Irene Munno

Immunological Aspects in Migraine: Increase of IL-10 Plasma Levels During Attack

In the present study, 23 patients with migraine without aura were monitored during a migraine attack. Plasma levels of interleukin (IL)‐4, IL‐5, IL‐10, and interferon‐γ were measured by enzyme‐linked immunosorbent assay techniques. Interestingly, we observed low to undetectable IL‐5 and IL‐4 levels, whereas high IL‐10 levels were seen in 52.2% of the patients. Interferon‐γ plasma levels were undetectable in all patients. After treatment with sumatriptan, 10 patients showed a subsequent decrease in IL‐10 and an increase in both IL‐4 and IL‐5 plasma levels. Although these findings are derived from a limited number of patients, the apparent return to the IL‐4 and IL‐5 cytokine profile observed during the interictal period leads us to speculate that a preferential enhancement of TH2‐type cytokine production may contribute to the pathogenesis of migraine.

Cytokines and migraine: increase of IL-5 and IL-4 plasma levels.

Thirty‐two patients suffering from migraine without aura were assessed during the interictal period to evaluate the contribution of cytokines to the pathophysiology of migraine. To this end, plasma levels of IFN‐γ, IL‐4, IL‐5, and IL‐10 were measured by enzyme‐linked immunosorbent assay (ELlSA) techniques. Plasma levels of both IFN‐γ and IL‐10 were not increased in the patients and did not differ significantly from healthy controls. Of interest, we observed a strong increase of IL‐5 levels in 84.3% as well as increased IL‐4 levels in 37.5% of patients with migraine without aura. These results suggest a preferential enhancement of some Th2‐type cytokines and may support the growing arguments of an immunoallergic mechanism in the pathophysiology of migraine.

Spontaneous and Induced Release of Prostaglandins, Interleukin (IL)-1β, IL-6, and Tumor Necrosis Factor-α by Placental Tissue from Normal and Preeclamptic Pregnancies

Munno I, Chiechi LM, Lacedra G, Putignano G, Patimo C, Lobascio A, Loizzi P. Spontaneous and induced release of prostaglandins, interleukin (IL)‐1β, IL‐6, and tumor necrosis factor‐α by placental tissue from normal and preeclamptic pregnancies. AJRI 1999; 42:369–374

Interleukin-Ibeta and Beta-Endorphin Orcadian Rhythms are Inversely Related in Normal and Stress-Altered Sleep

Normal sleep is associated to physiological nocturnal rises in Interleukin 1 beta (IL 1 beta) secretion. The 24 h pattern of IL 1 beta, beta-Endorphin (beta-EPH), ACTH and cortisol (F) production was evaluated in four male healthy volunteers. Two subjects were unable to sleep, due to the stress of the experiment; in these cases, no detectable plasma IL 1 beta secretion, both diurnal and nocturnal, was present, beta-EPH plasma levels were significantly higher (p < 0.01) than in the subjects who slept regularly and, in one case, increased F plasma levels were also reported. A strong negative correlation between IL 1 beta and beta-EPH plasma levels was present in all the cases. In conclusion, stress-induced sleep alterations might deeply affect both diurnal and nocturnal IL 1 beta plasma secretion, probably due to the hypothalamus-pituitary-adrenal axis (HPAA) activation, and beta-EPH might be the reliable marker of the stress-induced HPAA activation level.

Migraine, daily chronic headache and fibromyalgia in the same patient: an evolutive “continuum” of non organic chronic pain? About 100 clinical cases

Abstract.Aim of this study is to evaluate if migraine, daily chronic headache and fibromyalgia in the same patient can be considered as an evolutive continuum of non organic chronic pain. Therefore, migraine, daily chronic headache and fibromyalgia should be considered the expression of chronic antinociceptive system alteration.

Evaluation of Nonspecific Immunity and Plasma Levels of Interferon-γ, Interleukin-6 and Tumor Necrosis Factor-α in Preeclampsia

AbstractSUMMARYIn this study we evaluated the maternal cell-mediated immune aspects of preeclampsia in terms of phagocytosis and killing of monocytes and polymorphonuclear cells. To evaluate the contribution of cytokines (Cks) in the pathophysiology of preeclampsia, we investigated the plasma levels of interferon-γ (IFN-γ), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), respectively, by an enzyme-linked immunosorbent assay. Data showed that phagocytic and killing activities of monocytes were depressed in preeclamptic and normal pregnancies. At the same time, IFN-γ plasma levels were undectable in both groups. Conversely, we detected significant levels of TNF-α in plasma from preeclamptic and normal pregnancies. Moreover, since in three preeclamptic patients the onset of severe preeclampsia was associated with a sharp increased of TNF-α plasma levels, we suggest that an increased production of this CK may be implicated in the pathophysiology of preeclampsia.

