title: Exercise suppresses COX-2 pro-inflammatory pathway in vestibular migraine.
abstract: Migraine and dizziness are relatively common disorders. Patients with dizziness have a higher incidence of migraines than the general population. The discomfort experienced by these patients is often poorly controlled by medication. However, the pathophysiology of vestibular migraine (VM) remains unclear. We hypothesized that patients with VM would experience remission from symptoms after exercise training and that this effect may be mediated through the suppression of cyclooxygenase-2 (COX-2)-mediated inflammation. Thus, the aim of the present study was to investigate the efficacy and possible anti-inflammatory benefits of exercise in patients with VM. We assessed the level of soluble inflammatory mediators in plasma from VM patients and control subjects. Our analysis of cytokine expression in the patients with VM undergoing exercise treatment revealed a significant reduction in pro-inflammatory cytokines and/or cytotoxic factors, such as tumor necrosis factor-α, interleukins, nitric oxide (NO), inducible NO synthase, and reactive oxygen species. In contrast, we found an increase in the level of anti-inflammatory cytokines after exercise. Moreover, the group undergoing exercise training showed significant symptomatic improvement and demonstrated suppressed antioxidant enzyme activity. To summarize, our data suggest that exercise significantly inhibits COX-2 activity, leading to the suppression of pro-inflammatory cytokines and changes in redox status. These results suggest that there is a molecular link between the central nervous system and the immune system. Furthermore, elucidation of the neurobiological mechanisms underlying VM could potentially lead to the development of novel therapeutic interventions for these patients.
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan.
authors.forename: Yi-Yen
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Yang
authors.affiliation: Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Cancer Center, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan.
authors.forename: Pin-I
authors.initials: PI
authors.lastname: Huang
authors.affiliation: Department of Occupation Medicine, Chang-Gung Memorial Hospital, Taipei, 199, Tung Hwa North Road, Taipei 105, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
authors.affiliation: Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan; Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan.
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Huang
authors.affiliation: Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan.
authors.forename: Chung-Lan
authors.initials: CL
authors.lastname: Kao
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Department of Pediatrics, Renai Branch, Taipei City Hospital, No. 10, Sec. 4, Ren'ai Rd., Da'an Dist., Taipei City 106, Taiwan; Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei 11221, Taiwan.
authors.forename: Yann-Jang
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Faculty of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 11221, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec.2, Shih-Pai Road, Taipei 11217, Taiwan. Electronic address: mtchen@vghtpe.gov.tw.
authors.forename: Ming-Teh
authors.initials: MT
authors.lastname: Chen
mesh_terms: D051546:Cyclooxygenase 2 / Q000097:blood*; D016207:Cytokines / Q000097:blood; D004244:Dizziness / Q000201:enzymology* / Q000628:therapy*; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D008881:Migraine Disorders / Q000201:enzymology* / Q000628:therapy*; D052247:Nitric Oxide Synthase Type II / Q000097:blood; D018384:Oxidative Stress / Q000502:physiology; D012333:RNA, Messenger / Q000097:blood; D017382:Reactive Oxygen Species / Q000097:blood; D015398:Signal Transduction
chemical_list: D016207:Cytokines; D012333:RNA, Messenger; D017382:Reactive Oxygen Species; D008315:Malondialdehyde; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human
keywords: Cyclooxygenase-2 (COX-2); Exercise; Migraine; Vestibular