Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Drug Dev Res. 2021 Nov;82(7):896-906. doi: 10.1002/ddr.21819. Epub 2021 Apr 1.
Sumatriptan is the first available medication from triptans family that was approved by the U.S. Food and Drug Administration for migraine attacks and cluster headaches in 1991. Most of its action is mediated by selective 5-HT receptor agonism. Recent investigations raised the possibility of repositioning of this drug to other indications beyond migraine, as increasing evidence suggests for an anti-inflammatory property of sumatriptan. We performed a literature search using PubMed, Web of Science, Scopus, and Google Scholar using "inflammation AND sumatriptan" or "inflammation AND 5HT1B/D" as the keywords. Then, articles were screened for their relevance and those directly discussing the correlation between inflammation and sumatriptan or 5HT1B/D were included. Total references reviewed or inclusion/exclusion were 340 retrieved full-text articles (n = 340), then based on critical assessment 66 of them were included in this systematic review. Our literature review indicates that at low doses, sumatriptan can reduce inflammatory markers (e.g., interleukin-1β, tumor necrosis factor-α, and nuclear factor-κB), affects caspases and changes cells lifespan. Additionally, nitric oxide synthase and nitric oxide signaling seem to be regulated by this drug. It also inhibits the release of calcitonin gene-related peptide. Sumatriptan protects against many inflammatory conditions including cardiac and mesenteric ischemia/reperfusion, skin flap, pruritus, peripheral, and central nervous system injuries such as spinal cord injury, testicular torsion-detorsion, oral mucositis, and other experimental models. Considering the safety and potency of low dose sumatriptan compared to corticosteroids and other immunosuppressive medications, it is worth to take advantage of sumatriptan in inflammatory conditions.
舒马曲坦是曲坦类家族中第一种获得美国食品和药物管理局批准用于治疗偏头痛和丛集性头痛的药物，于 1991 年获批。其大部分作用是通过选择性 5-HT 受体激动作用介导的。最近的研究提出了将这种药物重新定位用于偏头痛以外的其他适应症的可能性，因为越来越多的证据表明舒马曲坦具有抗炎作用。我们使用 PubMed、Web of Science、Scopus 和 Google Scholar 进行了文献检索，使用“炎症和舒马曲坦”或“炎症和 5-HT1B/D”作为关键词。然后，根据相关性筛选文章，并纳入直接讨论炎症与舒马曲坦或 5-HT1B/D 之间相关性的文章。共审查了 340 篇全文文章（n=340），然后根据批判性评估，其中 66 篇被纳入本系统评价。我们的文献综述表明，低剂量舒马曲坦可以降低炎症标志物（如白细胞介素-1β、肿瘤坏死因子-α 和核因子-κB），影响半胱天冬酶并改变细胞寿命。此外，一氧化氮合酶和一氧化氮信号似乎受该药物调节。它还抑制降钙素基因相关肽的释放。舒马曲坦可预防多种炎症性疾病，包括心脏和肠系膜缺血/再灌注、皮瓣、瘙痒、外周和中枢神经系统损伤，如脊髓损伤、睾丸扭转-复位、口腔粘膜炎和其他实验模型。考虑到低剂量舒马曲坦与皮质类固醇和其他免疫抑制药物相比的安全性和有效性，在炎症情况下利用舒马曲坦是值得的。
