Öz
Amaç: Migren çocuk ve ergen yaş grubunda değişen yaşam tarzları ve psikososyal faktörler ile birlikte görülme sıklığı giderek artan önemli bir klinik problemdir. Birincil baş ağrıları arasında yer alan migrenin biyokimyasal, genetik ve çevresel faktörlerle ilişkili nörovasküler bir hastalık olduğu bilinmektedir. Son yıllarda yapılan birçok çalışmada migren patogenezinde oksidatif stres sorumlu tutulmuştur. Oksidatif stres varlığında tiyol/disülfit homeostazisinin disülfit yönünde bozulması beklenmektedir. Tiyol/disülfit homeostazisinin çocuklarda migren ile olan ilişkisini araştıran geniş çaplı araştırmalar mevcut değildir. Çalışmamızda migren tanılı çocuklarda dinamik tiyol/disülfit homeostazisi ilişkisini belirlemeyi ve bu dengede disülfit yönünde bozulma görülürse migren proflaksisi ve/veya tedavisinde oksidatif stresten korunma ve/veya antioksidan tedavi kullanımı ile ilgili literatüre katkı sağlanmasını amaçladık.
Gereç ve Yöntemler: Çalışmaya Sağlık Bilimleri Üniversitesi, Ankara Keçiören Eğitim ve Araştırma Hastanesi’nde Çocuk Nöroloji Polikliniği’nde değerlendirilerek migren tanısı alan 8-18 yaş arasındaki 71 hasta ve Genel Çocuk Polikliniği’ne başvuran 70 sağlıklı çocuk dahil edilmiştir. Toplanan örneklerde serum doğal tiyol, total tiyol, disülfit, disülfit/doğal tiyol yüzdesi, disülfit/total tiyol yüzdesi ve doğal tiyol/total tiyol yüzdesi ölçümleri yapılarak migren hastaları ve sağlam çocuklar karşılaştırılmıştır.
Bulgular: Migren sıklığı yaşla birlikte artmış; 8-12 yaş %18.3, 13-15 yaş %36.6, 16-18 yaş %45.1 olarak tespit edilmiştir. Ağrı şekli %85.9 ile en sık zonklayıcı olup ağrıların %59.2’si bilateral bulunmuştur. Hastaların %11.3’ü atak ağrısının 30 dakikadan kısa sürdüğünü belirtmiştir. Gruplar karşılaştırıldığında doğal tiyol, doğal tiyol/total tiyol değerleri kontrol grubunda anlamlı olarak yüksek saptanmıştır (sırasıyla p=0.022, p=0.005). Disülfit, disülfit/doğal tiyol, disülfit/total tiyol değerleri ise hasta grubunda anlamlı olarak yüksek bulunmuştur (sırasıyla p=0.039, p=0.005, p=0.005). İstatistiksel olarak anlamlı olmasa da kontrol grubunda total tiyol değerleri hasta grubundan yüksek bulunmuştur (p=0.115).
Sonuç: Migren hastalığı sık görülmesine rağmen çocuklarda bu konuda yapılmış prospektif çalışma oldukça az sayıdadır. Çalışmamızda migren tanılı çocuklarda migren hastalığı ile tiyol/disülfit homeostazisi arasındaki ilişki incelenmiş olup oksidatif strese yönelik parametreler yüksek bulunmuştur. Migren hastalarındaki yüksek oksidatif stres değerleri antioksidan etkili maddelerin hastalığın tedavisinde rol oynayabileceğini düşündürmektedir. Bu konuyla ilgili destekleyici çalışmalara ihtiyaç vardır.
Anahtar Kelimeler
Kaynakça
- Wöber-Bingöl C. Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep 2013;17:341.
- Özge A, Abu-Arafeh I, Gelfand AA, Goadsby PJ, Cuvellier JC, Valeriani M, et al. Experts’ opinion about the pediatric secondary headaches diagnostic criteria of the ICHD-3 beta. J Headache Pain 2017;18:113.
- Zielman R, Wijnen JP, Webb A, Onderwater GLJ, Ronen I, Ferrari MD, et al.Cortical glutamate in migraine.Brain 2017;140:1859-71.
- Sutherland HG, Albury CL, Griffiths LR. Advances in genetics of migraine. J Headache Pain 2019;20:72.
- Pizza AV, Agresta A, Iorio EL, Capasso A. Impaired oxidative balance in migraine: the evidence from d-ROMs test and bap test. Pharmacologyonline 2013;1:25–8.
