tobacco is guilty of activating the disease

An international multicentre study involving Spain concluded that smoking or exposure to tobacco triggers the disease in people with a genetic predisposition to the disease.

A international multicentre study sheds light on the causes of cluster headache, a highly disabling disease that mainly affects men and which, fortunately, is very rare (0.1%): there are eight regions of the genome associated with an increased risk of suffering from it, which are activated especially with addiction to tobacco. Or in another way: smoking causes the activation of the disease in people with a genetic predisposition to it. This partly explains why 80% of those affected are smokers, and the rest are people who were exposed to tobacco smoke from smoking parents as children.

A study in which 16 groups of headache researchers collaborated 13 countries and which was published in Annals of Neurologyand is based on the genetic data of 4777 patients with cluster headache and 31575 healthy people from Europe and East Asia. The cohort will continue to grow, which will improve knowledge about the genetic factor of the disease and analyze ethnic differences.

Cluster headache is a headache characterized by very acute episodes that affect one side of the brainespecially around the eyes and above the ear. Episodes of pain may occur more than once a day for a period of three weeks to three months, and in some cases may become chronic.

Patricia Pozo-Rosic, Head of the Department of Neurological Services and Headache at the Val d’Hebron University Hospital in Barcelona, ​​Head of the Headache and Neurological Pain Group at the Val d’Hebron Research Institute (VHIR) and Director Migraine Adaptive Brain Center (Center for Migraine and the Adaptive Brain) Val-d’Hebron, told this newspaper about the study, which also included the VHIR Psychiatry, Mental Health and Addictions team, which made possible by the creation of an international consortium on the genetics of migraine from which the other originated (many researchers, including those from Val d’Hebron, are part of both), focused on cluster headache, a disease about which very little was known until now due to a lack of research. .

The expert recalls that prior to this study, neuroimaging tests knew damage to the posterior hypothalamus and a 2007 study in animal models showed that hypoxia (may be caused by tobacco) acts on the hypothalamus, which is the central regulator of biorhythms (when hormones should be released).

Highlights of a new international study that links the disease to several genes associated with the brain and arteries, bolstering the idea of role of blood vessels in pathology. The habit of smoking, for its part, is also associated with deterioration of the arteries. And this study showed that smoking increases the expression of the MERTK gene (also associated with migraine) and reduces it in the CFTR gene, which are changes seen in cluster headache patients.

Pozo-Rosich also highlights the importance of these new data for disease prevention as well as for the clinic, as in a patient with cluster headache, does not quit smoking very difficult to control the disease and conversely, if you quit the habit, you will get better.

He points out that habitual tobacco use in these patients can be explained by genetic factors in common with depression, defiant behavior, attention deficit hyperactivity disorder (ADHD), musculoskeletal pain, and a similar but not the same disease: migraine. The paper examines in detail the relationship between cluster headache and migraine and concludes that the genetic base differs significantly between them.

Pozo-Rosich suggests that there may be another factor associated with the disease, which, as mentioned earlier, is eminently masculine: testosterone. “Perhaps more than one factor is involved in the manifestation of the disease,” he concludes.


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