The role of angiotensin-converting enzyme gene in migraine patients.

Several authors have reported an association between the Angiotensin-Converting Enzyme (ACE)-D allele and coronary artery disease. The mechanism of the basis of this association remains unclear. Recently, it has been suggested that the ACE-DD polymorphism may play an important role in the determinism and in the frequency of migraine attacks. Therefore, the aim of our study was to determine the incidence of ACE polymorphism in a series of migrainous patients (ICHDII-2004 diagnostic criteria) and patients affected by myocardial infarction. We studied a series of 51 migrainous patients aged 38.6 +/-18.8 years (8 MWA and 43 MwA, ICHDII-2004 criteria) during the years 2005–2006. The control group consisted of 58 patients affected by acute myocardial infarction (AMI) and admitted to the ICCU (Intensive Coronary Care Unit) of S.Luca Hospital in Vallo della Lucania during the same period. Exclusion criteria from the study were: positive anamnesis for analgesic abuse, presence of serious diseases and need to take drugs for other pathological conditions. The analysis was based on Polymerase Chain Reaction (PCR) and on reverse-hybridization and included 3 steps: 1.DNA isolation from non-coagulated blood, 2.PCR amplification using biotinylated primers, 3. Hybridization of amplification products to a test strip containing allele-specific oligonucleotide probes immobilized as an array of parallel lines. Bound biotinylated sequences were detected using streptavidin-alkaline phosphatase and an appropriate color substrate. Sixteen (42%) migrainous patients and 32 (56%) cardiopathy patients had an ID genotype; 19 (50%) migraineurs and 20 (34%) cardiopaths had a DD genotype. The results of our study confirm the association between migraine and ACE I/D genetic polymorphism. These data are also confirmed in the sample of patients affected by myocardial infarction. This study provides evidence of a strong relationship between migraine and major vascular diseases and allows us to hypothesize an important role of ACE system in the genetic model of migraine due to its capability to interfere with the endothelial regulatory tone.