2023-08-03 11:32:19
CARMEN FERNNDEZ
Barcelona
Updated Thursday, August 3, 2023 – 11:32
An international multicenter study, with Spanish participation, concludes that smoking or being exposed to tobacco triggers the disease in people with a genetic predisposition to suffer from it
80% of those affected are smokers and the rest were exposed to tobacco smoke in childhood.SHUTTERSTOCK
And international multicenter study sheds light on the causes of cluster headache, an extremely disabling disease that mostly affects men and which, fortunately, is very rare (0.1%): there are eight regions of the genome associated with a higher risk of suffering from it that are activated especially with the tobacco habit. Or put another way: smoking causes the activation of the disease in people with a genetic predisposition to suffer it. This would explain, in part, why 80% of those affected are smokers and the rest are people who as children were exposed to tobacco smoke by smoking parents.
The study, in which 16 headache research groups have collaborated, 13 passports and which has been published in Annals of Neurology, is based on genetic data from 4,777 cluster headache patients and 31,575 healthy people from Europe and East Asia. The cohort will continue to increase, which will make it possible to refine knowledge about the genetic factor of the disease and to analyze ethnic differences.
Cluster headache is a headache that is characterized by very acute episodes that affect one side of the brain, especially around the eyes and above the ear. The episodes of pain can occur more than once a day for a period of time ranging from three weeks to three months and, in some cases, can become chronic.
Patricia Pozo-Rosich, section chief of the Neurology Service and Headache Unit at the Vall d’Hebron University Hospital in Barcelona, head of the Headache and Neurological Pain group at the Vall d’Hebron Research Institute (VHIR) and director of the Migraine Adaptive Brain Center (Centre for Migraine and the Adaptive Brain) of Vall d’Hebron, explained to this newspaper about the study, in which the VHIR Psychiatry, Mental Health and Addictions group also collaborated, which has been possible because an international consortium was created on the genetics of migraine from which another emerged (many of the researchers, including those from Vall d’Hebron, are part of both) focused on cluster headache, a disease about which until now very little was known. because of its scant research.
The expert recalls that, before this work, neuroimaging tests were used to know the implication of the posterior hypothalamus and a 2007 study in an animal model indicated that hypoxia (can be caused by tobacco) acted on the hypothalamus, which is a central regulator of biorhythms (when hormones should be released).
Highlights of the new international study that associates the disease with several genes related to the brain and arteries, which reinforces the idea about the role of blood vessels in the pathology The smoking habit, for its part, is also related to the deterioration of the arteries. And it has been seen with this study that smoking increases the expression of the MERTK gene (also related to migraine) and decreases it in the CFTR gene, which are changes observed in patients with cluster headache.
Pozo-Rosich also underlines the importance of this new evidence for the prevention of the disease but also for the clinic, since in a patient with cluster headache who does not stop smoking it is very difficult to control the disease and, conversely, if you stop the habit, it will improve.
He points out that the habitual tobacco consumption in these patients could be explained by genetic factors shared with depression, defiant behaviour, attention deficit hyperactivity disorder (ADHD), musculoskeletal pain and a similar but not the same disease: migraine. The work delves precisely into the relationship between cluster headache and migrate and concludes that the genetic basis differs considerably between them.
Pozo-Rosich believes that it is possible that there is another factor related to the disease, which, as previously mentioned, is eminently masculine: the testosterone. “Possibly there is more than one factor involved in the manifestation of the disease,” she concludes.
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