摘要
背景:偏头痛是最致残的神经系统疾病之一,并伴有较高的社会经济成本。尽管偏头痛发病机制的某些方面仍未完全了解,但主要假说暗示了三叉神经血管系统激活的作用。 Triptans被认为是当前偏头痛发作的金标准疗法。但是,它们在临床实践中的使用受到限制。预防性治疗包括预防偏头痛的非特异性方法。所有这些都支持对未来研究的需求,以开发创新的抗偏头痛药物。 目的:本研究是对有关偏头痛研究中新疗法的最新文献的综述。 方法:在PUBMED数据库中进行了系统的文献检索,以探讨直至2017年7月发表的偏头痛的治疗策略。 结果:正在进行的5-HT1F受体激动剂和谷氨酸受体拮抗剂的临床试验为急性偏头痛治疗提供了有希望的新方面。抗CGRP和CGRP受体的单克隆抗体在预防性治疗方面具有革命性意义。但是,需要进一步的长期研究以测试其耐受性。临床前研究表明,PACAP和犬尿酸相关治疗取得了积极成果。其他有希望的治疗策略(例如针对TRPV1,P物质,NOS或orexin的治疗策略)在临床试验中未显示出疗效。 结论:由于其副作用,当前的治疗方法并不适合所有偏头痛患者。特别是频繁的发作性和慢性偏头痛代表了研究人员的治疗挑战。需要临床和临床前研究来阐明偏头痛的病理生理学,以便开发新的偏头痛特异性疗法。
关键词: 降钙素基因相关肽,5-HT1F受体激动剂,谷氨酸,垂体腺苷酸环化酶激活多肽,犬尿酸,三叉神经血管系统。
[http://dx.doi.org/10.1016/S0140-6736(12)61689-4] [PMID: 23245608]
[http://dx.doi.org/10.1093/brain/awt320] [PMID: 24277718]
[http://dx.doi.org/10.1001/archneurpsyc.1941.02280200137007]
[http://dx.doi.org/10.1080/00325481.2016.1175912] [PMID: 27078039]
[http://dx.doi.org/10.1177/0333102415593089] [PMID: 26156076]
[http://dx.doi.org/10.1016/S1474-4422(11)70048-5] [PMID: 21458376]
[http://dx.doi.org/10.1177/0333102413485658] [PMID: 23771276]
[http://dx.doi.org/10.1046/j.1468-2982.1991.1105229.x] [PMID: 1773437]
[http://dx.doi.org/10.1212/WNL.0000000000002789] [PMID: 27335112]
[http://dx.doi.org/10.1177/0333102411398152] [PMID: 21335366]
[http://dx.doi.org/10.1111/j.1468-2982.2008.01829.x] [PMID: 19250290]
[http://dx.doi.org/10.1007/BF00237586] [PMID: 3007190]
[http://dx.doi.org/10.1016/0306-4522(93)90264-G] [PMID: 7687754]
[http://dx.doi.org/10.1016/j.pain.2011.11.029] [PMID: 22244439]
[http://dx.doi.org/10.1016/S1474-4422(13)70067-X] [PMID: 23578775]
[http://dx.doi.org/10.1016/j.npep.2015.03.006] [PMID: 26094101]
[http://dx.doi.org/10.1038/nrn3617] [PMID: 24281245]
[http://dx.doi.org/10.1038/nn.3144] [PMID: 22837035]
[http://dx.doi.org/10.1016/j.pain.2013.07.021] [PMID: 23891892]
[http://dx.doi.org/10.1523/JNEUROSCI.0511-10.2010] [PMID: 20592202]
[http://dx.doi.org/10.1046/j.1468-2982.2002.00404.x] [PMID: 12383060]
[http://dx.doi.org/10.1046/j.1468-2982.1999.019006581.x] [PMID: 10448545]
[http://dx.doi.org/10.1002/14651858.CD009108.pub2] [PMID: 24865446]
[http://dx.doi.org/10.1016/S0140-6736(05)74950-3] [PMID: 9950449]
[http://dx.doi.org/10.1517/14740338.2015.1026325] [PMID: 25773005]
[http://dx.doi.org/10.1046/j.1468-2982.1999.019004223.x] [PMID: 10376167]
[http://dx.doi.org/10.1046/j.1468-2982.2000.00116.x] [PMID: 11167896]
[http://dx.doi.org/10.3390/toxins7072615] [PMID: 26184313]
[http://dx.doi.org/10.3390/toxins7072659] [PMID: 26193319]
