A New Fat-Based Target for Migraine Therapy?
For several years, a group of Migraine researchers have been looking at a unique hormone secreted by fat cells, which could serve as a bio-marker for Migraine attacks as well as potentially lead researchers to another new way to target future Migraine treatments.
This is good news for Migraineurs!
Fat as an organ
Fat doesn’t just store energy and keep us warm. Although obesity isn’t a risk factor for Migraine, it has been linked to an increase in both frequency and severity of Migraine attacks as well as being an independent risk factor for chronic daily headache (CDH). It is an important comorbid condition that can exacerbate our Migraine disease.
Did you know you have different kinds of fat cells in your body, and that some of them act just like an endocrine gland? Our bodies are so complex and amazing and this interaction helps explain some other frequently comorbid conditions with Migraine disease too. Research has been ongoing for years, leading some scientists to speculate that obesity may actually be a unique endocrine disorder.
First some background
An endocrine gland secretes hormones that alter the way your organs and cells function. Examples of endocrine glands include
A special kind of fat called adipose fat is found primarily in the abdomen and is often known as *belly fat*. Those with larger tummies have more adipose fat. It is often considered to be an unofficial endocrine organ too because of its unique role in the production of special hormones. A part of the brain called the hypothalamus controls the secretion of hormones from adipose fat.
Some of the hormones adipose cells secrete play roles in our body’s energy and inflammatory homeostasis (balance). Homeostasis is good, and it’s really very important in keeping sensitive Migraine brains from being triggered resulting in a cascade of neuronal and other activity that can lead to a Migraine attack.
These hormones are called Adiponectins because they’re made by adipose fat, and there are two different kinds that seem to directly relate to Migraine. High Molecular Weight (HMW) and Low Molecular Weight (LMW). (A third, Middle Molecular Weight or MMW is a building block that contributes to the formation of HMW resulting in increased inflammation)
In this case the thing to remember is this: High is bad. Low is good.
Because some of these hormones play a part in modulating inflammation and insulin sensitivity and therefore energy metabolism, we want them to stay in balance. We want our body to be able to use energy efficiently (good insulin sensitivity), and we want to minimize inflammation that plays a role in Migraine pathogenesis (how a Migraine attack occurs inside our brains) and other painful conditions.
The old research gives us clues
A few years ago, researchers found several points of interest when they looked at adiponectin in patients with Migraine and chronic daily headache (CDH).
Some interesting things they have learned previously that can be applied to Migraine patients:
- At puberty, females have higher HMW than males.
- Estrogen suppresses adiponectin, and menstrual Migraines usually occur as estrogen levels decline during the end of the menstrual cycle. Could adiponectin then play a part in menstrual Migraine?
- Testosterone suppresses adiponectin which may account for the success of testosterone treatment of male cluster headache patients.
- There is hypothalamic involvement in Migraine, and there are adiponectin receptors in the hypothalamus.
The new research builds on the old studies
In a more recent, but very small preliminary research study of 20 patients, the ratio between HMW’s and LMW’s was higher during pain. The LMW’s increased though as pain decreased.
According to the authors, HMW’s seem to activate pain pathways and inflammation. LMW’s seem to have anti-inflammatory properties. Having a higher HMW:LMW ratio helped indicate which patients would be responsive to Migraine therapy. Knowing this might help doctors diagnose headache disorders with more accuracy, and may help them decide which treatments might be the most likely to be effective in a given patient.
This study utilized placebos – a *pretend*or sham treatment that won’t actually help a Migraine attack. Those getting the placebo didn’t know that’s what they were getting. However, another interesting finding was that those in the placebo group who felt they had relief of their pain also had corresponding changes in their adiponectin levels.
It is hoped that discovering a way to target and lower adiponectin levels, or even more specifically HMW levels, might be possible. This would represent a brand new way to identify and treat Migraine. Hopefully more research will be done on this in the future.
Sources: 1. Peterlin, B. Lee, DO; White, Linda, CRNP; Dash, Paul, MD; Hammond, Edward, MD, MPH; Haythornethwaite, Jennifer, PhD. “Blood Levels of Fat Cell Hormone May Predict Severity of Migraines”. Johns Hopkins Medicine. Available at: http://www.hopkinsmedicine.org/news/media/releases/blood_levels_of_fat_cell_hormone_may_predict_severity_of_migraines. Release Date 3/18/2013 2. Peterlin, B. Lee, DO; "The Role of Adiponectin in Migraine. Migraine Resource Network". Available at: http://www.migraineresourcenetwork.com/index.php?option=com_content&view=article&id=141&catid=16&Itemid=53. Last Updated: November 17, 2009
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