CH history, genetic link and nicotine

Annette · CH history, genetic link and nicotine

It is interesting to note that CH is a relatively new disease. Considering the amount of pain and the unusual physical manifestation one would speculate that had CH existed for a very long time, there should some description of it early in the medical history of man. However, the very first description of a head pain that matches CH was in 1641. The first text book report of CH was in 1745. The name cluster headache was not coined until 1952 when the cyclical nature of the condition was first noted.

http://www.springerlink.com/content/8g039438847x6x05/

Since a very high percentage of CHers smoke, lets look at the history of tobacco. Although tobacco was smoked by the Mayans thousands of years ago, it was only used in high quantity to produce psychedelic effects in shamans and high priests. Native American Indian men smoked tobacco only during special ceremonies. Christopher Columbo discovered tobacco on his famous trip in 1498. Tobacco was then slowly introduced into Europe, Asia and the Middle East from 1500 to 1600. However, not until 1604 that the first commercialised tobacco plant was formed in America which began to supply England and Europe with large quantities.

The number of smokers ( all men ) increased steadily from 1600. The first description of CH was in 1641. Was it a coincidence?

Now lets look at CH in women. CH in women was considered rare initially, but the gap is closing.

Before 1960s M: F ratio 6.2 -1
1960s 5.6 -1
1970s 4.3 -1
1980s 3 -1
1990s 2.1 -1

What about the rate of smoking tobacco in woman ? I couldnt find one for US but found one for Australia, which I would say is quite representative of the industrialised countries.

So as men and women started to smoke and gradually increasing the amount of tobacco consumed, there seem to be a correlation of CH reported. Is it still coincidental ?

Now lets look at CH and nicotine. So far apart from the observation that most CHers smoke and the above seemingly coincidental ratio, we havent really got an concrete causal correlation between the two. Or have we ?

The first genetic risk factor for CH has been identified in the Hypocretin Receptor 2 gene. CH appears to be associated with the G1246A polymorphism of this gene.

http://www.neurology.org/cgi/content/abstract/66/12/1917

http://www.ncbi.nlm.nih.gov/pubmed/15477554

Hypocretin 1 and 2 are two newly identified peptides produced exclusively in the dorsal and lateral hypothalamus. They have widespread neuroexcitatory activies throughout the brain.

http://www.ncbi.nlm.nih.gov/sites...tailView&TermToSearch=9419374

They have a major role in the hypothalamic control of hunger, the circadian clock through sleep-wake mechanisms and pain perception via the brain stem. Starting to sound familiar ?

Now its interesting to note that nicotine from tobacco binds to the same receptors and mimic the effects of hypocretins.

http://www.jneurosci.org/cgi/content/full/25/21/5225/FIG2

http://www.jneurosci.org/cgi/content/abstract/25/21/5225

What would happen if excessive nicotine intake over the long period of time ( even generations ) causes abnormal reactions in the hypothalamus which starts to derail the circadian clock? This will no doubt lead to an imbalance of melatonin and serotonin. Can this lead to the development of CH ? In theory it can.

Prof Goadsby has found an abnormal area in the hypothalamus that is related to CH. Could this have been caused by nicotine exposure? We will need more detailed studies to look at it specifically.

http://news.bbc.co.uk/1/hi/health/380497.stm

Furthermore Hypocretin has a direct effects on other neurotransmitters such as dopamine, norepinephrine and GABA, all of which are involved in the mechanism of CH.

So what does all this mean ? It means there is a link between nicotine in tobacco and CH. Does one cause the other? We will need more studies to determine.

In the mean time, you are welcome to draw your own conclusion.

Thank you for reading and painfree wishes to all :)