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Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Recognizing the role of CGRP and CGRP receptors in migraine and its treatment

Publikation: Bidrag til tidsskriftReviewForskningpeer review

DOI

  1. Cellular distribution of PACAP-38 and PACAP receptors in the rat brain: Relation to migraine activated regions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Ictal neck pain investigated in the interictal state - a search for the origin of pain

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  3. Persistent post-traumatic headache attributed to mild traumatic brain injury: Deep phenotyping and treatment patterns

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  4. Letter to the editor regarding proposed new diagnostic criteria for migraine

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  5. Eptinezumab in episodic migraine: A randomized, double-blind, placebo-controlled study (PROMISE-1)

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  1. Expression of the CGRP Family of Neuropeptides and their Receptors in the Trigeminal Ganglion

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. CGRP in rat mesenteric artery and vein - receptor expression, CGRP presence and potential roles

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Cellular distribution of PACAP-38 and PACAP receptors in the rat brain: Relation to migraine activated regions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Understanding side-effects of anti-CGRP and anti-CGRP receptor antibodies

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

Vis graf over relationer

PREMISE: The brain and the sensory nervous system contain a rich supply of calcitonin gene-related peptide (CGRP) and CGRP receptor components. Clinical studies have demonstrated a correlation between CGRP release and acute migraine headache that led to the development of CGRP-specific drugs that either abort acute attacks of migraine (gepants) or are effective as prophylaxis (antibodies). However, there is still much discussion concerning the site of action of these drugs.

PROBLEM: Here we describe the most recent data related to CGRP in the trigeminal ganglion and its connections to the CNS, putative key regions involved in migraine pathophysiology. Gepants are small molecules that have limited ability to cross the blood-brain barrier (BBB), whereas CGRP antibodies are 1500 times larger molecules, and are virtually excluded from the brain, with a BBB permeability of < 0.1%. Thus we propose that the primary site of action for the antimigraine drugs is outside the CNS in areas not limited by the BBB.

POTENTIAL SOLUTION: Therefore, it is reasonable to discuss the localization of CGRP and its receptor components in relation to the BBB. The trigeminovascular system, located outside the BBB, has a key role in migraine symptomatology, and it is likely targeted by the novel CGRP drugs that successfully terminate migraine headache.

OriginalsprogEngelsk
TidsskriftCephalalgia : an international journal of headache
Vol/bind39
Udgave nummer3
Sider (fra-til)366-373
Antal sider8
ISSN0333-1024
DOI
StatusUdgivet - 2019

ID: 52342232