CGRP: New Focus in Migraine

被引:1
作者
Karli, Necdet [1 ]
Bicakci, Sebnem [2 ]
Bozkurt, Manal Mehtar [3 ]
机构
[1] Bursa Uludag Univ, Dept Neurol, Fac Med, Bursa, Turkey
[2] Cukurova Univ, Dept Neurol, Fac Med, Adana, Turkey
[3] Novartis Pharmaceut, Istanbul, Turkey
关键词
Calcitonin gene related peptide; CGRP; migraine; trigeminovascular system; CORTICAL SPREADING DEPRESSION; GENE-RELATED PEPTIDE; EXTRACEREBRAL CIRCULATION; PATHOPHYSIOLOGY; PHASE; SENSITIZATION; ACTIVATION; HEADACHE; ERENUMAB; RELEASE;
D O I
10.4274/tnd.2022.88027
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Migraine is a neurological disorder characterized by recurrent attacks of headache usually accompanied by symptoms such as nausea, vomiting, photophobia and phonophobia. According to the Global Burden of Disease Study 2019 estimates, it affects more than 1.12 billion people worldwide and is a major cause of disability worldwide. Although migraine has been recognized for centuries, its pathophysiology has not been fully understood yet. Several theories have been proposed so far, the most recent being the neurovascular theory. Supported by the developments in neuroradiology and immunohistochemistry, the theory emphasizes the essential role of the trigeminovascular (TGV) system in migraine pathophysiology. It is obvious that the TGV system, regulating the cranial blood flow and nociceptive transmission, contributes to initiation and progression of serial complex events associated with migraine. The identification of vasoactive neuropeptides which had a role in migraine pathophysiology also created an opportunity for development of new treatment strategies in migraine. Calcitonin gene related peptide (CGRP) is one of the neurotransmitters that has attracted most attention since it is abundantly found in the TGV system and plays a significant role in different processes of migraine including vasodilation, neurogenic inflammation, peripheral and central sensitization. It became the focus of research in the last few decades and extensively investigated. Both small molecules antagonizing CGRP receptor and monoclonal antibodies targeting either CGRP or its receptor have been developed and used in migraine treatment. This article overviews the role of the TGV system in migraine pathophysiology and treatment with a specific focus on CGRP.
引用
收藏
页码:1 / 5
页数:5
相关论文
共 51 条
[31]   Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks [J].
Maniyar, Farooq Husain ;
Sprenger, Till ;
Monteith, Teshamae ;
Schankin, Christoph ;
Goadsby, Peter James .
BRAIN, 2014, 137 :232-241
[32]   My Migraine Voice survey: a global study of disease burden among individuals with migraine for whom preventive treatments have failed [J].
Martelletti, Paolo ;
Schwedt, Todd J. ;
Lanteri-Minet, Michel ;
Quintana, Rebeca ;
Carboni, Veruska ;
Diener, Hans-Christoph ;
de la Torre, Elena Ruiz ;
Craven, Audrey ;
Rasmussen, Annette Vangaa ;
Evans, Simon ;
Laflamme, Annik K. ;
Fink, Rachel ;
Walsh, Donna ;
Dumas, Paula ;
Vo, Pamela .
JOURNAL OF HEADACHE AND PAIN, 2018, 19
[33]   Current understanding of trigeminal ganglion structure and function in headache [J].
Messlinger, Karl ;
Russo, Andrew F. .
CEPHALALGIA, 2019, 39 (13) :1661-1674
[34]  
MOSKOWITZ MA, 1979, LANCET, V2, P883
[35]   Gepants for the treatment of migraine [J].
Negro, Andrea ;
Martelletti, Paolo .
EXPERT OPINION ON INVESTIGATIONAL DRUGS, 2019, 28 (06) :555-567
[36]   Migraine pathophysiology: Anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain [J].
Noseda, Rodrigo ;
Burstein, Rami .
PAIN, 2013, 154 :S44-S53
[37]   Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition [J].
Olesen, Jes .
CEPHALALGIA, 2018, 38 (01) :1-211
[38]  
Patel NM, StatPearls
[39]   The Biology of Monoclonal Antibodies: Focus on Calcitonin Gene-Related Peptide for Prophylactic Migraine Therapy [J].
Raffaelli, Bianca ;
Reuter, Uwe .
NEUROTHERAPEUTICS, 2018, 15 (02) :324-335
[40]   Hypothalamus as a mediator of chronic migraine Evidence from high-resolution fMRI [J].
Schulte, Laura H. ;
Allers, Angie ;
May, Arne .
NEUROLOGY, 2017, 88 (21) :2011-2016