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The role of a potential biomarker in patients with migraine: review and new insights

Journal

EXPERT REVIEW OF NEUROTHERAPEUTICS
Volume 21, Issue 7, Pages 817-831

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14737175.2021.1951236

Keywords

Headache; migraine; biomarker; calcitonin gene-related peptide; glutamate

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The article discusses potential biomarkers for migraine found in cerebrospinal fluid, blood, and saliva, with a focus on biomarkers related to treatment and clinical outcomes. The authors highlight the importance of identifying reliable biomarkers to improve early disease stage treatment with specific medications. Key biomarkers include CGRP, glutamate, nerve growth factor, inflammatory markers, and oxidative stress markers. New genetic and epigenetic biomarkers are emerging candidates for future research.
Introduction: The search for an ideal biomarker for migraine has persisted for a long time. There is plentiful evidence of potential biomarkers for migraine found in cerebrospinal fluid, blood, and saliva. Areas covered: Herein, the authors highlight and discuss the most promising candidates in the literature. An electronic search was performed for studies published between 2010 and 2020 in MEDLINE, PubMed, and EMBASE, related to potential biomarkers in migraine patients, found in cerebrospinal fluid, saliva, and serum, focusing on biomarkers that can be related to treatment and clinical outcomes. Expert opinion: An ideal biomarker, or a panel of biomarkers, could revolutionize the way we address and propose treatments for this disease. Once severe presentations and phenotypes have been identified using a reliable biomarker, patients could be treated at earlier disease stages with more specific medications. The most important biomarkers with the most significant levels of evidence comprised calcitonin gene-related peptide (CGRP), glutamate, nerve growth factor, some inflammatory (CRP, TNF-alpha, interleukins) and oxidative stress markers. CGRP was associated with episodic, chronic migraine and response to treatment. Pituitary adenylate cyclase-activating polypeptide is an emerging neuropeptide involved in migraine diagnostics and severity. New genetic and epigenetic biomarkers will be candidates for future research.

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