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Association between Helicobacter pylori cytotoxic type I CagA-positive strains and migraine with aura
A Gasbarrini1, M Gabrielli, G Fiore
1Angiology Department, Catholic University, Rome, Italy. angiologia@rm.unicatt.it
Abstract:
Recent studies have suggested an association between Helicobacter pylori infection and migraine. However, various strains of the bacterium are present, some endowed with greater pathogenicity. In particular, H. pylori type I CagA-positive strains induce a higher release of proinflammatory substances by the gastric mucosa that could trigger systemic vasospasms. The aim of the present study was to assess the prevalence of H. pylori CagA-positive strains in subjects with migraine. One hundred and seventy-five patients affected by migraine (49 with aura, 126 without aura) were consecutively enrolled and matched for sex, age, social background and geographical origin with 152 controls. Helicobacter pylori infection was assessed through 13C-urea breath test. Specific serological IgG against CagA were detected through ELISA. The prevalence of H. pylori infection was similar in migraine patients and in controls (40% vs. 39%, respectively). Among migraine patients, prevalence of infection was not related to presence or absence of aura (45% vs. 37%, respectively). However, among infected subjects, a significantly higher prevalence of CagA-positive strains was observed in patients affected by migraine with aura when compared with those affected by migraine without aura (41% vs. 19%, P < 0.01) and with controls (41% vs. 17%, P < 0.01). CagA-positive H. pylori strains were found to be strongly associated with migraine with aura. A higher inflammatory response of the gastric mucosa to more virulent strains could release substances that may act as triggers of vasospasm in peculiar cerebral arterial districts, probably implicated in the 'aura' phenomenon.
Insights
Helicobacter pylori CagA-positive strains are strongly linked to migraine with aura. This suggests a potential inflammatory trigger for vasospasms in migraine patients with specific H. pylori infections.
Area of Science:
- Gastroenterology
- Neurology
- Infectious Diseases
Background:
- Emerging research suggests a link between Helicobacter pylori infection and migraine.
- H. pylori strains vary in pathogenicity, with Type I CagA-positive strains potentially triggering systemic responses.
Purpose of the Study:
- To investigate the prevalence of H. pylori CagA-positive strains in individuals experiencing migraine.
- To determine if specific H. pylori strains are associated with migraine subtypes, particularly migraine with aura.
Main Methods:
- 175 migraine patients (49 with aura, 126 without) and 152 controls were enrolled.
- H. pylori infection was detected using the 13C-urea breath test.
- Serological IgG against CagA was measured via ELISA.
Main Results:
- Overall H. pylori infection rates were similar between migraineurs (40%) and controls (39%).
- Among infected individuals, CagA-positive strains were significantly more prevalent in migraine with aura patients (41%) compared to migraine without aura (19%) and controls (17%).
- H. pylori CagA-positive strains showed a strong association with migraine with aura.
Conclusions:
- The study identifies a significant association between CagA-positive H. pylori strains and migraine with aura.
- A heightened inflammatory response to virulent H. pylori strains may release substances that trigger cerebral vasospasms, potentially explaining the aura phenomenon.