Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Headache. 2019 Jul;59 Suppl 2(Suppl 2):50-65. doi: 10.1111/head.13585.
Migraine is a complex disorder that is characterized by an assortment of neurological and systemic effects. While headache is the most prominent feature of migraine, a host of symptoms affecting many physiological functions are also observed before, during, and after an attack. Furthermore, migraineurs are heterogeneous and have a wide range of responses to migraine therapies. The recent approval of calcitonin gene-related-peptide based therapies has opened up the treatment of migraine and generated a renewed interest in migraine research and discovery. Ongoing advances in migraine research have identified a number of other promising therapeutic targets for this disorder. In this review, we highlight emergent treatments within the following biological systems: pituitary adenylate cyclase activating peptdie, 2 non-mu opioid receptors that have low abuse liability - the delta and kappa opioid receptors, orexin, and nitric oxide-based therapies. Multiple mechanisms have been identified in the induction and maintenance of migraine symptoms; and this divergent set of targets have highly distinct biological effects. Increasing the mechanistic diversity of the migraine tool box will lead to more treatment options and better patient care.
偏头痛是一种复杂的疾病，其特征是一系列的神经和全身效应。虽然头痛是偏头痛最突出的特征，但在发作前、发作期间和发作后，还观察到许多影响许多生理功能的症状。此外，偏头痛患者存在异质性，对偏头痛治疗有广泛的反应。降钙素基因相关肽为基础的治疗方法的最近批准为偏头痛的治疗开辟了新的途径，并激发了对偏头痛研究和发现的新兴趣。偏头痛研究的不断进展已经确定了该疾病的许多其他有前途的治疗靶点。在这篇综述中，我们重点介绍了以下生物系统中的新兴治疗方法：垂体腺苷酸环化酶激活肽、2 种具有低滥用倾向的非μ阿片受体——δ 和 κ 阿片受体、食欲素和基于一氧化氮的治疗方法。在偏头痛症状的诱导和维持中已经确定了多种机制；而这一组不同的靶点具有高度不同的生物学效应。增加偏头痛工具包的机制多样性将导致更多的治疗选择和更好的患者护理。
