Biological and small molecule strategies in migraine therapy with
relation to the CGRP family of peptides.
Abstract
Migraine is one of the most common of neurological disorders with a
global prevalence of up to 15%. One in five migraineurs have frequent
episodic or chronic migraine requiring prophylactic treatment. In recent
years, specific pharmaceutical treatments targeting calcitonin
gene-related peptide (CGRP) signalling molecules have provided safe and
effective treatments; monoclonal antibodies for prophylaxis and gepants
for acute therapy. Albeit the beneficious impact of these new drugs, it
is important to understand the molecular mechanisms involved to better
understand migraine pathophysiology and improve the therapy. Here we
describe current views on the role of the CGRP family of peptides CGRP,
calcitonin (CT), adrenomedullin (AM), amylin (AMY) and their receptors
in the trigeminovascular system (TGV). All these molecules are present
within the TGV system but differ in expression and localization. It is
likely that they have different roles, which can be utilized in
providing additional drug targets.