Humphrey P P, Feniuk W, Perren M J, Connor H E, Oxford A W
Glaxo Group Research Limited, Ware, Hertfordshire, UK.
Cephalalgia. 1989;9 Suppl 9:23-33. doi: 10.1111/J.1468-2982.1989.TB00069.X.
We describe the identification of a novel drug, GR43175, for the acute treatment of migraine. GR43175 is a tryptamine analogue with a very selective agonist action at a 5-HT1-like receptor subtype first identified in the dog saphenous vein. Using this drug as a research probe, we have now shown that this 5-HT receptor type predominates in the carotid circulation, which explains the remarkably selective vasoconstrictor action of GR43175 in vivo in the carotid arterial bed of dogs and cats. Its vasoconstrictor action can be shown to be localized even further to arteriovenous anastomoses (shunts) within the carotid circulation, in such a way that blood flow to the brain as well as to extracerebral capillary beds remains unaffected or may even be increased. In the treatment of migraine demonstrated to date, the impressive effectiveness of GR43175 must reinforce the evidence in favour of an important vascular component being involved in the aetiology of the disease. The question is again raised as to whether the opening of carotid shunts is involved, as suggested by Heyck. If not, an alternative vascular locus needs to be identified.
我们描述了一种用于偏头痛急性治疗的新型药物GR43175的鉴定。GR43175是一种色胺类似物,对最初在犬隐静脉中发现的一种5-HT1样受体亚型具有非常选择性的激动作用。使用这种药物作为研究探针,我们现已表明,这种5-HT受体类型在颈动脉循环中占主导地位,这解释了GR43175在犬和猫的颈动脉床体内具有显著选择性的血管收缩作用。其血管收缩作用甚至可进一步定位于颈动脉循环内的动静脉吻合处(分流),使得流向大脑以及脑外毛细血管床的血流不受影响,甚至可能增加。在迄今为止已证明的偏头痛治疗中,GR43175令人印象深刻的有效性必定强化了支持该病病因中存在重要血管成分的证据。正如Heyck所暗示的,颈动脉分流开放是否参与其中的问题再次被提出。如果没有,就需要确定另一个血管位点。