Chemical Mediators of Migraine: Preclinical and Clinical Observations

Authors

  • Saurabh Gupta PhD,

    1. From Glostrup Research Institute, Glostrup Hospital, Faculty of Health Science, University of Copenhagen, Glostrup, Denmark (S. Gupta); Thomas Jefferson University, Philadelphia, PA, USA (S.J. Nahas); Johns Hopkins University, Bayview, Baltimore, MD, USA (B.L. Peterlin).
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  • Stephanie J. Nahas MD,

    1. From Glostrup Research Institute, Glostrup Hospital, Faculty of Health Science, University of Copenhagen, Glostrup, Denmark (S. Gupta); Thomas Jefferson University, Philadelphia, PA, USA (S.J. Nahas); Johns Hopkins University, Bayview, Baltimore, MD, USA (B.L. Peterlin).
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  • B. Lee Peterlin DO

    1. From Glostrup Research Institute, Glostrup Hospital, Faculty of Health Science, University of Copenhagen, Glostrup, Denmark (S. Gupta); Thomas Jefferson University, Philadelphia, PA, USA (S.J. Nahas); Johns Hopkins University, Bayview, Baltimore, MD, USA (B.L. Peterlin).
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  • Conflict of Interest: None

S. Gupta, Danish Headache Center, Department of Neurology, Glostrup Hospital, Faculty of Health Science, University of Copenhagen, DK-2600 Glostrup, Denmark. Email: SAUGUP01@glo.regionh.dk

Abstract

Migraine is a neurovascular disorder, and although the pathophysiology of migraine has not been fully delineated, much has been learned in the past 50 years. This knowledge has been accompanied by significant advancements in the way migraine is viewed as a disease process and in the development therapeutic options. In this review, we will focus on 4 mediators (nitric oxide, histamine, serotonin, and calcitonin gene-related peptide) which have significantly advanced our understanding of migraine as a disease entity. For each mediator we begin by reviewing the preclinical data linking it to migraine pathophysiology, first focusing on the vascular mechanisms, then the neuronal mechanisms. The preclinical data are then followed by a review of the clinical data which support each mediator's role in migraine and highlights the pharmacological agents which target these mediators for migraine therapy.

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