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Goto T, Iwai H, Kuramoto E, Yamanaka A. Neuropeptides and ATP signaling in the trigeminal ganglion. JAPANESE DENTAL SCIENCE REVIEW 2017; 53:117-124. [PMID: 29201256 PMCID: PMC5703691 DOI: 10.1016/j.jdsr.2017.01.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/10/2016] [Accepted: 01/31/2017] [Indexed: 01/08/2023] Open
Abstract
Peripheral nociceptive stimuli from orofacial structures are largely transmitted by the trigeminal nerve. According to the peripheral noxious stimuli, neurons in the trigeminal ganglion (TG) produce neuropeptides such as substance P, and calcitonin-gene-related peptide, etc. Beside the production of neuropeptides, there exists unique non-synaptic interaction system between maxillary and mandibular neurons in the TG. Neurons in the TG are surrounded by satellite glial cells (SGCs), which initially receive the signal from TG neurons. These activated SGCs secrete a transmitter to activate adjacent SGCs or TG neurons, thereby amplifying the signal, for example, from mandibular neurons to maxillary neurons in the TG. Similar to the dorsal root ganglion, in the TG, microglia/macrophage-like cells (MLCs) are activated by uptake of a transmitter from TG neurons or SGCs. This communication between neurons, SGCs, and MLCs results in responses such as ectopic pain, hyperesthesia, or allodynia. The focus of this review is the cooperative interaction of the maxillary and mandibular nerves in the TG by neuropeptides, and adenosine 3′-phosphate (ATP) signaling from neurons to SGCs and MLCs. Stimulated neurons either secrete ATP by means of vesicular nucleotide transporters, or secrete neuropeptides from the neuronal cell body to mediate signal transmission.
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Key Words
- ATP
- ATP, adenosine 3′-phosphate
- CGRP, calcitonin-gene-related peptide
- DRG, dorsal root ganglion
- MLC, microglia/macrophage-like cell
- Neuron
- Neuropeptides
- PACAP, pituitary adenylate-cyclase-activating polypeptide receptor type 1
- SGC, satellite glial cell
- SP, substance P
- Satellite glial cell
- TG, trigeminal ganglion
- Trigeminal ganglion
- VIP, vasoactive intestinal peptide
- VNUT, vesicular nucleotide transporter
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Affiliation(s)
- Tetsuya Goto
- Department of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Haruki Iwai
- Department of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Eriko Kuramoto
- Department of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Atsushi Yamanaka
- Department of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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Abstract
Many animal models of migraine have been described. Some of them have been useful in the development of new therapies. All of them have their shortcomings. Animal models of chronic migraine have been relatively less frequently described. Whether a rigid distinction between episodic and chronic migraine is useful when their underlying pathophysiology is likely to be the same and that migraine frequency probably depends on complex polygenic influences remains to be determined. Any model of chronic migraine must reflect the chronicity of the disorder and be reliable and validated with pharmacological interventions. Future animal models of chronic migraine are likely to involve recurrent activation of the trigeminal nociceptive system. Valid models would provide a means for investigating pathophysiological mechanism of the transformation from episodic to chronic migraine and may also be used to test the efficacy of potential preventive medications.
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Abstract
OPINION STATEMENT The shift in our understanding of migraine as a vascular disorder to a brain disorder has opened new avenues for the development of novel therapeutics with neural targets. The advent of 5-HT1B/1D receptor agonists, the triptans, in the 1990s was a crucial step in the modern evolution of treatment. The use of triptans, like their predecessors, is limited by their vasoconstrictor effects, and new development has been slowed by poor academic research funding to identify new targets. The development of agents without vascular effects, such as calcitonin gene-related peptide receptor antagonists and selective serotonin 5-HT1F receptor agonists, will bring more effective treatments to a population currently without migraine-specific options. In addition, advances in understanding migraine pathophysiology have identified new potential pharmacologic targets such as acid-sensing ion channels, glutamate and orexin receptors, nitric oxide synthase (NOS), and transient receptor potential (TRP) channels. Although previous attempts to block subtypes of glutamate receptors, NOS, and TRP channels have had mixed outcomes, new molecules for the same targets are currently under investigation. Finally, an entirely new approach to migraine treatment with noninvasive neuromodulation via transcutaneous neurostimulation or transcranial magnetic stimulation is just beginning. Hopefully in the coming years we will see a new era of migraine therapy, with multiple classes of better-tolerated, more effective agents targeting diverse yet specific migraine mechanisms.
