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Citation
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HERO ID
2245034
Reference Type
Journal Article
Subtype
Review
Title
Calcitonin gene-related peptide in migraine: intersection of peripheral inflammation and central modulation
Author(s)
Raddant, AnnC; Russo, AF
Year
2011
Is Peer Reviewed?
Yes
Journal
Expert Reviews in Molecular Medicine
ISSN:
1462-3994
Volume
13
Page Numbers
e36
Language
English
PMID
22123247
DOI
10.1017/S1462399411002067
Web of Science Id
WOS:000297810800001
Abstract
Over the past two decades, a convergence of basic and clinical evidence has established the neuropeptide calcitonin-gene-related peptide (CGRP) as a key player in migraine. Although CGRP is a recognised neuromodulator of nociception, its mechanism of action in migraine remains elusive. In this review, we present evidence that led us to propose that CGRP is well poised to enhance neurotransmission in migraine by both peripheral and central mechanisms. In the periphery, it is thought that local release of CGRP from the nerve endings of meningeal nociceptors following their initial activation by cortical spreading depression is critical for the induction of vasodilation, plasma protein extravasation, neurogenic inflammation and the consequential sensitisation of meningeal nociceptors. Mechanistically, we propose that CGRP release can give rise to a positive-feedback loop involved in localised increased synthesis and release of CGRP from neurons and a CGRP-like peptide called procalcitonin from trigeminal ganglion glia. Within the brain, the wide distribution of CGRP and CGRP receptors provides numerous possible targets for CGRP to act as a neuromodulator.
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