Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system.
Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system.
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DOI：
10.1007/s10194-008-0011-4
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发表时间：
2008-02
影响因子：
7.4
通讯作者：
Edvinsson, Lars
中科院分区：
文献类型：
--
作者：
Link, Andrea Stephanie;Kuris, Aniko;Edvinsson, Lars
偏头痛等原发性头痛是最常见的神经系统疾病之一，影响多达五分之一的成年人。过去十年的科学工作已经揭开了偏头痛的许多病理生理学背景，偏头痛现在被认为是一种神经血管疾病。研究发现，三叉神经-脑血管系统通过释放强有力的血管扩张剂降钙素基因相关肽（CGRP）在偏头痛的病理生理学中起关键作用。这种神经肽与疼痛平行释放，其浓度与头痛的强度密切相关。曲坦类药物的开发为急性发作提供了缓解，但代价是主要是心血管副作用。因此，改善治疗的意图导致了小CGRP受体拮抗剂如奥西吉潘（BIBN 4096 BS）和MK-0974的开发，其减轻了急性偏头痛发作而没有急性副作用。本文综述了偏头痛的病理背景，并阐明曲坦类药物和有前途的CGRP受体阻滞剂的作用机制。
Primary headaches such as migraine are among the most prevalent neurological disorders, affecting up to one-fifth of the adult population. The scientific work in the last decade has unraveled much of the pathophysiological background of migraine, which is now considered to be a neurovascular disorder. It has been discovered that the trigemino-cerebrovascular system plays a key role in migraine headache pathophysiology by releasing the potent vasodilator calcitonin gene-related peptide (CGRP). This neuropeptide is released in parallel with the pain and its concentration correlates well with the intensity of the headache. The development of drugs of the triptan class has provided relief for the acute attacks but at the cost of, mainly cardiovascular, side effects. Thus, the intention to improve treatment led to the development of small CGRP receptor antagonists such as olcegepant (BIBN4096BS) and MK-0974 that alleviate the acute migraine attack without acute side events. The purpose of this review is to give a short overview of the pathological background of migraine headache and to illustrate the mechanisms behind the actions of triptans and the promising CGRP receptor blockers.
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