Leukotriene B4 Generation by Polymorphonuclear Leukocytes: Possible Involvement in the Pathogenesis of Headache

SYNOPSIS
Leukotriene B₄ (LTB₄) levels in plasma and its generation in vitro from isolated polymorphonuclearleukocytes (PMN) were measured in migraine and cluster headache patients during and between painattacks. The LTB₄plasma levels in cluster headache patients during an attack were significantly higherthan in patients between attacks. There was a positive correlation between the time of sampling from thebeginning of attack and the LTB₄level. The LTB₄ plasma levels in migraine patients during and betweenattacks did not differ significantly from control levels. The results suggest that LTB₄appears rapidly in thecirculation at the beginning of a cluster attack and thereafter declines in amount. LTB₄release from PMNwas induced by stimulation with the calcium ionophore A23187. The release of LTB₄was significantlyhigher in migraine patients during attacks on stimulation with a submaximal dose of A23187 0.5 μM. LTB₄ release induced by A23187 in migraine patients during symptom-free intervals and cluster headachepatients did not differ from healthy controls. LTB₄ release was not affected by 5HT and NA inconcentrations up to 10^-4M. The results suggest that LTB₄is more easily generated in migraine patientsduring attacks. These studies on isolated cells provide a suitable model for the investigation of themetabolism of lipoxygenase derivates in headache patients.