偏头痛与CGRP、5-HT、ET-1的研究进展

Research progress on the correlation between migraine and CGRP,5-HT as well as ET-1

偏头痛是一种神经系统疾病,主要表现为与感觉改变有关的虚弱性头痛。迄今为止,已有的临床前和临床研究表明偏头痛与降钙素原基因相关肽(CGRP)、五羟色胺(5-HT)、内皮素-1(ET-1)关系密切。CGRP、5-HT、ET-1通过体内不同的受体或者在体内的浓度改变发挥其对中枢血管的调节作用,介导偏头痛的病理生理机制。CGRP通过神经血管途径产生强大的血管收缩作用;5-HT有可能因其在体内浓度的不同,对血管影响也随之改变;ET-1通过不同的受体,发挥其血管收缩作用。本文旨在探讨偏头痛与CGRP、5-HT、ET-1的直接和间接证据,阐述它们之间的相互作用关系。并对CGRP相关药物研究现状,临床治疗效果进行总结,以及曲普坦类药物治疗偏头痛的不足之处。特别是对刚通过美国FDA认证用于治疗偏头痛新药利米地坦进行详细报道,为偏头痛患者用药提供新的选择。

Migraine is a kind of nervous system disease,mainly manifested as feeble headache related to sensory change.So far,the preclinical and clinical studies have showed that migraine is closely related to CGRP(procalcitonin gene-related peptide),5-HT(serotonin),ET-1(endothelin-1).CGRP,5-HT and ET-1,which play a role in regulating central blood vessels through different receptors or concentration changes in vivo,and mediate the pathophysiological mechanism of migraine.CGRP has a strong vasoconstrictive effect through neurovascular pathway;5-HT may change its effect on blood vessels due to its different concentration in vivo;ET-1 plays a vasoconstrictive role through different receptors.This article is aimed to explore the direct and indirect evidence of migraine and CGRP,5-HT,ET-1,and to elucidate the interaction between them.In addition,the research current situation about CGRP related drug and clinical curative effects are summarized,as well as the shortcomings of tripotan in treatment of migraine.Especially,the new drug-rimitidine,which has just passed the FDA certification in the United States,is reported in detail to provide an new choice of drug administration for patients with migraine.