Background & Aims

The present investigation sought to conduct a comprehensive appraisal of oropharyngeal microbiota biotopes and explore the ramifications of food allergies on migraine pathogenesis. Through a meticulous examination of 70 migraine patients and 15 age- and gender-matched healthy controls, diverse evaluative methodologies including headache diaries, migraine severity scales, gastrointestinal symptom assessments, immuno-enzyme analyses, and microbiological assessments were employed. The primary objective was to discern any disruptions within the oropharyngeal microbiome and ascertain the prevalence of food hypersensitivities within the migraine population.

Methods

The purpose of this study was a comprehensive assessment of the state of biotopes of the oropharyngeal microbiota and the effect of food allergies on the course of migraine.
70 patients with migraine (21-56 years old) and 15 healthy subjects, comparable in gender and age, were examined using: headache diary, MIDAS and VAS scales, gastrointestinal symptoms scale (GSRS), immuno-enzyme analysis (ELISA) of specific antibodies of the IgG4 class (delayed type food allergy), microbiological examination a smear from the mucosa of the posterior wall of the oropharynx with an assessment by the method of mass spectrometry of microbial markers (MSMM) with the determination of 57 microorganisms.

Results

Our analyses unveiled substantive perturbations within the oropharyngeal microbiota among migraine sufferers vis-à-vis healthy counterparts, with the entirety of migraine patients exhibiting deviations as detected by the mass spectrometry of microbial markers (MSMM) technique. Noteworthy alterations encompassed diminished levels of bifidobacteria alongside an augmented presence of pathogenic and conditionally pathogenic microorganisms, concomitant with viral markers such as cytomegaloviruses, herpes groups, and Epstein-Barr viruses. Additionally, all migraine subjects evinced concurrent gastrointestinal and visceral dyspeptic comorbidities, indicative of a plausible contributory role in migraine etiology. The majority of migraine patients further demonstrated elevated levels of specific IgG4 antibodies against commonplace food allergens, notably cow’s milk, wheat flour, chicken and quail eggs, beef, potatoes, sweet pepper, and coffee.

Conclusions

The current study underscores the pivotal role of delayed-type food hypersensitivities in modulating the trajectory of migraine pathology, particularly in individuals afflicted with chronic and severe manifestations of the disorder. The observed association between heightened IgG4 titers directed against wheat allergens and the severity of migraine symptoms, concomitant with the presence of oral dysbiosis characterized by pathological viral and fungal elements, elucidates the intricate interplay between immune responses to dietary allergens and dysbiotic alterations within the oropharyngeal microbiota. These findings portend promising therapeutic avenues centered on mitigating food allergies and reinstating microbial homeostasis within the oropharynx, thereby potentially ameliorating migraine symptomatology and enhancing overall patient well-being.

References

1) A chapter in the book “Infectious lesions of the Central nervous system” has been published New Approaches to the Study of the Etiology and Pathogenesis
of Migraine and Patient Management.The Importance of the Throat Microbiota.
Authors: I.L. Naidenova, Al.B. Danilov, A.V. Simonova, E.G. Filatova.

2) Method of treatment of episodic migraine
Authors of the patent: Naidenova Irina Leonidovna (RU)
Simonova Albina Valerievna (RU) Danilov Alexey Borisovich (RU)
https://findpatent.ru/patent/278/2781099.html©, 2012-2023

3) Oropharyngeal microbiome status in migraine patients
Authors:Naidenova I.L., Danilov A.B., Simonova A.V., Pilipovich A.A., Filatova E.G.
Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(2): 112 119
DOI: 10.17116/jnevro2023123021112

4) “The role of food allergy as a provoking factor of migraine”
Authors:Naidenova I.L., Danilov A.B., Simonova A.V., Pilipovich A.A., Filatova E.G.
Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2023; in No. 8-23

Presenting Author

Viacheslav Novikov

Poster Authors

Viacheslav Novikov

MD

Sechenov University

Lead Author

E-mail

Irina Naydenova MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

E-mail

Alexey Danilov PhD MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

E-mail

Albina Simonova PhD MD

GBUZ MO Moscow Regional Research Clinical Institute named after M.F.Vladimirsky, Moscow, Russia

Lead Author

E-mail

Anna Pilipovich PhD MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

E-mail

Elena Filatova PhD MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

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Anastasiia Badaeva MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

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Yulia Vorobyeva

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)"

Lead Author

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Andrey Danilov PhD MD

FGAOU VO "The First I.M. Sechenov Moscow State Medical University (Sechenov University)" Ministry of

Lead Author

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Topics

  • Specific Pain Conditions/Pain in Specific Populations: Migraine