Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine

Abstract

Targeting calcitonin gene-related peptide (CGRP) and its receptor by antibodies and antagonists was a breakthrough in migraine prevention and treatment. However, not all migraine patients respond to CGRP-based therapy and a fraction of those who respond complain of aliments mainly in the gastrointestinal tract. In addition, CGRP and migraine are associated with obesity and metabolic diseases, including diabetes. Therefore, CGRP may play an important role in the functioning of the gut-brain-microflora axis. CGRP secretion may be modulated by dietary compounds associated with the disruption of calcium signaling and upregulation of mitogen-activated kinase phosphatases 1 and 3. CGRP may display anorexigenic properties through induction of anorexigenic neuropeptides, such as cholecystokinin and/or inhibit orexigenic neuropeptides, such as neuropeptide Y and melanin-concentrating hormone CH, resulting in the suppression of food intake, functionally coupled to the activation of the hypothalamic 3′,5′-cyclic adenosine monophosphate. The anorexigenic action of CGRP observed in animal studies may reflect its general potential to control appetite/satiety or general food intake. Therefore, dietary nutrients may modulate CGRP, and CGRP may modulate their intake. Therefore, anti-CGRP therapy should consider this mutual dependence to increase the efficacy of the therapy and reduce its unwanted side effects. This narrative review presents information on molecular aspects of the interaction between dietary nutrients and CGRP and their reported and prospective use to improve anti-CGRP therapy in migraine.

Assessment of Some Biometrics and Biochemical Parameters in Migraine Patients

“…Raffaelli, et al, (2023) note that female in reproductive age have significant high level of CGRP (25). This peptide correlated with female hormones (26). It is active vasodilator, trigger for migraine attack and stimulated during it.…”

“…The problem of this disease is lack of laboratory or other test, but it is diagnosed according to patient condition (7). The prevalence of migraine is 14% globally (1), (2.6-32) % in Arabic region (8) and 44% of Iraqi women (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) year's age in Sulaimania province (9). It prevalent in women more than men, and varies according to race (10).…”

Migraine Comorbidities

“…It is evidence that dietary compounds may modulate CGRP secretion. CGRP also may suppress food intake via induction of anorexigenic neuropeptides, such as cholecystokinin, or inhibiting orexigenic neuropeptides, such as neuropeptide Y [96].…”

Diet and migraine: what is proven?

“…Nutritional research in migraine is expected to continue considering a mechanism-based approach, similar to what is seen for pharmacological strategies. For instance, it has been proposed that dietary nutrients may alter the level and function of CGRP, and CGRP may influence food intake [80]. Therapeutic nutritional recommendations are expected to be adjusted to patient needs, for example, for children, adolescents [81], pregnant or nursing women, and geriatrics with migraine [82].…”