Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

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

Research output: Contribution to journalReviewResearchpeer-review

DOI

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

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Monitoring chronic headache and medication-overuse headache prevalence in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Diagnostic delay of cluster headache: A cohort study from the Danish Cluster Headache Survey

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. PACAP27 induces migraine-like attacks in migraine patients

    Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalLetterResearchpeer-review

  2. Loss of retinal tension and permanent decrease in retinal function: a new porcine model of rhegmatogenous retinal detachment

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Hyperpolarization through ATP-sensitive potassium channels; relevance to migraine pathology

    Research output: Contribution to journalLetterResearchpeer-review

  4. Calcitonin Gene-Related Peptide (CGRP) and Cluster Headache

    Research output: Contribution to journalReviewResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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.

Original languageEnglish
JournalCephalalgia : an international journal of headache
Volume39
Issue number3
Pages (from-to)366-373
Number of pages8
ISSN0333-1024
DOIs
Publication statusPublished - 2019

    Research areas

  • Journal Article, BBB, CLR, CGRP, gepants, RAMP1, monoclonal antibodies

ID: 52342232