[PMID: 23136725]
[http://dx.doi.org/10.1016/j.pharmthera.2012.08.011] [PMID: 22939884]
[http://dx.doi.org/10.1093/brain/88.5.997] [PMID: 5325360]
[http://dx.doi.org/10.1111/j.1476-5381.1989.tb11787.x] [PMID: 2538184]
[http://dx.doi.org/10.1046/j.1468-2982.1997.1706631.x] [PMID: 9350382]
[http://dx.doi.org/10.1038/sj.bjp.0702773] [PMID: 10578124]
[http://dx.doi.org/10.1042/CS20050016] [PMID: 15853772]
[http://dx.doi.org/10.1046/j.1468-2982.1997.1704525.x] [PMID: 9209774]
[http://dx.doi.org/10.1016/S0014-2999(97)83028-2] [PMID: 9203569]
[http://dx.doi.org/10.1093/brain/119.5.1419] [PMID: 8931567]
[PMID: 7938165]
[http://dx.doi.org/10.1016/S1471-4892(01)00003-0] [PMID: 11712532]
[http://dx.doi.org/10.1007/BF00168556] [PMID: 8584041]
[http://dx.doi.org/10.1093/brain/123.1.9] [PMID: 10611116]
[http://dx.doi.org/10.1016/S0091-3057(01)00746-8] [PMID: 11888546]
[http://dx.doi.org/10.1016/j.pain.2012.01.005] [PMID: 22305629]
[http://dx.doi.org/10.1016/j.brainres.2010.09.004] [PMID: 20833155]
[http://dx.doi.org/10.1097/00004647-199908000-00010] [PMID: 10458598]
[http://dx.doi.org/10.1517/17425255.2014.963554] [PMID: 25253587]
[http://dx.doi.org/10.1097/00001756-199707070-00029] [PMID: 9243618]
[http://dx.doi.org/10.1007/s00210-005-1035-9] [PMID: 15900510]
[http://dx.doi.org/10.1046/j.1468-2982.1999.1910851.x] [PMID: 10668103]
[http://dx.doi.org/10.1038/sj.bjp.0703587] [PMID: 11015308]
[http://dx.doi.org/10.1016/S0140-6736(01)06347-4] [PMID: 11675061]
[http://dx.doi.org/10.1177/0333102410370873] [PMID: 20855361]
[http://dx.doi.org/10.1080/13543784.2017.1280457] [PMID: 28076702]
[http://dx.doi.org/10.1177/0333102410375512] [PMID: 20855362]
[http://dx.doi.org/10.1007/s10194-012-0428-7] [PMID: 22430431]
[http://dx.doi.org/10.1177/1756285614562419] [PMID: 25584073]
[http://dx.doi.org/10.1016/S1474-4422(12)70047-9] [PMID: 22459549]
[http://dx.doi.org/10.1177/0333102412466967] [PMID: 23155193]
[http://dx.doi.org/10.1016/j.clinthera.2010.01.006] [PMID: 20171420]
[http://dx.doi.org/10.1016/j.sjpain.2012.08.002] [PMID: 29913885]
[http://dx.doi.org/10.1111/j.1468-2982.2008.01749.x] [PMID: 19170689]
[http://dx.doi.org/10.1111/j.1526-4610.2007.00812.x] [PMID: 17578532]
[http://dx.doi.org/10.1016/S0006-8993(01)02557-4] [PMID: 11430863]
[http://dx.doi.org/10.1186/1744-8069-4-12] [PMID: 18416824]
[http://dx.doi.org/10.1111/j.1526-4610.2006.00489.x] [PMID: 16927963]
[http://dx.doi.org/10.1186/s10194-017-0746-x] [PMID: 28337634]
