Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Curr Neurol Neurosci Rep. 2015 May;15(5):25. doi: 10.1007/s11910-015-0547-z.
Migraine is a complex disorder of the brain that is common and highly disabling. As understanding of the neural pathways has advanced, and it has become clear that the vascular hypothesis does not explain the disorder, new therapeutic avenues have arisen. One such target is calcitonin gene-related peptide (CGRP)-based mechanisms. CGRP is found within the trigeminovascular nociceptive system widely from the trigeminal ganglion to second-order and third-order neurons and in regulatory areas in the brainstem. Studies have shown CGRP is released during severe migraine attacks and the reversal of the attack with effective triptan treatment normalizes those levels. CGRP administration triggers migraine in patients, and CGRP receptor antagonists have been shown to abort migraine. Here, we review the current state of CGRP mechanism antagonist therapy as its research and development is increasing in migraine therapeutics. We discuss several recent trials, highlighting the evidence base behind these novel drugs, and their potential future contribution to migraine management.
偏头痛是一种常见且高度致残的大脑复杂紊乱。随着对神经通路的理解不断深入，血管假说已无法解释该疾病，新的治疗途径也随之出现。降钙素基因相关肽（CGRP）机制就是其中之一。CGRP 存在于三叉血管伤害性系统中，从三叉神经节到二级和三级神经元以及脑干的调节区域广泛分布。研究表明，CGRP 在严重偏头痛发作期间释放，有效的曲坦类药物治疗可逆转头痛并使 CGRP 水平正常化。CGRP 的给药会引发偏头痛，而 CGRP 受体拮抗剂已被证明可终止偏头痛。在这里，我们综述了 CGRP 机制拮抗剂治疗的现状，因为其在偏头痛治疗中的研究和开发正在不断增加。我们讨论了几项最近的试验，强调了这些新型药物背后的证据基础，以及它们在偏头痛管理方面的潜在未来贡献。
