW to LMW increased, the pain severity increased.
In fact, the authors found that they could determine who would respond to treatment and who would not based on the results of the blood test and the ratio of HMW and LMW adiponectin.
“The blood tests could predict response to treatment,” Dr. Peterlin said.
Dr. Peterlin, who is an associate professor of neurology and director of headache research at The Johns Hopkins University School of Medicine, noted that these findings may be extremely helpful clinically after more study. Considerably more research is needed, the authors stressed, but ADP may prove to be a biomarker for migraine, and it may assist health care professionals in determining which medication would be most appropriate for individual migraineurs.