- Gruber HJ, Bernecker C, Lechner A, Weiss S, Wallner-Blazek M, Meinitzer A, et al. Increased nitric oxide stress is associated with migraine. Cephalalgia 2010;30:486-92.
- Cheeseman KH, Slater TF. An introduction to free radical biochemistry. Br Med Bull 1993;49:481-93.
- Atmaca G. Antioxidant effects of sulfur-containing amino acids. Yonsei Med J 2004;45:776-88.
- Erel O, Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem 2014;47:326–32.
- Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med 2013;65:244–53.
- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 201838:1-211.
- Yorns WR Jr, Hardison HH. Mitochondrial dysfunction in migraine. Semin Pediatr Neurol 2013;20:188-93.
- Borkum JM. The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory. Headache 2018;58:118-135.
- Rahal A, Kumar A, Singh V, Yadav B, Tiwari R, Chakraborty S, et al. Oxidative stress, prooxidants, and antioxidants: the interplay. Biomed Res Int 2014;2014:761264.
- Pasaoglu H, Sancak B, Bukan N. Lipid peroxidation and resistance to oxidation in patients with type 2 diabetes mellitus. Tohoku J Exp Med 2004;203:211-8.
- Kurt ANC, Aydın A, Demir H, Erel O. Headache in children and dynamic thiol/disulfide balance evaluation with a new method. Neurol Sci2017;3:1495-9.
- Gumusyayla S, Vural G, Bektas H, Neselioglu S, Deniz O, Erel O. A novel oxidative stress marker in migraine patients: dynamic thiol-disulfide homeostasis. Neurol Sci 2016;37:1311-7.
- Lynch SM, Campione AL, Moore MK. Plasma thiols inhibit hemin-dependent oxidation of human lowdensity lipoprotein. Biochim Biophys Acta 2000;1485:11–22.
- Cencioni C, Spallotta F, Martelli F, Valente S, Mai A, Zeiher AM, et al. Oxidative stress and epigenetic regulation in ageing and age-related diseases. Int J Mol Sci 2013;14:17643-63.
- Borkum JM. Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis. Headache 2016;56:12-35.
- Tripathi GM, Kalita J, Misra UK. A study of oxidative stress in migraine with special reference to prophylactic therapy. Int J Neurosci 2018;128:318-24.
- Tuncel D, Tolun FI, Gokce M, Imrek S, Ekerbiçer H. Oxidative Stress in Migraine with and Without Aura. Biol Trace Elem Res 2008;126:92-7.
- Eren Y, Dirik E, Neşelioğlu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg. 2015;115:643-9.
- Alp R, Selek S, Alp S, Taşkin A, Koçyiğit A. Oxidative and antioxidative balance in patients of migraine. Eur Rev Med Pharmacol Sci 2010; 14:877-82.
- Gupta R, Pathak R, Bhatia M, Banerjee BD. Comparison of oxidative stress among migraineurs, tensiontype headache subjects, and a control group. Ann Indian Acad Neurol 2009;12:167-72.
- Erol I, Alehan F, Aldemir D, Ogus E. Increased vulnerability to oxidative stress in pediatric migraine patients. Pediatr Neurol 2010;43:21-4.
- Kander MC, Cui Y, Liu Z. Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases. J Cell Mol Med 2017;21:1024-32.
Öz
Objective: Migraine is a common disease in childhood. Oxidative stress has been implicated in the pathogenesis of migraine. Dynamic thiol/disulfide homeostasis is proven to be a marker of oxidative stress. We aimed to investigate the correlation between migraine and dynamic thiol/disulfide homeostasis.
Material and Methods: A total of 141 children (71 migrain and 70 controls) were included. The serum total thiol, native thiol, and disulfide levels were measured and the ratios of disulfide/native thiol, disulfide/total thiol and native thiol/total thiol were compared between migraine patients and healthy children during attack-free period.
Results: Native thiol levels and native thiol/total thiol ratio were significantly lower in the migraine group than the control group (p=0.022, p=0.005, respectively); whereas disulfide levels, disulfide/native thiol and disulfide/total thiol ratios were significantly higher in the migraine group than the control group (p=0.039, p=0.022, p=0.005 respectively).
Conclusion: Our results demonstrate that there is an ongoing oxidative process in pediatric migraineurs even during attack-free period. This result may shed light on further studies analyzing dynamic changes in the oxidant-antioxidant balance during the attack and the aura phase to support the presence and importance of oxidative stress in pediatric migraine.