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Affiliation(s)
- Amy R Tso
- Headache Group, Department of Neurology, University of California San Francisco, 2330 Post Street, 6th floor, San Francisco, CA, 94115, USA,
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Capuano A, Greco MC, Navarra P, Tringali G. Correlation between algogenic effects of calcitonin-gene-related peptide (CGRP) and activation of trigeminal vascular system, in an in vivo experimental model of nitroglycerin-induced sensitization. Eur J Pharmacol 2014; 740:97-102. [PMID: 24998872 DOI: 10.1016/j.ejphar.2014.06.046] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/23/2014] [Accepted: 06/25/2014] [Indexed: 01/03/2023]
Abstract
The neural mechanism(s) underlying migraine remain poorly defined at present; preclinical and clinical studies show an involvement of CGRP in this disorder. However current evidence pointed out that CGRP does not exert an algogenic action per se, but it is able to mediate migraine pain only if the trigeminal-vascular system is sensitized. The present study was addressed to investigate CGRP-evoked behavior in nitric oxide (NO) sensitized rats, using an experimental model of nitroglycerin induced sensitization of trigeminal system, looking at neuropeptide release from different cerebral areas after the intra-peritoneal (i.p.) administration of NO-donors. CGRP injected into the rat whisker pad did not induce significant changes in face rubbing behavior compared to controls. On the contrary, CGRP injected in animals pre-treated with 10mg/kg nitroglycerin significantly increased the time spent in face rubbing. Nitroglycerin pre-treated animals did not show any rubbing behavior after locally injected saline. Furthermore, the i.p. treatment with nitroglycerin produced an increase of CGRP levels in brainstem and trigeminal ganglia, but not in the hypothalamus and hippocampus. The absolute amounts of CGRP produced in the brainstem were lower compared to those in the trigeminal ganglion; however, after nitroglycerin stimulation the percentage increase was higher in the brainstem. In conclusion, findings presented in this study suggest that CGRP induces a painful behavior in rats only after sensitization of trigeminal system; thus supporting the concept that a genetic as well as acquired predisposition to trigemino- vascular activation represents the neurobiological basis of CGRP nociceptive effects in migraineurs.
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Affiliation(s)
- Alessandro Capuano
- Division of Neurology, Bambino Gesù Children׳s Hospital, IRCCS, Rome, Italy.
| | | | - Pierluigi Navarra
- Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy.
| | - Giuseppe Tringali
- Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy.
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Sun-Edelstein C, Mauskop A. Role of magnesium in the pathogenesis and treatment of migraine. Expert Rev Neurother 2014; 9:369-79. [DOI: 10.1586/14737175.9.3.369] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kaiser EA, Russo AF. CGRP and migraine: could PACAP play a role too? Neuropeptides 2013; 47:451-61. [PMID: 24210136 PMCID: PMC3859433 DOI: 10.1016/j.npep.2013.10.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 09/27/2013] [Accepted: 10/09/2013] [Indexed: 11/24/2022]
Abstract
Migraine is a debilitating neurological disorder that affects about 12% of the population. In the past decade, the role of the neuropeptide calcitonin gene-related peptide (CGRP) in migraine has been firmly established by clinical studies. CGRP administration can trigger migraines, and CGRP receptor antagonists ameliorate migraine. In this review, we will describe multifunctional activities of CGRP that could potentially contribute to migraine. These include roles in light aversion, neurogenic inflammation, peripheral and central sensitization of nociceptive pathways, cortical spreading depression, and regulation of nitric oxide production. Yet clearly there will be many other contributing genes that could act in concert with CGRP. One candidate is pituitary adenylate cyclase-activating peptide (PACAP), which shares some of the same actions as CGRP, including the ability to induce migraine in migraineurs and light aversive behavior in rodents. Interestingly, both CGRP and PACAP act on receptors that share an accessory subunit called receptor activity modifying protein-1 (RAMP1). Thus, comparisons between the actions of these two migraine-inducing neuropeptides, CGRP and PACAP, may provide new insights into migraine pathophysiology.
