## Protocol Section
### Identification Module
**NCT ID:** NCT06426316

**Acronym:** SIIM

**Brief Title:** The Role of Cytokines and Regulatory T Lymphocytes in Migraine Pathophysiology.

**Official Title:** Immune System, Inflammation, Migraine - The Role of Cytokines and Regulatory T Lymphocytes in Migraine Pathophysiology

#### Organization Study ID Info
**ID:** RBHP 2023 STUCHFIELD
#### Organization
**Class:** OTHER
**Full Name:** University Hospital, Clermont-Ferrand
#### Secondary ID Infos
**Domain:** ANSM
**ID:** 2023-A01503-42
**Type:** OTHER
### Status Module
#### Completion Date
**Date:** 2027-04-30

**Type:** ESTIMATED

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2024-05-23

**Type:** ACTUAL

**Last Update Submit Date:** 2024-05-22

**Overall Status:** NOT_YET_RECRUITING

#### Primary Completion Date
**Date:** 2027-04-30

**Type:** ESTIMATED

#### Start Date
**Date:** 2024-05-15

**Type:** ESTIMATED

**Status Verified Date:** 2024-05

#### Study First Post Date
**Date:** 2024-05-23
**Type:** ACTUAL
**Study First Submit Date:** 2024-04-30
**Study First Submit QC Date:** 2024-05-22
### Sponsor Collaborators Module

#### Lead Sponsor

**Class:** OTHER

**Name:** University Hospital, Clermont-Ferrand

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Is FDA Regulated Device:** False

**Is FDA Regulated Drug:** False

**Oversight Has DMC:** False

### Description Module

**Brief Summary:** Migraine is a frequent and debilitating neurologic disorder. It is more frequent in women, and more prevalent in patients with autoimmune and/or inflammatory diseases such as multiple sclerosis (MS), rheumatoid arthritis (RA), Crohn's disease (CD), systemic lupus erythematosus (SLE) and endometriosis, whereas patients with long standing type 1 diabetes mellitus (T1DM) - an autoimmune but non inflammatory disease - seem to be less affected compared to the general population. Despite new migraine prevention treatments, a large number of patients remain unresponsive to currently available anti-migraine therapy and migraine pathophysiology remains unclear. Several peptides (calcitonin gene-related peptide (CGRP), pituitary adenylate cyclase activating peptide-38 (PACAP-38), vasoactive intestinal polypeptide (VIP)) and hormones (estrogens, prolactin) and the immune system play an important role in migraine pathophysiology. Among T lymphocytes, regulatory T (Treg) cells suppress inflammation. Studies have evidenced higher levels of inflammatory molecules (cytokines) in migraine patients and have suggested decreased proportions of Treg cells in migraine, as well as in MS, RA, CD and SLE, whereas inflammation declines and Treg levels seem increased in long-standing T1DM. Inflammation, which participates in migraine pain, seems to be a common factor for migraine and these diseases. However, these studies display conflicting results and further investigation is required to better understand the mechanisms behind migraine.

In this study, the investigators will compare Treg levels, as well as identify Treg subpopulations and measure cytokine levels in migraine and migraine-free participants with and without an autoimmune/inflammatory disorder (MS, RA, CD, SLE, T1DM and endometriosis).

**Detailed Description:** Migraine is the 6th most frequent disease (14% of the population) and the second leading cause of disability worldwide. From puberty and onward, migraine is 2 to 3 times more frequent in women, which also suffer from more severe attacks. Migraine is also up to twice as prevalent in patients suffering from autoimmune or inflammatory diseases such as multiple sclerosis (MS), rheumatoid arthritis (RA), Crohn disease (CD), systemic lupus erythematosus (SLE) and endometriosis, whereas patients with long standing type 1 diabetes mellitus (T1DM) - an autoimmune but non inflammatory disease - seem to be less affected compared to the general population.

Despite the identification of the role of peptides such as CGRP in migraine pathophysiology and the development of targetted anti-CGRP treatments, many patients remain unresponsive and the mechanisms behind migraine are still unclear.

The trigemino-vascular system is involved in the perception of migraine pain. Migraine occurs with trigemino-cervical neuron sensitization, leading to peptide secretion (such as CGRP, PACAP-38 and VIP), which induce neurogenic inflammation that is responsible for vasodilation, capillary leakage, oedema and further sensitization of the trigemino-vascular system, leading to amplified perception of migraine pain. CGRP, PACAP-38 and VIP infusions all induce migraine attacks in migraine patients, and only mild or no headache in healthy volunteers.

