Migraine and calcitonin gene-related peptide pathway antibodies: a treatment route in tertiary care

2019 ◽  
Vol 15 (5) ◽  
pp. 212-215
Author(s):  
Ria Bhola ◽  
Juel Tuazon
Keyword(s):  
Tertiary Care ◽  
Calcitonin Gene Related Peptide ◽  
Patient Treatment ◽  
Treatment Pathway ◽  
Related Peptide ◽  
Early Adoption ◽  
Calcitonin Gene ◽  
Potent Vasodilator ◽  
Migraine Pathophysiology ◽  
New Treatment

Inhibiting the calcitonin gene-related peptide (CGRP) pathway is a new treatment to prevent migraines. CGRP is a potent vasodilator and is a key neuropeptide which plays a crucial role in migraine pathophysiology. Following the European Medicines Agency's approval of three CGRP pathway monoclonal antibodies (mAbs), erenumab, fremanezumab and galcanezumab, the authors proceeded with early adoption in practice. Here they summarise and share their patient treatment pathway using erenumab, the first mAb to become clinically available.

scholarly journals Role of Calcitonin Gene Related Peptide (CGRP) in Migraine

2017 ◽  
Vol 33 (1) ◽  
pp. 39-43
Author(s):  
Md Ashraf Ali ◽  
Habibur Rahaman
Keyword(s):  
Family Relationships ◽  
Preventive Treatment ◽  
Primary Headache ◽  
Calcitonin Gene Related Peptide ◽  
Childhood And Adolescence ◽  
Protein Extravasation ◽  
Related Peptide ◽  
Plasma Protein Extravasation ◽  
Calcitonin Gene ◽  
Potent Vasodilator

Migraine is the second most primary headache. The prevalence of Migraine is 12% in the general population, including 18% in women and 6% in men. Migraine can start in childhood and adolescence and continue throughout lifespan. It is most prevalent among people in their 30s and 40s. Migraine is a debilitating hemicranial headache that is pulsating, aggravated by movement, nausea, vomiting and having sensitivity to light and sound, with or without aura. It can affect all aspects of life as work and school, parenting and family relationships and personal and leisure time. There are some theory regarding pathogenesis of migraine which includes cortical spreading depression, cortical spreading oligemia, activation of trigeminocervical complex leading to neuroinflammation & release of vasodialating neuropeptides which include calcitonin gene related peptide (CGRP), substance P, vasoactive intestinal polypeptide (VIP), nitric oxide (NO), and pituitary adenylate cyclase activating peptide (PACAP) & genetic factor. CGRP is a potent vasodilator and causes perivascular plasma protein extravasation and nociceptive pain. Newer medications target CGRP both for acute and preventive treatment of migraine. Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 39-43

Calcitonin gene-related peptide and its role in migraine pathophysiology

2004 ◽  
Vol 500 (1-3) ◽  
pp. 315-330 ◽  
Author(s):  
Udayasankar Arulmani ◽  
Antoinette MaassenVanDenBrink ◽  
Carlos M. Villalón ◽  
Pramod R. Saxena
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Migraine Pathophysiology

The origin of circulating calcitonin gene-related peptide in the rat

1986 ◽  
Vol 110 (1) ◽  
pp. 185-190 ◽  
Author(s):  
M. Zaidi ◽  
P. J. R. Bevis ◽  
G. Abeyasekera ◽  
S. I. Girgis ◽  
S. J. Wimalawansa ◽  
...  
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Potent Vasodilator ◽  
Perivascular Nerves ◽  
Old Rats ◽  
Different Sources

ABSTRACT It is known that in addition to the calcitonin precursor the calcitonin gene also encodes a novel peptide, calcitonin gene-related peptide (CGRP). This potent vasodilator has been found in the circulation of man. This present study demonstrates that CGRP is also found in the circulation of the rat and that plasma CGRP comes from two different sources: the thyroid, a major source in old rats, and the perivascular nerves probably at all ages. J. Endocr. (1986) 110, 185–190

Calcitonin gene-related peptide is a potent vasodilator

Nature ◽  
1985 ◽  
Vol 313 (5997) ◽  
pp. 54-56 ◽  
Author(s):  
S. D. Brain ◽  
T. J. Williams ◽  
J. R. Tippins ◽  
H. R. Morris ◽  
I. MacIntyre
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Potent Vasodilator

scholarly journals Calcitonin Gene-Related Peptide: Physiology and Pathophysiology

2014 ◽  
Vol 94 (4) ◽  
pp. 1099-1142 ◽  
Author(s):  
F. A. Russell ◽  
R. King ◽  
S.-J. Smillie ◽  
X. Kodji ◽  
S. D. Brain
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Sensory Nerves ◽  
Therapeutic Area ◽  
Protective Mechanisms ◽  
Related Peptide ◽  
Pain Pathways ◽  
Calcitonin Gene ◽  
Potent Vasodilator ◽  
Skin Conditions ◽  
Diabetes And Obesity