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Affiliation(s)
- Eric A. Kaiser
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA 52242
| | - Andrew F. Russo
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA 52242
- Department of Neurology, University of Iowa, Iowa City, IA 52242
- Veterans Affairs Medical Center, Iowa City, IA 52246
- Corresponding Author: Andrew F. Russo, University of Iowa, Department of Molecular Physiology and Biophysics, 5-432 BSB, 51 Newton Rd, Iowa City, IA 52242; Tel (319) 335-7872; Fax (319) 335-7330;
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Mauskop A, Varughese J. Why all migraine patients should be treated with magnesium. J Neural Transm (Vienna) 2012; 119:575-9. [DOI: 10.1007/s00702-012-0790-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 03/03/2012] [Indexed: 10/28/2022]
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De Corato A, Lisi L, Capuano A, Tringali G, Tramutola A, Navarra P, Dello Russo C. Trigeminal satellite cells express functional calcitonin gene-related peptide receptors, whose activation enhances interleukin-1β pro-inflammatory effects. J Neuroimmunol 2011; 237:39-46. [PMID: 21719118 DOI: 10.1016/j.jneuroim.2011.05.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 12/12/2022]
Abstract
Calcitonin gene-related peptide (CGRP) is the main mediator of trigeminal pain signal. Functional CGRP receptors were detected in trigeminal satellite cells, a specialized type of glia found within the sensory ganglia. CGRP displayed modest pro-inflammatory effects per se on trigeminal satellite cells, while it significantly enhanced IL-1β actions, increasing the expression and activity of cycloxygenase 2 as well as the expression of the inducible form of nitric oxide synthase and IL-1β. CGRP effects were reverted by a specific CGRP receptor antagonist and mimicked by elevation of intracellular cAMP levels. CGRP exerted also minor proinflammatory effects on cortical astrocytes.
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Affiliation(s)
- Alice De Corato
- Institute of Pharmacology, Catholic University Medical School, L.go F Vito 1, Rome, Italy
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Potential mechanisms of prospective antimigraine drugs: A focus on vascular (side) effects. Pharmacol Ther 2011; 129:332-51. [DOI: 10.1016/j.pharmthera.2010.12.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 11/09/2010] [Indexed: 12/13/2022]
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Bagdy G, Riba P, Kecskeméti V, Chase D, Juhász G. Headache-type adverse effects of NO donors: vasodilation and beyond. Br J Pharmacol 2010; 160:20-35. [PMID: 20331608 DOI: 10.1111/j.1476-5381.2010.00643.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Although nitrate therapy, used in the treatment of cardiovascular disorders, is frequently associated with side-effects, mainly headaches, the summaries of product characteristics of nitrate-containing medicines do not report detailed description of headaches and even do not highlight the possibility of nitrate-induced migraine. Two different types of nitrate-induced headaches have been described: (i) immediate headaches that develop within the first hour of the application, are mild or medium severity without characteristic symptoms for migraine, and ease spontaneously; and (ii) delayed, moderate or severe migraine-type headaches (occurring mainly in subjects with personal or family history of migraine), that develop 3-6 h after the intake of nitrates, with debilitating, long-lasting symptoms including nausea, vomiting, photo- and/or phono-phobia. These two types of headaches are remarkably different, not only in their timing and symptoms, but also in the persons who are at risk. Recent studies provide evidence that the two headache types are caused by different mechanisms: immediate headaches are connected to vasodilation caused by nitric oxide (NO) release, while migraines are triggered by other actions such as the release of calcitonin gene-related peptide or glutamate, or changes in ion channel function mediated by cyclic guanosine monophosphate or S-nitrosylation. Migraines usually need anti-attack medication, such as triptans, but these drugs are contraindicated in most medical conditions that are treated using nitrates. In conclusion, these data recommend the correction of summaries of nitrate product characteristics, and also suggest a need to develop new types of anti-migraine drugs, effective in migraine attacks, that could be used in patients with risk for angina pectoris.
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Affiliation(s)
- G Bagdy
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.