Sex hormones, prolactin and insulin are also involved in migraine pathophysiology, and the immune system, through cytokine production and immune cell dysregulations seems to also play a role in the pathogenesis of migraine. Both are closely related as sex hormone levels may have an influence on the levels of certain immune cell subtypes. Several pro-inflammatory cytokines (tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma and interleukin (IL)-6) were shown to be elevated in migraine patients but also inflammatory diseases such as MS and endometriosis compared to controls and are associated with migraine pathophysiology. Inflammation seems to be a common factor for migraine and these diseases. However, these studies provide conflicting results and further investigation is needed to better understand the role of inflammation in migraine pathophysiology.

Among T lymphocytes, regulatory T (Treg) cells regulate inflammation by suppressing effector T cells through several suppressive mechanisms such as IL-10 secretion or the hydrolysis of pro-inflammatory and nociceptive adenosine triphosphate (ATP) into anti-inflammatory and anti-nociceptive adenosine by cluster of differentiation (CD) 39 and 73 enzymes on the Treg cell surface. Recent studies have suggested decreased Treg proportions in migraine patients, particularly CD 39 and CD 73-positive Treg cells, whereas Treg cells were shown to be increased in T1DM patients. This suggests the role of Treg cells in migraine, but further studies are needed.

In this study, the investigators aim to compare Treg levels, as well as identify Treg subpopulations and measure cytokine levels in migraine and migraine-free participants with and without an autoimmune/inflammatory disorder (MS, RA, CD, SLE, T1DM and endometriosis). This will provide better understanding of migraine pathophysiology and lead to the development of targeted and personalized treatment strategies, according to the immune pain profile and associated inflammatory diseases of migraine patients.

### Conditions Module

**Conditions:**

- Migraine Disorders

- Pain

- Autoimmune Diseases

- Multiple Sclerosis

- Endometriosis

- Rheumatoid Arthritis

- Crohn Disease

- Lupus Erythematosus

**Keywords:**

- Migraine Disorders

- Pain

- Cytokines

- Regulatory T cell

### Design Module

#### Design Info

**Allocation:** NON_RANDOMIZED

**Intervention Model:** PARALLEL

##### Masking Info

**Masking:** NONE

**Primary Purpose:** BASIC_SCIENCE

#### Enrollment Info

**Count:** 396

**Type:** ESTIMATED

**Phases:**

- NA

**Study Type:** INTERVENTIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** Migraine - no autoimmune/inflammatory disease group

**Intervention Names:**

- Biological: Blood test

**Label:** Migraine - no autoimmune/inflammatory disease

**Type:** EXPERIMENTAL

#### Arm Group 2

**Description:** No migraine - no autoimmune/inflammatory disease group

**Intervention Names:**

- Biological: Blood test

**Label:** No migraine - no autoimmune/inflammatory disease

**Type:** EXPERIMENTAL

#### Arm Group 3

**Description:** No migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis) group

**Intervention Names:**

- Biological: Blood test

**Label:** No migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis)

**Type:** EXPERIMENTAL

#### Arm Group 4

**Description:** Migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis) group

**Intervention Names:**

- Biological: Blood test

**Label:** Migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis)

**Type:** EXPERIMENTAL

### Interventions

#### Intervention 1

**Arm Group Labels:**

- Migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis)

- Migraine - no autoimmune/inflammatory disease

- No migraine - autoimmune/inflammatory disease (MS, RA, CD, SLE, T1DM, endometriosis)

- No migraine - no autoimmune/inflammatory disease

**Description:** 1 blood test of maximum 40 millilitres per patient

**Name:** Blood test

**Type:** BIOLOGICAL

### Outcomes Module

#### Primary Outcomes

**Description:** To measure Treg cell levels in migraine and migraine-free participants, with and without autoimmune/inflammatory diseases (MS, RA, CD, SLE, endometriosis, T1DM) using flow cytometry

**Measure:** Treg cell levels in cell/microliter (cell/µL)

**Time Frame:** Once, at inclusion

**Description:** To measure Treg cell levels in migraine and migraine-free participants, with and without autoimmune/inflammatory diseases (MS, RA, CD, SLE, endometriosis, T1DM) using flow cytometry