Calcitonin gene-related peptide (CGRP) is a 37-amino acid neuropeptide. Discovered 30 years ago, it is produced as a consequence of alternative RNA processing of the calcitonin gene. CGRP has two major forms (α and β). It belongs to a group of peptides that all act on an unusual receptor family. These receptors consist of calcitonin receptor-like receptor (CLR) linked to an essential receptor activity modifying protein (RAMP) that is necessary for full functionality. CGRP is a highly potent vasodilator and, partly as a consequence, possesses protective mechanisms that are important for physiological and pathological conditions involving the cardiovascular system and wound healing. CGRP is primarily released from sensory nerves and thus is implicated in pain pathways. The proven ability of CGRP antagonists to alleviate migraine has been of most interest in terms of drug development, and knowledge to date concerning this potential therapeutic area is discussed. Other areas covered, where there is less information known on CGRP, include arthritis, skin conditions, diabetes, and obesity. It is concluded that CGRP is an important peptide in mammalian biology, but it is too early at present to know if new medicines for disease treatment will emerge from our knowledge concerning this molecule.

CALCITONIN GENE-RELATED PEPTIDE: POTENT VASODILATOR AND MAJOR PRODUCT OF CALCITONIN GENE

The Lancet ◽  
1985 ◽  
Vol 326 (8445) ◽  
pp. 14-16 ◽  
Author(s):  
SamiaI. Girgis ◽  
JohnC. Stevenson ◽  
Catherine Lynch ◽  
ColinH. Self ◽  
DavidW.R. Macdonald ◽  
...  
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Major Product ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Potent Vasodilator

scholarly journals Fluorescent Analogues of Human α-Calcitonin Gene-Related Peptide with Potent Vasodilator Activity

2020 ◽  
Vol 21 (4) ◽  
pp. 1343 ◽  
Author(s):  
Jing Zhu ◽  
Mahdieh Dagina Pedersen ◽  
Laraib Sabbah Ahmed ◽  
Bahareh Abdolalizadeh ◽  
Anne-Sofie Grell ◽  
...  
Keyword(s):  
Solid Phase ◽  
Solid Phase Peptide Synthesis ◽  
Calcitonin Gene Related Peptide ◽  
Receptor Internalization ◽  
Cgrp Receptor ◽  
Nociceptive Transmission ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Potent Vasodilator ◽  
Fluorescent Analogues

Human α-calcitonin gene-related peptide (h-α-CGRP) is a highly potent vasodilator peptide that belongs to the family of calcitonin peptides. There are two forms of CGRP receptors in humans and rodents: α-CGRP receptor predominately found in the cardiovascular system and β-CGRP receptor predominating in the gastrointestinal tract. The CGRP receptors are primarily localized to C and Aδ sensory fibers, where they are involved in nociceptive transmission and migraine pathophysiology. These fibers are found both peripherally and centrally, with extensive perivascular location. The CGRP receptors belong to the class B G-protein-coupled receptors, and they are primarily associated to signaling via Gα proteins. The objectives of the present work were: (i) synthesis of three single-labelled fluorescent analogues of h-α-CGRP by 9-fluorenylmethyloxycarbonyl (Fmoc)-based solid-phase peptide synthesis, and (ii) testing of their biological activity in isolated human, mouse, and rat arteries by using a small-vessel myograph setup. The three analogues were labelled with 5(6)-carboxyfluorescein via the spacer 6-aminohexanoic acid at the chain of Lys24 or Lys35. Circular dichroism (CD) experiments were performed to obtain information on the secondary structure of these fluorescently labelled peptides. The CD spectra indicated that the folding of all three analogues was similar to that of native α-CGRP. The three fluorescent analogues of α-CGRP were successfully prepared with a purity of >95%. In comparison to α-CGRP, the three analogues exhibited similar efficacy, but different potency in producing a vasodilator effect. The analogue labelled at the N-terminus proved to be the most readily synthesized, but it was found to possess the lowest vasodilator potency. The analogues labelled at Lys35 or Lys24 exhibited an acceptable reduction in potency (i.e., 3–5 times and 5–10 times less potent, respectively), and thus they have potential for use in further investigations of receptor internalization and neuronal reuptake.

Development and performance of a highly sensitive carboxyl-terminal-specific radioimmunoassay of calcitonin gene-related peptide.

1988 ◽  
Vol 34 (4) ◽  
pp. 655-660 ◽  
Author(s):  
M Zaidi ◽  
S I Girgis ◽  
I MacIntyre
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Specific Radioimmunoassay ◽  
Calcitonin Gene ◽  
Highly Sensitive ◽  
Potent Vasodilator ◽  
High Concentrations ◽  
And Performance ◽  
Highly Sensitive Detection ◽  
Development And Validation

Abstract The calcitonin genes encode a small family of peptides: the circulating hormone calcitonin; its flanking peptide, katacalcin; and a third novel peptide, calcitonin gene-related peptide (CGRP). CGRP is a potent vasodilator and a major circulating product from the calcitonin genes; it may be a physiologically important regulator of blood flow in humans. High concentrations of circulating CGRP are found in medullary thyroid carcinoma. We report the development and validation of a highly sensitive (detection limit 500 amol per tube) radioimmunoassay of CGRP involving a high-affinity antibody directed against the carboxyl terminus of the molecule and a highly pure tracer. The assay is precise, robust, and reproducible, and is therefore a potentially useful analytical method for studying the normal and abnormal physiology of this peptide.

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