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Histamine metabolism in cluster headache and migraine

Catabolism of 14C histamine

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Summary

Various parameters of histamine metabolism were studied in patients with migraine, cluster headache and chronic paroxysmal hemicrania. These included urinary excretion of radioactivity and of 14C histamine and its metabolites, exhaled 14CO2 and fecal radioactivity after oral as well as subcutaneous administration of radioactive histamine.

No marked deviation from the normal was found except in one patient with the cluster headache variant, chronic paroxysmal hemicrania, in whom an aberration in 14C histamine degradation seemed to be present. Only minute quantities of the 14C histamine metabolite C14 imidazoleacetic acid riboside seemed to be formed during a period with severe paroxysms. During a symptom-free period no deviation from normal was observed.

The most likely explanation for this finding seems to be a defect in the conversion of imidazoleacetic acid to its riboside. This defect may possibly explain the increased urinary excretion of histamine in this particular patient. The relationship of this metabolic aberration to the production of headache still remains dubious for various reasons.

Zusammenfassung

Bei Patienten mit Migräne, Bing-Horton Kopfschmerz (cluster headache) und chronisch paroxysmaler Hemikranie wurden folgende Parameter des Histaminstoffswechsels untersucht:

Die Urinausscheidung der Gesamtradioaktivität, C14-Histamin und seiner Abbauprodukte sowie die Menge von abgeatmetem C14-CO2 und die Gesamtradioaktivität im Stuhl nach oraler und subcutaner Verabfolgung radioaktiv markiertem Histamins. Mit Ausnahme einer Patientin mit einer Variante des „cluster headache“ — der chronisch paroxysmalen Hemikranie — wurden keinerlei Abweichungen von der Norm festgestellt. Bei der Patientin mit chronisch paroxysmaler Hemikranie schien eine Störung des Histaminabbaues vorzuliegen, indem zu Zeiten schwerer paroxysmaler Kopfschmerzen nur sehr geringe Mengen des C14-Histamin Abbauproduktes C14-Imidazolessigsäure-Ribosid gebildet wurden. Im symptomarmen Intervall wurden keine sicheren Abweichungen von der Norm festgestellt.

Die naheliegendste Erklärung für diesen Befund scheint die Annahme eines Defektes in der Umwandlung von Imidazolessigsäure zu seinem Ribosid zu bieten. Dieser Defekt könnte möglicherweise die erhöhte Ausscheidung von Histamin im Urin dieser Patientin erklären.

Die Bedeutung dieser Stoffwechselstörung für die Entstehung von Kopfschmerzen ist aus verschiedenen Gründen noch ungeklärt.

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Authors and Affiliations

  1. Departments of Neurology and Surgical Research, Rikshospitalet, Pilestredet 32, Oslo, Norway

    Ottar Sjaastad

  2. Institute of Physiology, Veterinary College of Norway, Olso, Norway

    Ø. V. Sjaastad

Authors
  1. Ottar Sjaastad
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  2. Ø. V. Sjaastad
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Sjaastad, O., Sjaastad, Ø.V. Histamine metabolism in cluster headache and migraine. J. Neurol. 216, 105–117 (1977). https://doi.org/10.1007/BF00312944

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  • DOI: https://doi.org/10.1007/BF00312944

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