Increased Spontaneous Release of Tumor Necrosis Factor-α/Cachectin in Headache Patients. A Possible Correlation with Plasma Endotoxin and Hypothalamic-Pituitary-Adrenal Axis

Tumor Necrosis Factor-alpha/cachectin (TNF-alpha/cachectin), Lipopolysaccharide (LPS), ACTH, beta-Endorphin (beta-EPH), and Cortisol (F) levels were determined in 33 Headache patients: 22 patients were affected with Migraine (M) and 11 patients with Chronic Type Tension Headache (CTTH). TNF-alpha/cachectin serum level was detected in 15 out of 22 migraneous patients and in no CTTH patients. Plasma LPS was observed in 11 out of 15 TNF-alpha/cachectin positive migraneous patients (73%) and in 3 out of 11 CTTH patients (27%). A negative correlation was observed between TNF-alpha/cachectin values and either ACTH or beta-EPH. In the group of migraneous patients the presence of serum TNF-alpha/cachectin showed a sensibility of .6 and a specificity of 1. The endocrine and immunological implications concerning these data are discussed.

Effects of Acetyl-L-Carnitine Oral Administration on Lymphocyte Antibacterial Activity and TNF-α Levels in Patients with Active Pulmonary Tuberculosis. A Randomized Double Blind Versus Placebo Study

Acetyl-L-carnitine (ALC), a drug for the treatment of ageing-related neuroendocrine dysfunctions, was orally administered--2 gm/day for 30 days--to 10 patients with active pulmonary tuberculosis (TBC). Lymphocyte-mediated antibacterial activity and serum levels of tumor necrosis factor (TNF)-alpha were evaluated before and after treatment, comparing the values with those of 10 TBC patients receiving placebo. Results show that by day 30, antibacterial activity remained unmodified or increased in ALC-treated subjects, while decreased in the placebo group. No influence of ALC on TNF-alpha levels was detectable. These data suggest that the hosts immune responses to M. tuberculosis infection can be selectively modulated by drugs acting on the neuroendocrine axis.

Th2-dependent cytokine release in patients treated with coronary angioplasty.

AimThe aim of this study is to investigate the T helper (Th)2-dependent release of interleukin(IL)-4 and IL-13 in patients with unstable angina treated with coronary angioplasty (PCI). MethodsThis study involved 48 consecutive patients with unstable angina who underwent PCI. Blood samples were taken before and 48 h after PCI to evaluate serum IL-4 and IL-13 levels. Coronary atherosclerosis was assessed in terms of the severity of the treated lesions and the presence of multivessel disease, and compared with IL release. ResultsBefore and after PCI, serum IL-4 levels were, respectively, 53.1±110.7 and 35.1±16.9 pg/ml (P not significant), and serum IL-13 levels 6.7±3.7 and 6.0±2.9 pg/ml (P<0.05). A correlation was present between the severity of the treated coronary lesions and serum IL-13 levels (r 0.36; P<0.05). The patients with multivessel coronary artery disease had a higher periprocedure ratio of IL-4 than those with single-vessel coronary artery disease (1.46±0.76 vs. 0.89±0.34, P<0.001). ConclusionA significant decrease was observed in Th2-dependent IL concentrations after PCI; increased Th2-dependent IL levels before PCI seem to correlate with the severity of coronary atherosclerosis.

Evaluation of Hypothalamic-Pituitary-Adrenocortical Hormones and Inflammatory Cytokines in Patients with Persistent Vegetative State

Hypothalamic-pituitary-adrenocortical hormones, i.e. prolactin (PRL), human growth hormone (hGH), thyroid stimulating hormone (TSH), and Cortisol and plasma levels of cytokines, i.e. tumor necrosis factor-alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), and interleukin-6 (IL-6), were assessed in 27 patients with persistent vegetative state (PVS) and in 16 outcome patients. In comparison with normal parameters, plasma levels of TSH were not significantly altered, while elevated basal hGH concentrations in 48.1% of PVS subjects and depressed cortisol levels in all PVS individuals and in patients who emerged from coma (outcome patients), respectively, were observed. In addition, higher TNF-alpha plasma levels in PVS subjects than in outcome patients and in healthy donors were found, while IL-1 beta plasma levels were elevated in both groups of patients in comparison with healthy controls. Of interest, in 55% PVS male patients hyperprolactinemia was observed, whereas in outcome patients more than six months these values were within normal range. In four patients, who emerged from coma in the course of this study, prolactin plasma levels were followed-up and increased basal values progressively fell to normal range within six months.