**Measure:** Treg cell levels in percentage (%) of white blood cells

**Time Frame:** Once, at inclusion

**Description:** Age at inclusion

**Measure:** Age in years

**Time Frame:** Once, at inclusion

**Description:** Weight on scales during inclusion visit

**Measure:** Weight in kilograms (kg)

**Time Frame:** Once, at inclusion

**Description:** Score to be answered at inclusion to determine anxiety and depression levels : ranges from 0 to 21 for each (anxiety and depression). A score of 11 and above ascertains anxiety or depression. Licence n° 2403391 with Mapi Research Trust.

**Measure:** Score on the Hospital Anxiety and Depression Scale

**Time Frame:** Once, at inclusion

**Description:** Score to be answered at inclusion to determine the impact of headache on patients' daily life, ranging from 36 to 78. The higher the score, the higher the impact of headache on daily life. Licence to be signed shortly with QualityMetrics

**Measure:** Score on the Headache Impact Test

**Time Frame:** Once, at inclusion

**Description:** To be completed at inclusion to confirm migraine diagnosis. No licence needed

**Measure:** Migraine diagnostic criteria from the International Classification of Headache Disorders 3rd edition (ICHD-3)

**Time Frame:** Once, at inclusion

**Description:** Number of days with a headache to determine whether migraine is episodic or chronic (average during last 3 months)

**Measure:** Number of headache days per month in days/month

**Time Frame:** Once, at inclusion

**Description:** To measure the absolute white blood cell count to determine the percentage of Treg cells

**Measure:** White blood cell count in giga/liter (G/L)

**Time Frame:** Once, at inclusion

**Description:** For sex repartition

**Measure:** Sex (female, male)

**Time Frame:** Once, at inclusion

**Description:** Date of last menstrual period start day to measure the impact of the menstrual cycle on Treg levels

**Measure:** Date of last menstrual period as a date in the form: day/month/year

**Time Frame:** Once, at inclusion

**Description:** To insure exclusion of pregnant women

**Measure:** Human chorionic gonadotropin subunit beta level in milli-international units per milliliter (mIU/mL)

**Time Frame:** Once, at inclusion

**Description:** Measured at inclusion

**Measure:** Height in meters (m)

**Time Frame:** Once, at inclusion

**Description:** Weight in kilograms and height in meters will be combined to determine the body mass index in kilogram per square meter

**Measure:** Body mass index (BMI) in kilogram per square meter (kg/m2)

**Time Frame:** Once, at inclusion

#### Secondary Outcomes

**Description:** To measure cytokine levels (interleukin 1b, interleukin 2, interleukin 6, interleukin 10, interleukin 12, interleukin 17, interleukin 18, interleukin 21, interleukin 23, interleukin 35, tumor necrosis factor a, interferon g and transforming growth factor b) using a LUMINEX method