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Abstract
In the US, it is estimated that up to 10% of men and 25% of women, particularly those aged 25-55 years, experience debilitating migraines, such that the condition presents an enormous economic burden for patients, health systems, employers and society. Migraine headache is a particularly prevalent condition associated with major reductions in patients' quality of life. From a payer perspective, the implementation of relevant programmes of migraine prophylaxis is highly desirable. Consistent evidence exists, from several randomized, controlled studies, of the efficacy of amitriptyline, divalproex sodium, propranolol, timolol and topiramate in migraine prophylaxis. Considering resource utilization, various studies suggest that migraine prophylaxis with antiepileptics, antidepressants, beta-blockers or calcium channel antagonists markedly reduces triptan use and visits to physician offices and emergency departments (EDs), without compromising quality of care or treatment outcomes. Over recent years, the effects of topiramate in reducing resource utilization in patients with migraine have been relatively widely studied. In US claims database analyses involving >4000 patients with migraine, topiramate significantly reduced triptan use by up to 20% in the 12-month period after starting treatment. Reductions were also noted in the numbers of ED visits, diagnostic procedures, hospital admissions and migraine-related hospitalization days. These long-term benefits of topiramate manifested without any increase in overall headache-related costs. Furthermore, in detailed modelling analyses based on UK and US data, topiramate-induced savings in acute medical services were estimated to offset about one-quarter of the monthly per patient cost of the topiramate regimen, which was shown to be a dominant cost-effective intervention relative to no preventive therapy: cost-effectiveness ratios were calculated as pound 5728 per quality-adjusted life-year (QALY) [2005 costings] and $US10 888 per QALY (2002 costings), respectively. Overall, there is a need to improve quality of care in migraine, and prophylactic therapy appears to be an effective option, particularly with respect to decreasing resource use and improving productivity. For both health-plan payers and employers, topiramate appears to be a cost-effective intervention for preventing migraine.
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Affiliation(s)
- Miguel J A Láinez
- Department of Neurology, Hospital Clínico Universitario, Universidad de Valencia, 46010 Valencia, Spain.
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Abstract
Migraine is a complex neurological disorder that in recent years has received more and more attention. Knowledge regarding this primary headache has increased substantially, both with respect to its pathogenesis and how to effectively treat its symptoms. Over the years, the proposed location of the onset of migraine has moved from the periphery of the nervous system toward deeper parts of the brain. Migraine can be viewed as an inherited failure of trigeminal sensory processing with abnormal neuronal excitability in the trigeminal nucleus caudalis, which, in turn, causes central sensitization and amplification of the pain. Increased activation of the trigeminal nerve during a migraine attack causes release of the calcitonin gene-related peptide (CGRP) inside and outside the BBB. Within the CNS, CGRP promotes trigeminal sensory input and facilitates central sensitization. The future introduction of CGRP antagonists in clinical practice could represent significant progress for acute migraine therapy.
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Affiliation(s)
- Carl Dahlöf
- Professor of Neurology, Institute of Neuroscience & Physiology, Sahlgrenska University Hospital, Medical Director & Founder of Gothenburg Migraine Clinic, Gothenburg Migraine Clinic, c/o Läkarhuset, Södra vägen 27, S-411 35 Gothenburg, Sweden
| | - Hans-Christoph Diener
- Professor of Neurology, Department of Neurology, University Duisburg-Essen, Essen, Germany
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García ML, Baos V, Láinez M, Pascual J, López-Gil A. Responsiveness of Migraine-ACT and MIDAS Questionnaires for Assessing Migraine Therapy. Headache 2008; 48:1349-55. [DOI: 10.1111/j.1526-4610.2007.01026.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Park KY, Russo AF. Control of the Calcitonin Gene-related Peptide Enhancer by Upstream Stimulatory Factor in Trigeminal Ganglion Neurons. J Biol Chem 2008; 283:5441-51. [DOI: 10.1074/jbc.m708662200] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Johnson MP, Fernandez F, Colson NJ, Griffiths LR. A pharmacogenomic evaluation of migraine therapy. Expert Opin Pharmacother 2007; 8:1821-35. [PMID: 17696786 DOI: 10.1517/14656566.8.12.1821] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Migraine is a common idiopathic primary headache disorder with significant mental, physical and social health implications. Accompanying an intense unilateral pulsating head pain other characteristic migraine symptoms include nausea, emesis, phonophobia, photophobia and in approximately 20-30% of migraine cases, neurologic disturbances associated with the aura phase. Although selective serotonin (5-HT) receptor agonists (i.e., 5-HT(1B/1D)) are successful in alleviating migrainous symptoms in < or = 70% of known sufferers, for the remaining 30%, additional migraine abortive medications remain unsuccessful, not tested or yet to be identified. Genetic characterization of the migrainous disorder is making steady progress with an increasing number of genomic susceptibility loci now identified on chromosomes 1q, 4q, 5q, 6p, 11q, 14q, 15q, 17p, 18q, 19p and Xq. The 4q, 5q, 17p and 18q loci involve endophenotypic susceptibility regions for various migrainous symptoms. In an effort to develop individualized pharmacotherapeutics, the identification of these migraine endophenotypic loci may well be the catalyst needed to aid in this goal. In this review the authors discuss the present treatment of migraine, known genomic susceptibility regions and results from migraine (genetic) association studies. The authors also discuss pharmacogenomic considerations for more individualized migraine prophylactic treatments.
