What is the role of sterile inflammation in the pathogenesis of migraine?

Updated: Aug 15, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Amy Kao, MD  more...
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Investigators have also proposed that a sterile inflammatory process causes the release of vasoactive neuropeptides, such as substance P and neurokinin A, from the trigeminal nerve. This causes vasodilatation of the arterioles and arteries, which activates endothelial cells, mast cells, and platelets.

In turn, these release vasoactive substances such as histamine, serotonin, peptikinins, prostaglandins, catecholamines, and slow-reacting substances of anaphylaxis. These substances cause contraction and relaxation of smooth muscle and the symptoms of migraine. The sterile inflammation process is proposed to increase the pain and lengthen the duration of a migraine attack.

It is also known that obesity causes the release of tumor necrosis factor-alpha and other cytokines from adipocytes, which results in a low-grade systemic inflammatory state. Obesity may therefore play a role in headache predisposition. [4]

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