**Measure:** Cytokine levels in picogram per milliliter (pg/mL)

**Time Frame:** Once, at inclusion

**Description:** To determine correlation with Treg cell levels

**Measure:** Progesterone in nanogram per milliliter (ng/mL)

**Time Frame:** Once, at inclusion

**Description:** To determine correlation with Treg cell levels

**Measure:** Estrogen in picogram per milliliter (pg/mL)

**Time Frame:** Once, at inclusion

**Description:** To determine the correlation between the menstrual cycle period and Treg cell levels

**Measure:** Follicle stimulating hormone (FSH) in milli-international units per milliliter (mIU/mL)

**Time Frame:** Once, at inclusion

**Description:** To determine the correlation between the menstrual cycle period and Treg cell levels

**Measure:** Luteinizing hormone in international units per liter (IU/L)

**Time Frame:** Once, at inclusion

**Description:** To measure the general level of inflammation

**Measure:** Levels of C-reactive protein (CRP) in milligram per liter (mg/L)

**Time Frame:** Once, at inclusion

**Description:** To determine the correlation between sugar levels and Treg cell levels

**Measure:** Fasting blood glucose concentration in gram per liter (g/L)

**Time Frame:** Once, at inclusion

**Description:** To determine the correlation between insulin levels and Treg cell levels

**Measure:** Insulin levels in milligram per deciliter (mg/dL)

**Time Frame:** Once, at inclusion

**Description:** To determine the correlation between the presence of migraine and prolactin levels

**Measure:** Prolactin levels in nanogram per milliliter (ng/mL)

**Time Frame:** Once, at inclusion

**Description:** To study association between CGRP levels and migraine

**Measure:** Calcitonin gene-related peptide (CGRP) in picogram per milliliter (pg/mL)

**Time Frame:** Once, at inclusion

**Description:** To study association between VIP levels and migraine

**Measure:** Vasoactive intestinal polypeptide (VIP) in picogram per milliliter (pg/mL)

**Time Frame:** Once, at inclusion

**Description:** To study association between PACAP levels and migraine

**Measure:** Pituitary adenylate cyclase-activating polypeptide (PACAP) levels in nanogram per milliliter (ng/mL)

**Time Frame:** Once, at inclusion

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

* female
* 18 - 50 years of age
* at least 50 kg

Exclusion Criteria:

* menopause
* type 2 diabetes
* pregnancy (or delivery \< 3 months)
* breast feeding
* hysterectomy or adnexectomy
* characterized immune deficiency
* active cancer (or remission \< 1 year)
* bone marrow or solid organ transplant
* hormone therapy (other than birth control)
* migraine attack within 12 hours before or after blood test
* person under guardianship

**Healthy Volunteers:** True

**Maximum Age:** 50 Years

**Minimum Age:** 18 Years

**Sex:** FEMALE

**Standard Ages:**

- ADULT

### Contacts Locations Module

#### Central Contacts

**Contact 1:**

**Email:** promo_interne_drci@chu-clermontferrand.fr

**Name:** Lise LACLAUTRE

**Phone:** 334.73.754.963

**Role:** CONTACT

#### Locations

**Location 1:**

**City:** Clermont-Ferrand

**Country:** France

**Facility:** CHU de Clermont-Ferrand - Service de Neurologie

**State:** Aura

**Zip:** 63000

#### Overall Officials

**Official 1:**

**Affiliation:** University Hospital, Clermont-Ferrand

**Name:** Xavier MOISSET

**Role:** PRINCIPAL_INVESTIGATOR

### References Module

#### References

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**PMID:** 33192977

**Citation:** Stovner LJ, Hagen K, Linde M, Steiner TJ. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain. 2022 Apr 12;23(1):34. doi: 10.1186/s10194-022-01402-2.

**PMID:** 35410119

**Citation:** Ashina M. Migraine. N Engl J Med. 2020 Nov 5;383(19):1866-1876. doi: 10.1056/NEJMra1915327. No abstract available.

**PMID:** 33211930

**Citation:** Pellesi L, Al-Karagholi MA, De Icco R, Coskun H, Elbahi FA, Lopez-Lopez C, Snellman J, Hannibal J, Amin FM, Ashina M. Effect of Vasoactive Intestinal Polypeptide on Development of Migraine Headaches: A Randomized Clinical Trial. JAMA Netw Open. 2021 Aug 2;4(8):e2118543. doi: 10.1001/jamanetworkopen.2021.18543.

**PMID:** 34357396

**Citation:** Al-Karagholi MA, Kalatharan V, Ghanizada H, Gram C, Dussor G, Ashina M. Prolactin in headache and migraine: A systematic review of clinical studies. Cephalalgia. 2023 Feb;43(2):3331024221136286. doi: 10.1177/03331024221136286.

**PMID:** 36718026

**Citation:** Bhoi SK, Kalita J, Misra UK. Metabolic syndrome and insulin resistance in migraine. J Headache Pain. 2012 Jun;13(4):321-6. doi: 10.1007/s10194-012-0416-y. Epub 2012 Jan 26.

**PMID:** 22278639

**Citation:** Schetters STT, Gomez-Nicola D, Garcia-Vallejo JJ, Van Kooyk Y. Neuroinflammation: Microglia and T Cells Get Ready to Tango. Front Immunol. 2018 Jan 25;8:1905. doi: 10.3389/fimmu.2017.01905. eCollection 2017.

**PMID:** 29422891

**Citation:** Watkins LR, Maier SF. Glia: a novel drug discovery target for clinical pain. Nat Rev Drug Discov. 2003 Dec;2(12):973-85. doi: 10.1038/nrd1251. No abstract available.

