Abstract
INTRODUCTION: The etiology of migraine is not fully understood, but there is ongoing debate about the potential role of immune dysfunction in migraine pathophysiology. Some clinical studies have shown a reduction in CD4(+)CD25(+) regulatory T-cells (Treg) in migraine patients compared to healthy people. However, these studies have not been systematically analyzed. The primary objective of this study is to conduct a systematic review of Treg level changes in migraine patients. METHODS: A detailed literature search was conducted on PubMed, Scopus, Embase, ProQuest, Cochrane Review, Clinical trials, Academic thesis, American Academy of Neurology resources, and Google Scholar databases from 2010 to 2023. Studies that were appropriately designed to quantify Treg cell levels in migraine patients were included in this meta-analysis. RESULTS: Out of 17 studies initially reviewed, only 4 studies with 121 migraine patients were included for analysis. The meta-analysis revealed a statistically significant reduction in Treg cell levels in migraine patients compared to healthy volunteers (Z=1.21; P=0.23). CONCLUSION: The observation of lower levels of Treg cells in migraine patients, compared to healthy volunteers, supports the theory that migraine may be an autoimmune disorder. However, additional clinical data is required to understand the role of immune dysregulation in migraine pathogenesis fully. This is the first meta-analysis of Treg cell levels in the context of migraine research, significantly contributing to the existing literature on the topic.