[http://dx.doi.org/10.1146/annurev.pa.29.040189.002053] [PMID: 2543272]
[http://dx.doi.org/10.1124/pr.109.002451] [PMID: 20716669]
[http://dx.doi.org/10.1146/annurev-physiol-030212-183711] [PMID: 22974439]
[http://dx.doi.org/10.1016/j.coph.2006.08.011] [PMID: 17088105]
[http://dx.doi.org/10.1007/s00702-011-0658-x] [PMID: 21617892]
[http://dx.doi.org/10.1007/s40265-014-0262-0] [PMID: 25030431]
[http://dx.doi.org/10.1016/j.cellsig.2014.04.022] [PMID: 24793301]
[http://dx.doi.org/10.1073/pnas.052708599] [PMID: 11867751]
[http://dx.doi.org/10.1073/pnas.0611577104] [PMID: 17360426]
[http://dx.doi.org/10.1212/WNL.55.1.139] [PMID: 10891926]
[http://dx.doi.org/10.1212/WNL.0b013e3182824e66] [PMID: 23365053]
[http://dx.doi.org/10.1124/jpet.106.101428] [PMID: 16690725]
[http://dx.doi.org/10.1111/j.1468-2982.2004.00723.x] [PMID: 15196302]
[http://dx.doi.org/10.1093/med/9780199552764.003.0022]
[http://dx.doi.org/10.1038/jcbfm.1987.126] [PMID: 3500957]
[http://dx.doi.org/10.1016/0304-3940(94)11203-U] [PMID: 7715843]
[http://dx.doi.org/10.1016/0014-5793(86)81091-2] [PMID: 3492393]
[http://dx.doi.org/10.1677/joe.0.1560401] [PMID: 9582495]
[http://dx.doi.org/10.1016/0167-0115(85)90194-6] [PMID: 3877953]
[http://dx.doi.org/10.1038/sj.bjp.0704761] [PMID: 12086988]
[http://dx.doi.org/10.1016/j.tips.2010.06.006] [PMID: 20633935]
[http://dx.doi.org/10.1002/ana.410280213] [PMID: 1699472]
[http://dx.doi.org/10.1111/j.1526-4610.2006.00294.x] [PMID: 16412148]
[http://dx.doi.org/10.1177/0333102415625614] [PMID: 26888294]
[http://dx.doi.org/10.1016/j.brainres.2014.11.031] [PMID: 25463029]
[http://dx.doi.org/10.1007/s12311-013-0509-4] [PMID: 23917876]
[http://dx.doi.org/10.1016/j.brainres.2011.11.058] [PMID: 22208649]
[http://dx.doi.org/10.1002/jemt.1084] [PMID: 11301495]
[http://dx.doi.org/10.1186/s10194-015-0564-y] [PMID: 26329487]
[http://dx.doi.org/10.1177/0333102410382796] [PMID: 20851839]
[http://dx.doi.org/10.1016/j.neulet.2009.11.035] [PMID: 19925849]
[http://dx.doi.org/10.1111/j.1468-2982.2004.00726.x] [PMID: 15265053]
[http://dx.doi.org/10.1056/NEJMoa030505] [PMID: 15014183]
[http://dx.doi.org/10.1517/13543784.2015.960921] [PMID: 25219387]
[http://dx.doi.org/10.1177/0333102410362122] [PMID: 20855369]
[PMID: 19579177]
[http://dx.doi.org/10.1152/physrev.00034.2015] [PMID: 28179394]
[http://dx.doi.org/10.1177/0333102413500727] [PMID: 23965396]
[http://dx.doi.org/10.1177/0333102410388435] [PMID: 21172952]
[http://dx.doi.org/10.1177/0333102416653233] [PMID: 27269043]
