title: Emerging targets in migraine.
abstract: Migraine is a common and highly disabling neurological disorder. Despite the complexity of its pathophysiology, substantial advances have been achieved over the past 20 years in its understanding, as well as the development of pharmacological treatment options. The development of serotonin 5-HT(1B/1D) receptor agonists ("triptans") substantially improved the acute treatment of migraine attacks. However, many migraineurs do not respond satisfactorily to triptans and cardiovascular co-morbidities limit their use in a significant number of patients. As migraine is increasingly considered to be a disorder of the brain, and preclinical and clinical data indicate that the observed vasodilation is merely an epiphenomenon, research has recently focused on the development of neurally acting compounds that lack vasoconstrictor properties. This review highlights the most important pharmacological targets for which compounds have been developed that are highly likely to enter or have already advanced into clinical trials for the acute and preventive treatment of migraine. In this context, preclinical and clinical data on compounds acting on calcitonin gene-related peptide or its receptor, the 5-HT(1F) receptor, nitric oxide synthase, and acid-sensing ion channel blockers are discussed.
authors: Headache Group, Department of Neurology, University of California, San Francisco, 1701 Divisadero St, San Francisco, CA, 94115, USA.
authors: Jan
authors: J
authors: Hoffmann
authors: Peter J
authors: PJ
authors: Goadsby
mesh_terms: D062646:Acid Sensing Ion Channel Blockers / Q000494:pharmacology; D000818:Animals; D015740:Calcitonin Gene-Related Peptide / Q000187:drug effects / Q000378:metabolism; D000077221:Calcitonin Gene-Related Peptide Receptor Antagonists; D015195:Drug Design; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D058990:Molecular Targeted Therapy; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D011985:Receptors, Serotonin / Q000187:drug effects / Q000378:metabolism; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use; D014363:Tryptamines / Q000627:therapeutic use; D000096642:Receptor, Serotonin, 5-HT1F
chemical_list: D062646:Acid Sensing Ion Channel Blockers; D015740:Calcitonin Gene-Related Peptide; D000077221:Calcitonin Gene-Related Peptide Receptor Antagonists; D019001:Nitric Oxide Synthase; D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; D000096642:Receptor, Serotonin, 5-HT1F