Brief Article
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World J Cardiol. Oct 26, 2013; 5(10): 375-381
Published online Oct 26, 2013. doi: 10.4330/wjc.v5.i10.375
Migraine attack restores the response of vascular smooth muscle cells to nitric oxide but not to norepinephrine
Raffaele Napoli, Vincenzo Guardasole, Emanuela Zarra, Antonietta De Sena, Francesco Saccà, Antonio Ruvolo, Simona Grassi, Speranza Giugliano, Giovanna De Michele, Antonio Cittadini, Pietro Biagio Carrieri, Luigi Saccà
Raffaele Napoli, Vincenzo Guardasole, Emanuela Zarra, Antonietta De Sena, Antonio Ruvolo, Simona Grassi, Speranza Giugliano, Giovanna De Michele, Antonio Cittadini, Luigi Saccà, Department of Translational Medical Sciences, Federico II University School of Medicine, 80131 Naples, Italy
Francesco Saccà, Pietro Biagio Carrieri, Department of Neurology, Federico II University School of Medicine, 80131 Naples, Italy
Author contributions: Napoli R had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; Napoli R, Carrieri PB and Saccà L studied concept and designed; Napoli R, Guardasole V, Zarra E, De Sena A, Saccà F, Ruvolo A, Grassi S, Giugliano S, De Michele G and Cittadini A did the experiments and acquisition of data; Napoli R, Carrieri PB and Saccà L did the analysis and interpretation of data; Napoli R and Saccà L did the drafting of the manuscript; Guardasole V, Zarra E, De Sena A, Saccà F, Ruvolo A, Grassi S, Giugliano S, De Michele G, Cittadini A and Carrieri PB made critical revision of the manuscript for important intellectual content; Napoli R and Saccà L performed statistical analysis; Napoli R and Saccà L did study supervision; all authors have read and approved the final version of the article.
Correspondence to: Raffaele Napoli, MD, Department of Translational Medical Sciences, Federico II University School of Medicine, Via Pansini 5, 80131 Napoli, Italy. napoli@unina.it
Telephone: +39-81-7463736 Fax: +39-81-7463198
Received: May 8, 2013
Revised: August 10, 2013
Accepted: September 13, 2013
Published online: October 26, 2013
Core Tip

Core tip: Patients with migraine without aura studied in the interictal period are characterized by impaired ability of vascular smooth muscle cells (VSMCs) to relax in response to nitric oxide and to contract in response to norepinephrine. We hypothesize that the two defects compensate for each other and this provides for the maintenance of normal vascular resistance and blood pressure homeostasis. In contrast, during the headache attack, the VSMCs regain their ability to respond to nitric oxide, but remain unresponsive to norepinephrine. Such differential effect of the migraine attack is not surprising, given that nitric oxide and norepinephrine activate different intracellular signaling pathways in VSMCs.