**PMID:** 14654796

**Citation:** Perini F, D'Andrea G, Galloni E, Pignatelli F, Billo G, Alba S, Bussone G, Toso V. Plasma cytokine levels in migraineurs and controls. Headache. 2005 Jul-Aug;45(7):926-31. doi: 10.1111/j.1526-4610.2005.05135.x.

**PMID:** 15985111

**Citation:** Vignali DA, Collison LW, Workman CJ. How regulatory T cells work. Nat Rev Immunol. 2008 Jul;8(7):523-32. doi: 10.1038/nri2343.

**PMID:** 18566595

**Citation:** Arumugam M, Parthasarathy V. Reduction of CD4(+)CD25(+) regulatory T-cells in migraine: Is migraine an autoimmune disorder? J Neuroimmunol. 2016 Jan 15;290:54-9. doi: 10.1016/j.jneuroim.2015.11.015. Epub 2015 Nov 28.

**PMID:** 26711570

**Citation:** Faraji F, Shojapour M, Farahani I, Ganji A, Mosayebi G. Reduced regulatory T lymphocytes in migraine patients. Neurol Res. 2021 Aug;43(8):677-682. doi: 10.1080/01616412.2021.1915077. Epub 2021 Apr 14.

**PMID:** 33853506

**Citation:** Okimura H, Tanaka Y, Fujii M, Shimura K, Maeda E, Ito F, Khan KN, Nakamura Y, Mori T, Kitawaki J. Changes in the proportion of regulatory T cell subpopulations during menstrual cycle and early pregnancy. Am J Reprod Immunol. 2022 Dec;88(6):e13636. doi: 10.1111/aji.13636. Epub 2022 Oct 21.

**PMID:** 36217280

**Citation:** Moisset X, Bommelaer G, Boube M, Ouchchane L, Goutte M, Dapoigny M, Dallel R, Guttmann A, Clavelou P, Buisson A. Migraine prevalence in inflammatory bowel disease patients: A tertiary-care centre cross-sectional study. Eur J Pain. 2017 Oct;21(9):1550-1560. doi: 10.1002/ejp.1056. Epub 2017 May 16.

**PMID:** 28508514

**Citation:** Moisset X, Giraud P, Dallel R. Migraine in multiple sclerosis and other chronic inflammatory diseases. Rev Neurol (Paris). 2021 Sep;177(7):816-820. doi: 10.1016/j.neurol.2021.07.005. Epub 2021 Jul 27.

**PMID:** 34325914

**Citation:** Yang MH, Wang PH, Wang SJ, Sun WZ, Oyang YJ, Fuh JL. Women with endometriosis are more likely to suffer from migraines: a population-based study. PLoS One. 2012;7(3):e33941. doi: 10.1371/journal.pone.0033941. Epub 2012 Mar 19.

**PMID:** 22442736

**Citation:** Hagen K, Asvold BO, Midthjell K, Stovner LJ, Zwart JA, Linde M. Inverse relationship between type 1 diabetes mellitus and migraine. Data from the Nord-Trondelag Health Surveys 1995-1997 and 2006-2008. Cephalalgia. 2018 Mar;38(3):417-426. doi: 10.1177/0333102417690488. Epub 2017 Jan 23.

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**Citation:** Malutan AM, Drugan T, Costin N, Ciortea R, Bucuri C, Rada MP, Mihu D. Pro-inflammatory cytokines for evaluation of inflammatory status in endometriosis. Cent Eur J Immunol. 2015;40(1):96-102. doi: 10.5114/ceji.2015.50840. Epub 2015 Apr 22.

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**Citation:** Gobel K, Ruck T, Meuth SG. Cytokine signaling in multiple sclerosis: Lost in translation. Mult Scler. 2018 Apr;24(4):432-439. doi: 10.1177/1352458518763094. Epub 2018 Mar 7.

