Role of CGRP in Migraine
Role of CGRP in Migraine
复制标题
DOI：
10.1007/164_2018_201
复制
发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Edvinsson, Lars
中科院分区：
文献类型：
--
作者：
Edvinsson, Lars
偏头痛是一种常见的神经系统疾病，在大多数国家，高达15%的成年人患有偏头痛，其中女性居多。其特征是发作性的，通常是致残性头痛，恐惧症和声音恐惧症，自主神经症状（恶心和呕吐），在一个亚组中，在发作开始时有先兆。虽然仍有争议，许多研究人员认为偏头痛是一种疾病，其中中枢神经系统功能障碍起着关键作用，而三叉神经系统的各个部分是必要的相关症状的表达。近年来，治疗偏头痛的药物，靶向三叉神经感觉神经肽降钙素基因相关肽（CGRP）或其受体的发展。这些药物中的几种现在被批准用于频繁发作和慢性偏头痛。CGRP相关疗法比现有药物提供了相当大的改进，因为它们是第一个专门设计用于三叉神经疼痛系统的药物：它们更具体，几乎没有或没有不良反应。小分子CGRP受体拮抗剂gepants可有效缓解偏头痛，而针对CGRP（Eptinezumab、Fremanezumab和Galcanezumab）或CGRP受体（Erenumab）的单克隆抗体可有效预防偏头痛发作。CGRP信号传导的神经生物学与CGRP在偏头痛中的作用的关键临床证据一起简要总结，包括CGRP靶向治疗的疗效。
Migraine is a common neurological disorder that afflicts up to 15% of the adult population in most countries, with predominance in females. It is characterized by episodic, often disabling headache, photophobia and phonophobia, autonomic symptoms (nausea and vomiting), and in a subgroup an aura in the beginning of the attack. Although still debated, many researchers consider migraine to be a disorder in which CNS dysfunction plays a pivotal role while various parts of the trigeminal system are necessary for the expression of associated symptoms.Treatment of migraine has in recent years seen the development of drugs that target the trigeminal sensory neuropeptide calcitonin gene-related peptide (CGRP) or its receptor. Several of these drugs are now approved for use in frequent episodic and in chronic migraine. CGRP-related therapies offer considerable improvements over existing drugs, as they are the first to be designed specifically to act on the trigeminal pain system: they are more specific and have little or no adverse effects. Small molecule CGRP receptor antagonists, gepants, are effective for acute relief of migraine headache, whereas monoclonal antibodies against CGRP (Eptinezumab, Fremanezumab, and Galcanezumab) or the CGRP receptor (Erenumab) effectively prevent migraine attacks. The neurobiology of CGRP signaling is briefly summarized together with key clinical evidence for the role of CGRP in migraine headache, including the efficacy of CGRP-targeted treatments.