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- Title
Blood serum levels of PACAP and migraine onset: A systematic review and meta‐analysis of observational studies.
- Authors
Zhu, Guoliang; Wang, Miao; Kong, Fanyi
- Abstract
Objective: We conducted a systematic review and meta‐analysis to explore the relationship between blood pituitary adenylate cyclase‐activating polypeptide (PACAP) levels and migraine. Background: PACAP is involved in the onset of migraine, but the results from clinical studies on PACAP level variations across different periods of migraine are conflicting. Methods: We systematically searched for observational studies that reported PACAP levels in people with migraine and non‐migraine controls published in English from the PubMed, Web of Science, and Ovid electronic databases, or in Chinese from the Chinese National Knowledge Infrastructure and the WanFang Med database. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The quality of evidence for each outcome was assessed according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Of the 514 identified studies, 8 were eligible for inclusion. There was a "very low" level of evidence suggesting that the PACAP level is negatively correlated with migraine disease duration in adults with migraine (summary r = −0.35, 95% confidence interval [CI] −0.49 to −0.22) and that the PACAP is higher in people with migraine during the ictal period than in the interictal period (standardized mean difference = 0.41, 95% CI 0.17 to 0.66) for both adults and children with migraine. Adult patients with episodic migraine (weighted mean difference [WMD] = −9.58 pg/mL, 95% CI −13.41 to −5.75 pg/mL) or chronic migraine (WMD = −10.93 pg/mL, 95% CI −15.57 to −6.29 pg/mL) had lower blood PACAP levels than non‐migraine controls during the interictal period, supported by a "low" or "very low" quality of evidence, respectively, according to the GRADE rules. Conclusion: There is a very low certainty of evidence suggesting that the PACAP level is negatively correlated with migraine disease duration of adults with migraine and it varies greatly among different periods of migraine of both adults and children with migraine. Plain Language Summary: Pituitary adenylate cyclase‐activating polypeptide (PACAP) is thought to be involved in migraine attacks, but studies looking at the relationship between PACAP levels and migraine have not shown consistent results. We reviewed and summarized data from studies that looked at PACAP levels and migraine to clarify this relationship. Our study showed that PACAP levels were lower in people who have a longer history of migraine, which might mean that PACAP could be important for treating migraine; however, more research will be needed to find out whether this is true.
- Subjects
MIGRAINE diagnosis; META-analysis; SYSTEMATIC reviews; MEDLINE; NEUROPEPTIDES; ONLINE information services; CONFIDENCE intervals; BIOMARKERS; MIGRAINE
- Publication
Headache: The Journal of Head & Face Pain, 2024, Vol 64, Issue 5, p573
- ISSN
0017-8748
- Publication type
Article
- DOI
10.1111/head.14711