Benemei Silvia, Cortese Francesca, Labastida-Ramírez Alejandro, Marchese Francesca, Pellesi Lanfranco, Romoli Michele, Vollesen Anne Luise, Lampl Christian, Ashina Messoud
Health Sciences Department, University of Florence, and Headache Centre, Careggi University Hospital, Viale Pieraccini 6, 50134, Florence, Italy.
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy.
J Headache Pain. 2017 Oct 10;18(1):103. doi: 10.1186/s10194-017-0811-5.
The trigeminovascular system plays a key role in the pathophysiology of migraine. The activation of the trigeminovascular system causes release of various neurotransmitters and neuropeptides, including serotonin and calcitonin gene-related peptide (CGRP), which modulate pain transmission and vascular tone. Thirty years after discovery of agonists for serotonin 5-HT and 5-HT receptors (triptans) and less than fifteen after the proof of concept of the gepant class of CGRP receptor antagonists, we are still a long way from understanding their precise site and mode of action in migraine. The effect on cranial vasculature is relevant, because all specific anti-migraine drugs and migraine pharmacological triggers may act in perivascular space. This review reports the effects of triptans and CGRP blocking molecules on cranial vasculature in humans, focusing on their specific relevance to migraine treatment.
三叉神经血管系统在偏头痛的病理生理学中起关键作用。三叉神经血管系统的激活会导致多种神经递质和神经肽的释放，包括血清素和降钙素基因相关肽（CGRP），这些物质会调节疼痛传递和血管张力。在发现血清素5-HT和5-HT受体激动剂（曲坦类药物）30年后，以及在CGRP受体拮抗剂类药物的概念验证不到15年后，我们距离了解它们在偏头痛中的确切作用部位和作用方式仍有很长的路要走。对颅脑血管的影响是相关的，因为所有特定的抗偏头痛药物和偏头痛药理触发因素可能在血管周围间隙起作用。这篇综述报告了曲坦类药物和CGRP阻断分子对人体颅脑血管的影响，重点关注它们与偏头痛治疗的具体相关性。
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