5PSQ-009 Changes of inflammatory profile after anti-CGRP antibody treatment in migraine patients

<h3>Background and Importance</h3> The role of inflammation in the pathophysiology of migraine seems to be supported by evidence of an increase in pro-inflammatory cytokines, and by a reduction of regulatory lymphocyte subsets and prevalence of Th1 lymphocytes in the peripheral blood of patients. During acute severe migraine attacks, the calcitonin gene-related peptide is elevated in the cranial circulation and stimulates the release of inflammatory cytokines. <h3>Aim and Objectives</h3> Verifying and confirming the monoclonal antibody anti CGRP activity in the reduction of inflammation induced by migraine. How the use of monoclonal antibody reduces the release of pro-inflammatory cytokines. <h3>Material and Methods</h3> We investigated the levels of Th1 and Th2 cytokines, chemokines and adiponectin in the serum of the migraine patients: at each day hospital visit, blood samples were taken before the antibody was administered; 1 month after the infusion, the patient was made to return for visit to assess the cytokine level. Determination of serum levels of the cytokines was performed using commercial ELISA Kits. A Shapiro-Wilk’s test was performed to evaluate each variable’s departure from distribution. The quantitative variables were summarised as median and interquartile range. Midas questionnaire was used to assess change in degree of disability before and after 1 month of antibody treatment. <h3>Results</h3> The number of patients who underwent sampling was 13. Results showed that Th1/Th2 and TNF/IL-10 profiles are modulated by anti-CGRP treatment with a shift towards a Th2 immune response with concomitant improvement of symptoms in migraineurs (MIDAS scale score). Serum concentration of adiponectin, according to its anti-inflammatory activity, showed a significant increase after anti-CGRP treatment, suggesting a potential connection of a reduction of adiponectin to the pathophysiology of migraine. <h3>Conclusion and Relevance</h3> This preliminary study highlights that anti-CGRP treatment led to a shift towards a For Peer Review Th2 Immune response with concomitant improvement of symptoms in migraineurs, confirming the correlation between migraine and immune system dysfunctions. In conclusion, monoclonal antibody anti-CGRP demonstrate efficacy in the resolution of this pathology. <h3>References and/or Acknowledgements</h3> Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. <i>Lancet (London, England)</i> 2018. <h3>Conflict of Interest</h3> No conflict of interest