2015 issue 2

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Volume 31, issue 2

Review article

The role of the CGRP in the pathogenesis and treatment of migraine

Olga Kuzawińska1, Krzysztof Lis1, Grzegorz Cessak1, Ewa Bałkowiec-Iskra1
1. Medical University of Warsaw, Department of Experimental and Clinical Pharmacology
Farmakoterapia w Psychiatrii i Neurologii 2015, 31 (2), 127–140
Date of publication: 18-11-2015
DOI: http://dx.medra.org/10.17393/fpn.2015.10.001
Keywords: calcitonin gene-related peptide (CGRP), migraine, trigeminal nerve, CGRP antagonists, antibodies

Calcitonin gene-related peptide (CGRP) is a 37-amino acid neuropeptide. It has two forms: α and β. CGRP is widely expressed in the central and peripheral nervous systems. Great attention is paid to examining the role of CGRP in pain transmission, including modulation of the function of other neurotransmitters. CGRP is regarded as a key mediator in pain response; it is released from the trigeminovascular system after stimulation of sensory nerve endings. It is well documented that CGRP has a very important role in the pathogenesis of migraine. The concentration of CGRP increases in response to stimulation of the trigeminal ganglion. CGRP may affect the activity of sensory neurons by direct control of the pain response in the course of a migraine attack. Therefore, trials are being conducted to develop effective medicines, which could block CGRP’s activity or decrease its concentration. The efficacy of a few CGRP receptor antagonists in the treatment of migraine has been demonstrated in clinical trials. The potential use of monoclonal antibodies directed against CGRP or its receptors is also highlighted. They should decrease severity and frequency of migraine attacks by reducing the levels of CGRP or block its action. These drugs can become an effective alternative to triptans in migraine treatment and to other medicines used in the treatment of disorders associated with dysfunction of the trigeminal nerve.

Address for correspondence:
Warszawski Uniwersytet Medyczny
Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej
ul. Banacha 1b, 02-097 Warszawa, Poland
phone: +48 22 116 61 16
email: ebalkowiec@wum.edu.pl