The Effect of Enalapril on Anti-inflammatory Cytokines in Patients with Migraine: A Double-Blind, Randomized Clinical Trial

Abstract

Background: Migraine is one of the most common forms of headache. One of its possible mechanisms is neuro-inflammation in which some changes happen in inflammatory factors such as interleukins, adhesion molecules or acute phase reactants. On the other hand, one of the mechanisms by which angiotensin converting enzyme inhibitors (ACEIs) affect is anti-inflammation. The goal of this study was to evaluate the effect of enalapril on anti-inflammatory cytokines of patients with migraine. Methods: In this randomized double-blind placebo-controlled clinical trial, 10 mg enalapril daily was compared with matched placebo in 40 patients with migraine for two months. Serum IL-4, IL-10 and IL-13 levels were measured in all patients at 0 and 2 month. Findings: The serum level of IL-4 (P = 0.001), IL-10 (P < 0.001) and IL-13 (P < 0.001) increased significantly in the case group after treatment with enalapril. Conclusion: Enalapril may be effective in improvement of inflammatory responses in patients with migraine. This improvement could be the result of anti-inflammatory cytokines and may reduce the cerebrovascular risks in these patients.

Keywords

• Endothelium
• Migraine
• Angiotensin converting enzyme inhibitors (ACEIs)
• Cytokines
• Enalapril