title: Allergen-specific sublingual immunotherapy in the treatment of migraines: a prospective study.
abstract: BACKGROUND
  Inflammation is a cardinal feature of migraines. A number of observations point to the possibility that an allergic component of a type I (IgE-mediated) nature may be involved in at least some migraineurs. Not only are migraines frequent among patients with allergic rhinitis but quite frequently the same medical approaches are beneficial in both diseases: anti-inflammatories, adrenergic tone modifiers, immune suppressants. The effect that immunotherapy for allergic rhinitis has upon migraines is studied.
  
  
  METHODS
  Patients were recruited who suffered from typical migraines but were not treated with regular migraine controllers (beta blockers, antiepileptics, tricyclics, etc.). They underwent allergen-specific, sublingual immunotherapy with physician-formulated, individually-prepared airborne allergen extracts. Response to treatment was assessed with serum C-reactive protein level changes and symptom scores. Serum C-reactive protein (CRP), an acute phase reactant, was chosen as a marker because its usefulness has already been assessed in interictal migraine activity.
  
  
  RESULTS
  Interictal serum CRP levels decline was observed in the course of sublingual immunotherapy. Concurrent improvement in symptom scores for both rhinitis and migraines was also observed.
  
  
  CONCLUSIONS
  In patients with allergic rhinitis, migraine development and course may have a significant allergic component. Assessment of migraineurs for the possibility of coexisting allergic rhinitis is justified. Treatment of allergic rhinitis by immune response modifiers, such as immunotherapy, may have a place in the management of migraines for these patients.
authors.affiliation: Allergy Associates of La Crosse, La Crosse, WI, USA. dtheodoropoulos@allergy-solutions.com
authors.forename: D S
authors.initials: DS
authors.lastname: Theodoropoulos
authors.forename: D R
authors.initials: DR
authors.lastname: Katzenberger
authors.forename: W M
authors.initials: WM
authors.lastname: Jones
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
authors.forename: C
authors.initials: C
authors.lastname: Her
authors.forename: N A M
authors.initials: NA
authors.lastname: Cullen
authors.forename: D L
authors.initials: DL
authors.lastname: Morrisa
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D003888:Desensitization, Immunologic; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein