Pain Reporter: Asthma and Migraine

A recent Daily Dose reported a study connecting asthma and migraine. The Pain Reporter contacted lead author Vincent T. Martin, MD, in the Department of Internal Medicine at University of Cincinnati College of Medicine in Ohio, to ask him the following questions:

Q. What steered you and your team to this research?

A. I noticed that 20% to 30% of my chronic migraine patients also had asthma, which was much higher than the population prevalence of 8% to 10%. Therefore, I suspected that there might be an association.

“I would like to perform a clinical trial investigating the role of allergy shots in the prevention of migraine headache.”

Q. This was a large study; do you plan on continuing the research with even more participants?

A. I am not sure that we would repeat another epidemiological study with more patients, but we would like to unlock the mechanisms about why asthma predisposes to chronic migraine. I would like to get some basic science studies funded to explore some of these mechanisms.

Q. Migraine and asthma are comorbid chronic disorders. Can you explain why/how?

A. I think the 2 most intriguing potential mechanisms are allergies and parasympathetic hyperactivity. In our past studies of patients with allergic rhinitis and migraine we have found that those receiving allergy shots had a 50% reduction in the frequency of migraine headache as compared to those not receiving allergy shots. This would suggest that blunting the allergic response with allergy shots might decrease the frequency of migraine. Secondly, patients with asthma may represent a subgroup of patients with migraine that have parasympathetic hyperactivity, and this could predispose both to asthma and to chronic migraine. Still a work in progress!!!

Q. If inflammation is the culprit, and affects other parts of the body, might you and your team wish to study them?

A. I think that inflammation is mediated through mast cells and their release of inflammatory mediators like histamine, leukotrienes, etc. Mast cells reside in close apposition to trigeminal afferents in the dura and therefore release of inflammatory mediators might active trigeminal afferents and trigger migraine attacks.

Q. When you’re not working, how do you like to spend your free time?

A. I like studying the Italian language and culture as my grandfather was an Italian physician whom I was named after.

Q. What is a dream project you hope to work on?

A. I would like to perform a clinical trial investigating the role of allergy shots in the prevention of migraine headache. I really think that it would add a lot to our knowledge of the treatment of migraine headache.


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