Discrepancy between strong cephalic arterial dilatation and mild headache caused by prostaglandin D₂ (PGD₂).
BACKGROUND
Prostaglandins (PGs) are involved in nociception and mast cell degranulation. Prostaglandin D₂ (PGD₂) is a vasodilatator released during mast cell degranulation. The headache-eliciting effect of PGD₂ has not been studied in man.


METHODS
Twelve healthy volunteers were randomly allocated to receive intravenous infusion of 384 ng/kg/min PGD₂ over 25 min in a placebo-controlled, double-blind cross-over study. We recorded headache intensity and associated symptoms, velocity in the middle cerebral artery (V(MCA)) and diameter of the superficial temporal artery (STA) and radial artery (RA) using ultrasonography.


RESULTS
In the period 0-14 h, 11 subjects reported headache on PGD₂ compared to one subject on placebo (P = 0.002). During the in-hospital phase (0-120 min), the area under the headache curve was larger on PGD₂ compared to placebo (P < 0.05). Median peak headache, 1 (0-1), occurred 10 min after start of PGD(2) infusion. There was no difference in incidence of headache in the post-hospital phase between PGD₂ (n = 3) and placebo (n = 1). There was a decrease in V(MCA) (P < 0.001), increase in STA (P < 0.001) and RA (P < 0.006) diameter during PGD₂ infusion compared to placebo. Peak decrease in V(MCA) was 28.3% after 10 min and peak increase in STA was 55.7% after 20 min on the PGD₂ day.


CONCLUSIONS
The present study shows that PGD₂ is a very strong vasodilator of MCA, STA and RA, but causes only mild headache.
Danish Headache Centre and Department ofNeurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Nordre Ringvej 57, Glostrup, Copenhagen, Denmark. wienecke@dadlnet.dk
Troels
T
Wienecke
Jes
J
Olesen
Messoud
M
Ashina
D000293:Adolescent; D000328:Adult; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000187:drug effects; D015230:Prostaglandin D2 / Q000494:pharmacology*; D014664:Vasodilation / Q000187:drug effects*; D055815:Young Adult
D015230:Prostaglandin D2