Drugs Against Calcitonin Gene-related Peptide and Its Receptor Used in the Treatment of Migraine: What Are the New Progresses?

Abstract

Migraine is a chronic headache disorder that its exact pathomechanism is not very well known but research in the last two decades indicates that it might be a brain disorder, a dismodulation of sensory processing of the brainstem responsible for regulation of vascular tone and the pain. Several neurotransmitters and neuromodulators including neuropeptides have been implicated in the pathomechanism of migraine, among them, Calcitonin gene-related peptide (CGRP) has been the focus of many studies in recent years. Increased CGRP level (perhaps due to release from peripheral and central sensory nerve endings) has been detected in the blood of migraine patients and many basic and clinical investigators in recent years have been trying to block the CGRP receptor by means of newly developed CGRP-receptor antagonist drugs or inhibit its activity by even newer compounds, the monoclonal Antibodies (mAbs) against CGRP or its receptor. These latter ones are still in clinical trials but have had promising results so far in alleviating the pain of migraine patients. This article will briefly review and discuss the role of CGRP and its receptor in migraine and some of the other biological activities of CGRP, the CGRP receptor antagonist drugs and the new progresses in mAbs against CGRP or its receptor.