[http://dx.doi.org/10.1007/s40263-015-0253-z] [PMID: 26138383]
[http://dx.doi.org/10.1002/cpdd.345] [PMID: 28409893]
[http://dx.doi.org/10.1111/bcp.12618] [PMID: 25731075]
[http://dx.doi.org/10.1177/1078155214538085] [PMID: 24903270]
[http://dx.doi.org/10.1007/s40263-014-0156-4] [PMID: 24638916]
[http://dx.doi.org/10.1146/annurev-pharmtox-010510-100510] [PMID: 20936946]
[http://dx.doi.org/10.4161/mabs.1.2.7909] [PMID: 20061816]
[http://dx.doi.org/10.1016/S0300-483X(02)00051-3] [PMID: 11972986]
[http://dx.doi.org/10.1097/00042737-200406000-00018] [PMID: 15167167]
[http://dx.doi.org/10.1016/S1474-4422(14)70128-0] [PMID: 25127173]
[http://dx.doi.org/10.1016/S1474-4422(14)70309-6] [PMID: 25496895]
[http://dx.doi.org/10.1016/S1474-4422(16)00019-3] [PMID: 26879279]
[http://dx.doi.org/10.1016/S1474-4422(15)00249-5] [PMID: 26432182]
[http://dx.doi.org/10.1016/S1474-4422(15)00245-8] [PMID: 26432181]
[http://dx.doi.org/10.1111/j.1468-1331.2011.03612.x] [PMID: 22136117]
[http://dx.doi.org/10.1016/0006-291X(89)91757-9] [PMID: 2803320]
[http://dx.doi.org/10.1016/j.peptides.2016.03.003] [PMID: 26976270]
[PMID: 8246142]
[http://dx.doi.org/10.2174/0929867324666170227115019] [PMID: 28245765]
[http://dx.doi.org/10.1093/brain/awu014] [PMID: 24549810]
[http://dx.doi.org/10.1046/j.1468-2982.2001.00140.x] [PMID: 11422090]
[http://dx.doi.org/10.1016/S0165-1838(99)00024-7] [PMID: 10412842]
[http://dx.doi.org/10.1046/j.1468-2982.2002.00324.x] [PMID: 11972578]
[http://dx.doi.org/10.1016/S0006-8993(99)01260-3] [PMID: 10224296]
[http://dx.doi.org/10.1186/s10194-016-0664-3] [PMID: 27587062]
[http://dx.doi.org/10.1177/0333102413483931] [PMID: 23598374]
[http://dx.doi.org/10.1186/s10194-016-0660-7] [PMID: 27475101]
[http://dx.doi.org/10.1212/WNL.0000000000002261] [PMID: 26674334]
[http://dx.doi.org/10.1016/j.nurt.2010.02.003] [PMID: 20430318]
[http://dx.doi.org/10.1016/j.peptides.2007.04.026] [PMID: 17574305]
[http://dx.doi.org/10.1016/S0167-0115(98)00147-5] [PMID: 10100920]
[http://dx.doi.org/10.1126/scitranslmed.aaa7557] [PMID: 26446954]
[http://dx.doi.org/10.1016/j.jpain.2008.01.329] [PMID: 18337184]
[http://dx.doi.org/10.1177/0333102416644435] [PMID: 27084887]
[http://dx.doi.org/10.1038/nrd3793] [PMID: 23237916]
[http://dx.doi.org/10.3390/ijms16059772] [PMID: 25938971]
[http://dx.doi.org/10.1016/j.neuint.2006.08.012] [PMID: 17023091]
[http://dx.doi.org/10.1007/s00702-011-0697-3] [PMID: 21858430]
[http://dx.doi.org/10.2174/092986712800167365] [PMID: 22429096]