Anahtar Kelimeler
Kaynakça
- Wöber-Bingöl C. Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep 2013;17:341.
- Özge A, Abu-Arafeh I, Gelfand AA, Goadsby PJ, Cuvellier JC, Valeriani M, et al. Experts’ opinion about the pediatric secondary headaches diagnostic criteria of the ICHD-3 beta. J Headache Pain 2017;18:113.
- Zielman R, Wijnen JP, Webb A, Onderwater GLJ, Ronen I, Ferrari MD, et al.Cortical glutamate in migraine.Brain 2017;140:1859-71.
- Sutherland HG, Albury CL, Griffiths LR. Advances in genetics of migraine. J Headache Pain 2019;20:72.
- Pizza AV, Agresta A, Iorio EL, Capasso A. Impaired oxidative balance in migraine: the evidence from d-ROMs test and bap test. Pharmacologyonline 2013;1:25–8.
- Gruber HJ, Bernecker C, Lechner A, Weiss S, Wallner-Blazek M, Meinitzer A, et al. Increased nitric oxide stress is associated with migraine. Cephalalgia 2010;30:486-92.
- Cheeseman KH, Slater TF. An introduction to free radical biochemistry. Br Med Bull 1993;49:481-93.
- Atmaca G. Antioxidant effects of sulfur-containing amino acids. Yonsei Med J 2004;45:776-88.
- Erel O, Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem 2014;47:326–32.
- Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med 2013;65:244–53.
- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 201838:1-211.
- Yorns WR Jr, Hardison HH. Mitochondrial dysfunction in migraine. Semin Pediatr Neurol 2013;20:188-93.
- Borkum JM. The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory. Headache 2018;58:118-135.
- Rahal A, Kumar A, Singh V, Yadav B, Tiwari R, Chakraborty S, et al. Oxidative stress, prooxidants, and antioxidants: the interplay. Biomed Res Int 2014;2014:761264.
- Pasaoglu H, Sancak B, Bukan N. Lipid peroxidation and resistance to oxidation in patients with type 2 diabetes mellitus. Tohoku J Exp Med 2004;203:211-8.
- Kurt ANC, Aydın A, Demir H, Erel O. Headache in children and dynamic thiol/disulfide balance evaluation with a new method. Neurol Sci2017;3:1495-9.
- Gumusyayla S, Vural G, Bektas H, Neselioglu S, Deniz O, Erel O. A novel oxidative stress marker in migraine patients: dynamic thiol-disulfide homeostasis. Neurol Sci 2016;37:1311-7.
- Lynch SM, Campione AL, Moore MK. Plasma thiols inhibit hemin-dependent oxidation of human lowdensity lipoprotein. Biochim Biophys Acta 2000;1485:11–22.
- Cencioni C, Spallotta F, Martelli F, Valente S, Mai A, Zeiher AM, et al. Oxidative stress and epigenetic regulation in ageing and age-related diseases. Int J Mol Sci 2013;14:17643-63.
- Borkum JM. Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis. Headache 2016;56:12-35.
- Tripathi GM, Kalita J, Misra UK. A study of oxidative stress in migraine with special reference to prophylactic therapy. Int J Neurosci 2018;128:318-24.
- Tuncel D, Tolun FI, Gokce M, Imrek S, Ekerbiçer H. Oxidative Stress in Migraine with and Without Aura. Biol Trace Elem Res 2008;126:92-7.
- Eren Y, Dirik E, Neşelioğlu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg. 2015;115:643-9.
- Alp R, Selek S, Alp S, Taşkin A, Koçyiğit A. Oxidative and antioxidative balance in patients of migraine. Eur Rev Med Pharmacol Sci 2010; 14:877-82.
- Gupta R, Pathak R, Bhatia M, Banerjee BD. Comparison of oxidative stress among migraineurs, tensiontype headache subjects, and a control group. Ann Indian Acad Neurol 2009;12:167-72.
- Erol I, Alehan F, Aldemir D, Ogus E. Increased vulnerability to oxidative stress in pediatric migraine patients. Pediatr Neurol 2010;43:21-4.
- Kander MC, Cui Y, Liu Z. Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases. J Cell Mol Med 2017;21:1024-32.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ocak 2023 |
| Gönderilme Tarihi | 24 Aralık 2021 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 17 Sayı: 1 |