Relationship between serum levels of VIP, but not of CGRP, and cranial autonomic parasympathetic symptoms: A study in chronic migraine patients.

Background Cranial autonomic parasympathetic symptoms (CAPS) appear in at least half of migraine patients theoretically as a result of the release of peptides by the trigemino-vascular system (TVS). Cranial pain pathways become sensitised by repeated episodes of TVS activation, leading to migraine chronification. Objective The objective of this article is to correlate the presence of CAPS with serum levels of vasoactive intestinal peptides (VIP) and calcitonin gene-related peptide (CGRP). Patients and methods Patients with chronic migraine (CM) were asked about the presence - during migraine attacks - of five CAPS, which were scored from 0 to 10 by using a quantitative scale. Serum VIP and CGRP levels were determined by ELISA. Results We interviewed 87 CM patients (82 females; mean age 44.7 ± 10.6 years). Seventeen had no CAPS, while 70 reported at least one CAPS. VIP levels ranged from 20.8 to 668.2 pg/ml (mean 154.5 ± 123.2). There was a significant positive correlation between scores in the CAPS scale and VIP levels (Spearman correlation coefficient = 0.227; p = 0.035). VIP levels were significantly higher in CM patients by at least one point in the scale vs those with 0 points ( p = 0.002). Analysing symptoms individually, VIP levels were numerically higher in those patients with symptoms, though they were significantly higher only in those patients with lacrimation vs those without it ( p = 0.013). There was no significant correlation between CGRP levels and the score in the CAPS scale. Conclusions Serum VIP, but not CGRP, levels seem to reflect the rate of activation of the parasympathetic arm of the TVS in migraine.

Comparison of a direct antigen enzyme immunoassay, Herpchek, with cell culture for detection of herpes simplex virus from clinical specimens.

Direct enzyme immunoassay (Herpchek) was compared with culture on 21,522 specimens mainly from asymptomatic women for herpes simplex virus detection. Sensitivity and specificity were 73.8 and 97.7%, respectively. The 33% detection rate by enzyme immunoassay in 5 h increased to 43% when the enzyme immunoassay was combined with culture. Herpchek alone was not sensitive enough, but in combination with culture, maximum detection was achieved.

Spin-amplified culture followed by enzyme immunoassay for detection of herpes simplex virus in patient specimens: a comparative study.

In a comparative study it was found that a combination technique of spin-amplified culture and detection of herpes simplex virus (HSV) antigen in 48-h incubated cell culture lysate by a HSV antigen detection enzyme immunoassay kit (Dupont Herpchek) detected the largest number (227) of confirmed HSV positives when compared to standard cell culture (191) and direct Herpchek (146) on the same 415 clinical specimens.

Herpes simplex virus antigen direct detection in standard virus transport medium by Du Pont Herpchek enzyme-linked immunosorbent assay.

A commercial 5-h direct herpes simplex virus (HSV) antigen detection enzyme immunoassay kit (Du Pont Herpchek) was compared with a cell culture isolation system by using primary rabbit kidney and MRC-5 cells with 779 clinical specimens received in virus transport medium and with stock tissue culture preparations of HSV types 1 and 2. In the first study of 422 specimens from symptomatic patients, Herpchek detected 110 of 111 HSV-positive specimens (26.3% of all specimens), with a sensitivity of 99% and a specificity of 100%. In the second study of 357 specimens primarily from asymptomatic pregnant women, however, Herpchek detected 70 of 119 HSV-positive specimens (33% of all specimens), with a sensitivity of 58.8% and a specificity of 99.5%. Stock virus dilution experiments showed that Herpchek was 10 to 100 times less sensitive than culture. Herpchek was found to be an acceptable test for symptomatic patients, but for asymptomatic patients shedding a low titer of HSV it was not as sensitive and cell culture of Herpchek-negative specimens is recommended for such cases.

Enzyme-linked immunosorbent assay spin amplification technique for herpes simplex virus antigen detection.

A comparative study of herpes simplex virus diagnosis by standard cell culture and a new hybrid test (enzyme-linked immunosorbent assay spin amplification technique) was done on 300 specimens. The new test was found to be equally sensitive and specific, much less expensive to perform, and to report all results in 48 h.