Document Type : Original Article
Authors
- Zhaleh Salami 1
- Saeed Irian 2
- Mansoureh Togha 3
- Elham Jafari 3
- Delara Hazegh-Fetratjoo 4
- Paniz Salami 5
1 Department of Cellular and Molecular Biology, School of Biological Sciences, Kharazmi University, Tehran, Iran Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Cellular and Molecular Biology, School of Biological Sciences, Kharazmi University, Tehran, Iran
3 Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
4 School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Molecular and Cellular Sciences, School of Advanced Sciences and Technology, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Chronic migraine (CM) is a debilitating neurological disorder often complicated by medication overuse (MO). While abobotulinumtoxinA (ABO-BoNT-A) is a well-established preventive treatment for CM, its molecular mechanisms are not fully understood. Emerging evidence suggests that neurotrophic tyrosine receptor kinase 2 (NTRK2), SRC kinase signaling inhibitor 1 (SRCIN1), and P2X4 purinergic receptor (P2X4R) are involved in migraine chronification and botulinum neurotoxin A (BoNT-A) function, but their roles in humans remain underexplored. This case series investigated changes in NTRK2, SRCIN1, and P2X4R gene expression in peripheral blood pre- and post-BoNT-A treatment and assessed associated clinical outcomes in patients.
Methods: The messenger ribonucleic acid (mRNA) levels of NTRK2, SRCIN1, and P2X4R genes were analyzed in a sample of eight patients with CM and MO following BoNT-A treatment using quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, migraine characteristics were assessed using Migraine Disability Assessment Scale (MIDAS), Headache Impact Test-6 (HIT-6), and Patient Health Questionnaire-9 (PHQ-9).
Results: The intervention resulted in early measurable improvements in migraine symptoms and disability. Post-treatment, P2X4R expression significantly increased (P < 0.05), while NTRK2 and SRCIN1 showed no significant changes.
Conclusion: Findings indicate that P2X4R upregulation may be linked to the therapeutic effects of BoNT-A, while NTRK2 and SRCIN1 appear uninvolved. The trend in P2X4R expression suggests it may serve as a predictive biomarker and therapeutic target, but further validation in larger cohorts is necessary.
Keywords
Main Subjects
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