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**PMID:** 30723474

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000020278

- Term: Demyelinating Autoimmune Diseases, CNS

- ID: D000020274

- Term: Autoimmune Diseases of the Nervous System

- ID: D000009422

- Term: Nervous System Diseases

- ID: D000003711

- Term: Demyelinating Diseases

- ID: D000007154

- Term: Immune System Diseases

- ID: D000051270

- Term: Headache Disorders, Primary

- ID: D000020773

- Term: Headache Disorders

- ID: D000001927

- Term: Brain Diseases

- ID: D000002493

- Term: Central Nervous System Diseases

- ID: D000015212

- Term: Inflammatory Bowel Diseases

- ID: D000005759

- Term: Gastroenteritis

- ID: D000005767

- Term: Gastrointestinal Diseases

- ID: D000004066

- Term: Digestive System Diseases

- ID: D000007410

- Term: Intestinal Diseases

- ID: D000005831

- Term: Genital Diseases, Female

- ID: D000052776

- Term: Female Urogenital Diseases

- ID: D000005261

- Term: Female Urogenital Diseases and Pregnancy Complications

- ID: D000091642

- Term: Urogenital Diseases

- ID: D000091662

- Term: Genital Diseases

### Condition Browse Module - Browse Branches

- Abbrev: BC05

- Name: Musculoskeletal Diseases

- Abbrev: All

- Name: All Conditions

- Abbrev: BC23

- Name: Symptoms and General Pathology

- Abbrev: BC10

- Name: Nervous System Diseases

- Abbrev: BC20

- Name: Immune System Diseases

- Abbrev: BC17

- Name: Skin and Connective Tissue Diseases

- Abbrev: BC06

- Name: Digestive System Diseases

- Abbrev: BXS

- Name: Urinary Tract, Sexual Organs, and Pregnancy Conditions

### Condition Browse Module - Browse Leaves

- ID: M4476

- Name: Arthritis

- Relevance: LOW

- As Found: Unknown

- ID: M10293

- Name: Inflammation

- Relevance: LOW

- As Found: Unknown

- ID: M15415

- Name: Sclerosis

- Relevance: LOW

- As Found: Unknown

- ID: M12060

- Name: Multiple Sclerosis

- Relevance: HIGH

- As Found: Multiple Sclerosis

- ID: M4629

- Name: Autoimmune Diseases

- Relevance: HIGH

- As Found: Autoimmune Diseases

- ID: M4480

- Name: Arthritis, Rheumatoid

- Relevance: LOW

- As Found: Unknown

- ID: M6638

- Name: Crohn Disease

- Relevance: HIGH

- As Found: Crohn's Disease

- ID: M11852

- Name: Migraine Disorders

- Relevance: HIGH

- As Found: Migraine Disorders

- ID: M13066

- Name: Pain

- Relevance: LOW

- As Found: Unknown

- ID: M7877

- Name: Endometriosis

- Relevance: HIGH

- As Found: Endometriosis

- ID: M22098

- Name: Demyelinating Autoimmune Diseases, CNS

- Relevance: LOW

- As Found: Unknown

- ID: M22094

- Name: Autoimmune Diseases of the Nervous System

- Relevance: LOW

- As Found: Unknown

- ID: M6909

- Name: Demyelinating Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M10200

- Name: Immune System Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M9351

- Name: Headache

- Relevance: LOW

- As Found: Unknown

- ID: M22529

- Name: Headache Disorders

- Relevance: LOW

- As Found: Unknown

- ID: M26657

- Name: Headache Disorders, Primary

- Relevance: LOW

- As Found: Unknown

- ID: M5204

- Name: Brain Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M5742

- Name: Central Nervous System Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M17917

- Name: Inflammatory Bowel Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M10444

- Name: Intestinal Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M8875

- Name: Gastroenteritis

- Relevance: LOW

- As Found: Unknown

- ID: M8883

- Name: Gastrointestinal Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M7255

- Name: Digestive System Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M8943

- Name: Genital Diseases, Female

- Relevance: LOW

- As Found: Unknown

- ID: M2876

- Name: Genital Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M2875

- Name: Urogenital Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M27093

- Name: Female Urogenital Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M14127

- Name: Pregnancy Complications

- Relevance: LOW

- As Found: Unknown

- ID: M8399

- Name: Female Urogenital Diseases and Pregnancy Complications

- Relevance: LOW

- As Found: Unknown

### Condition Browse Module - Meshes

- ID: D000003424

- Term: Crohn Disease

- ID: D000009103

- Term: Multiple Sclerosis

- ID: D000008881

- Term: Migraine Disorders

- ID: D000004715

- Term: Endometriosis

- ID: D000001327

- Term: Autoimmune Diseases

### Misc Info Module

- Version Holder: 2024-05-31
