Plasma levels of VIP are not elevated during PACAP- and VIP-induced cluster headache attacks: an exploratory study

Deligianni, Christina; Pellesi, Lanfranco; Chaudhry, Basit Ali; Vollesen, Anne Luise Haulund; Snoer, Agneta; Hannibal, Jens; Jensen, Rigmor Højland; Ashina, Messoud

doi:10.3389/fneur.2023.1135246

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…PACAP38 can also trigger migraine‐like attacks, 134 cluster headache attacks, 102,135 and premonitory symptoms associated with migraine 107 when infused intravenously into patients with migraine, cluster headache in bout or chronic cluster headache. PACAP38 triggers migraine when infused more readily than VIP in a double‐blind crossover head‐to‐head study (73% vs. 18%) 136 .…”

Section: Pacap38—clinical Evidence In Migraine and Cluster Headachementioning

confidence: 99%

Pituitary cyclase‐activating polypeptide targeted treatments for the treatment of primary headache disorders

Karsan,

Edvinsson,

Vecsei

et al. 2024

Ann Clin Transl Neurol

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ObjectiveMigraine is a complex and disabling neurological disorder. Recent years have witnessed the development and emergence of novel treatments for the condition, namely those targeting calcitonin gene‐related peptide (CGRP). However, there remains a substantial need for further treatments for those unresponsive to current therapies. Targeting pituitary adenylate cyclase‐activating polypeptide (PACAP) as a possible therapeutic strategy in the primary headache disorders has gained interest over recent years.MethodsThis review will summarize what we know about PACAP to date: its expression, receptors, roles in migraine and cluster headache biology, insights gained from preclinical and clinical models of migraine, and therapeutic scope.ResultsPACAP shares homology with vasoactive intestinal polypeptide (VIP) and is one of several vasoactive neuropeptides along with CGRP and VIP, which has been implicated in migraine neurobiology. PACAP is widely expressed in areas of interest in migraine pathophysiology, such as the thalamus, trigeminal nucleus caudalis, and sphenopalatine ganglion. Preclinical evidence suggests a role for PACAP in trigeminovascular sensitization, while clinical evidence shows ictal release of PACAP in migraine and intravenous infusion of PACAP triggering attacks in susceptible individuals. PACAP leads to dural vasodilatation and secondary central phenomena via its binding to different G‐protein‐coupled receptors, and intracellular downstream effects through cyclic adenosine monophosphate (cAMP) and phosphokinase C (PKC). Targeting PACAP as a therapeutic strategy in headache has been explored using monoclonal antibodies developed against PACAP and against the PAC1 receptor, with initial positive results.InterpretationFuture clinical trials hold considerable promise for a new therapeutic approach using PACAP‐targeted therapies in both migraine and cluster headache.

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Section: Pacap38—clinical Evidence In Migraine and Cluster Headachementioning

confidence: 99%

Pituitary cyclase‐activating polypeptide targeted treatments for the treatment of primary headache disorders

Karsan,

Edvinsson,

Vecsei

et al. 2024

Ann Clin Transl Neurol

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Cluster headache: understandings of current knowledge and directions for whole process management

Xu,

Li,

Ren

et al. 2024

Front. Neurol.

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Cluster headache (CH) is a common primary headache that severely impacts patients’ quality of life, characterized by recurrent, severe, unilateral headaches often centered around the eyes, temples, or forehead. Distinguishing CH from other headache disorders is challenging, and its pathogenesis remains unclear. Notably, patients with CH often experience high levels of depression and suicidal tendencies, necessitating increased clinical attention. This comprehensive assessment combines various reports and the latest scientific literature to evaluate the current state of CH research. It covers epidemiology, population characteristics, predisposing factors, and treatment strategies. Additionally, we provide strategic insights into the holistic management of CH, which involves continuous, individualized care throughout the prevention, treatment, and rehabilitation stages. Recent advances in the field have revealed new insights into the pathophysiology of CH. While these findings are still evolving, they offer a more detailed understanding of the neurobiological mechanisms underlying this disorder. This growing body of knowledge, alongside ongoing research efforts, promises to lead to the development of more targeted and effective treatments in the future.

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Plasma levels of VIP are not elevated during PACAP- and VIP-induced cluster headache attacks: an exploratory study

Cited by 2 publications

References 14 publications

Pituitary cyclase‐activating polypeptide targeted treatments for the treatment of primary headache disorders

Pituitary cyclase‐activating polypeptide targeted treatments for the treatment of primary headache disorders

Cluster headache: understandings of current knowledge and directions for whole process management

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