Department of Neurology, West German Headache Center, University of Duisburg-Essen, Essen, Germany.
Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Cephalalgia. 2020 Oct;40(11):1255-1260. doi: 10.1177/0333102420933571. Epub 2020 Jun 14.
Wound healing disturbances as possible side effects of calcitonin gene-related peptide (CGRP) antibody treatment have been discussed previously but not yet described in humans. Basic research suggests that calcitonin gene-related peptide plays an important role in keratinocyte migration, vascularization and immune response and lack of calcitonin gene-related peptide may lead to impaired wound healing.
A 51-year-old female migraine patient was treated with the CGRP receptor antibody erenumab for 6 months, which led to a relevant reduction of migraine days. During the treatment, two periods of severely impaired wound healing occurred after a trivial skin injury without spatial relation to the injection site. Skin biopsy confirmed a deep perivascular and interstitial lymphohistiocytic infiltrate with admixed eosinophils, ulceration of the epithelium, a heavy edema of the papillary dermis and focally thrombosed vessels.
Impaired wound healing might be relevant side effects of CGRP antibody therapy and anamnesis within the course of treatment should also include possible observation of impaired wound healing or planned surgery.
降钙素基因相关肽（CGRP）抗体治疗的可能副作用包括伤口愈合障碍，此前已有相关讨论，但尚未在人体中描述。基础研究表明，降钙素基因相关肽在角质形成细胞迁移、血管生成和免疫反应中发挥重要作用，而降钙素基因相关肽的缺乏可能导致伤口愈合受损。
一名 51 岁女性偏头痛患者接受了 CGRP 受体抗体依瑞奈珠单抗治疗 6 个月，这导致偏头痛天数显著减少。在治疗过程中，两次轻微皮肤损伤后出现严重的伤口愈合受损，且与注射部位无空间关系。皮肤活检证实存在深部血管周围和间质淋巴组织细胞浸润，伴有嗜酸性粒细胞混合，上皮溃疡，乳头真皮重度水肿和局灶性血栓形成的血管。
伤口愈合受损可能是 CGRP 抗体治疗的相关副作用，治疗过程中的病史也应包括可能观察到的伤口愈合受损或计划进行的手术。