[http://dx.doi.org/10.1016/S0304-3940(02)00710-3] [PMID: 12359324]
[http://dx.doi.org/10.2174/157015911795596621] [PMID: 22131946]
[http://dx.doi.org/10.1016/j.neulet.2006.03.051] [PMID: 16644124]
[http://dx.doi.org/10.1007/s00702-008-0052-5] [PMID: 18446262]
[http://dx.doi.org/10.1016/0361-9230(92)90184-Y] [PMID: 1596743]
[http://dx.doi.org/10.1016/j.neuropharm.2009.06.033] [PMID: 19580819]
[http://dx.doi.org/10.1007/s00702-006-0545-z] [PMID: 16897600]
[http://dx.doi.org/10.1021/jm970467t] [PMID: 9435907]
[http://dx.doi.org/10.1016/S0960-894X(01)00758-2] [PMID: 11814797]
[http://dx.doi.org/10.1016/j.ejphar.2011.05.069] [PMID: 21664350]
[http://dx.doi.org/10.1007/s00702-010-0573-6] [PMID: 21194001]
[http://dx.doi.org/10.1007/s00702-011-0755-x] [PMID: 22231843]
[http://dx.doi.org/10.1186/s10194-016-0654-5] [PMID: 27377707]
[http://dx.doi.org/10.1186/s10194-015-0581-x] [PMID: 26627709]
[http://dx.doi.org/10.2174/092986709789909602] [PMID: 19929784]
[http://dx.doi.org/10.1007/s00702-011-0721-7] [PMID: 21997444]
[http://dx.doi.org/10.1007/s00702-016-1615-5] [PMID: 27629500]
[http://dx.doi.org/10.1016/j.jpba.2011.02.014] [PMID: 21392919]
[http://dx.doi.org/10.1007/s00702-013-1146-2] [PMID: 24385076]
[http://dx.doi.org/10.2174/0929867324666170712163437] [PMID: 28707585]
[http://dx.doi.org/10.1038/39807] [PMID: 9349813]
[http://dx.doi.org/10.1016/S0896-6273(02)00908-X] [PMID: 12367506]
[http://dx.doi.org/10.1254/jphs.12276FP] [PMID: 23728381]
[http://dx.doi.org/10.1177/0333102410375626] [PMID: 20974587]
[http://dx.doi.org/10.1007/s00210-009-0437-5] [PMID: 19690836]
[http://dx.doi.org/10.1124/jpet.106.116657] [PMID: 17392405]
[http://dx.doi.org/10.1016/S1090-3801(09)60705-9]
[http://dx.doi.org/10.1007/978-1-4757-0154-8_18] [PMID: 2433912]
[http://dx.doi.org/10.1111/j.1476-5381.1994.tb13168.x] [PMID: 7921621]
[http://dx.doi.org/10.1046/j.1468-2982.2003.00496.x] [PMID: 12662184]
[http://dx.doi.org/10.1046/j.1468-2982.2001.00161.x] [PMID: 11422091]
[http://dx.doi.org/10.1111/j.1468-2982.2004.00863.x] [PMID: 15839850]
[http://dx.doi.org/10.1046/j.1468-2982.2003.00586.x] [PMID: 14616929]
[http://dx.doi.org/10.1038/sj.bjp.0706168] [PMID: 15778742]
[http://dx.doi.org/10.1177/0091270008329548] [PMID: 19246728]
[http://dx.doi.org/10.1073/pnas.95.1.322] [PMID: 9419374]
[http://dx.doi.org/10.1111/j.1749-6632.2010.05513.x] [PMID: 20633143]
[http://dx.doi.org/10.1111/j.1460-9568.2006.05168.x] [PMID: 17156207]
[http://dx.doi.org/10.1177/0333102414544979] [PMID: 25106663]