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Affiliation(s)
- Matthew P Johnson
- Griffith University, Genomics Research Centre, School of Medical Science, PMB 50 GCMC Gold Coast, Queensland, Australia
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Westaway SM. The potential of transient receptor potential vanilloid type 1 channel modulators for the treatment of pain. J Med Chem 2007; 50:2589-96. [PMID: 17489570 DOI: 10.1021/jm060637e] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Susan M Westaway
- Neurology & GI CEDD, GlaxoSmithKline, New Frontiers Science Park, Harlow, Essex, CM19 5AW, UK.
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Zhang Z, Winborn CS, Marquez de Prado B, Russo AF. Sensitization of calcitonin gene-related peptide receptors by receptor activity-modifying protein-1 in the trigeminal ganglion. J Neurosci 2007; 27:2693-703. [PMID: 17344407 PMCID: PMC6672495 DOI: 10.1523/jneurosci.4542-06.2007] [Citation(s) in RCA: 186] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The neuropeptide calcitonin gene-related peptide (CGRP) from the trigeminal ganglion has been established as a key player in the pathogenesis of migraine. In this study, we provide evidence that the responsiveness of neuronal CGRP receptors is strongly enhanced in vitro and in vivo by expression of human receptor activity-modifying protein-1 (hRAMP1), an obligatory subunit of the CGRP receptor. We first demonstrated that activation of CGRP receptors on cultured trigeminal ganglion neurons increased endogenous CGRP mRNA levels and promoter activity. The promoter activation was cAMP dependent and blocked by the antagonist BIBN4096BS [1-piperidinecarboxamide, N-[2-[[5-amino-l-[[4-(4-pyridinyl)-l-piperazinyl]carbonyl]pentyl]amino]-1-[(3,5-dibromo-4-hydroxyphenyl)methyl]-2-oxoethyl]-4-(1,4-dihydro-2-oxo-3(2H)-quinazolinyl)], a new antimigraine drug. Gene transfer using an adenoviral hRAMP1 expression vector increased the maximal production of cAMP by 1.8 +/- 0.2-fold and decreased the EC50 to 2.3 +/- 0.8 nM from 9.0 +/- 5.9 nM and 15.6 +/- 5.2 nM in uninfected and control-infected cultures, respectively. To establish whether RAMP1 is limiting in vivo as indicated from the culture studies, a transgenic mouse expressing hRAMP1 in the nervous system was generated. After CGRP injection into the whiskerpad, the hRAMP1 transgenic mice displayed 2.2 +/- 0.2-fold greater plasma extravasation, which is a measure of neurogenic inflammation. These results demonstrate that RAMP1 is functionally rate limiting for CGRP receptor activity in the trigeminal ganglion, which raises the possibility that elevated RAMP1 might sensitize some individuals to CGRP actions in migraine.
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Affiliation(s)
| | | | | | - Andrew F. Russo
- Department of Molecular Physiology and Biophysics, and
- Genetics Program, University of Iowa, Iowa City, Iowa 52242
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Hunter G, Téllez-Zenteno JF. Treatment of migraine in the emergency department. Drug Dev Res 2007. [DOI: 10.1002/ddr.20202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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