Nerve growth factor and brain-derived neurotrophic factor: potential targets for migraine treatment?

Abstract

Background: Nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) are now established to be pivotal mediators of pain. Recent experimental and clinical evidence supports their intervention in the pathophysiological mechanisms of migraine, in particular chronic migraine (CM). Objective: To review existing literature suggesting the involvement of NGF and BDNF in increasing nociception and that supporting the development of molecules targeting these trophic factors, their receptors and related intracellular signalling as novel strategies for treating pain, including migraine. Methods: Bibliographic research was carried out using the PubMed database (January 1986 to January 2008). Patent literature was searched using the European Patent Office, Free Patents Online, and World Intellectual Property Organization websites. Results/conclusion: The majority of available patents concerning NGF- and BDNF-targeting molecules at the moment do not specifically refer to their potential use in migraine. Although no trials have yet been conducted with these compounds for the treatment of migraine, some NGF-targeting molecules are candidates for evaluation in future studies for their efficacy in CM. These molecules are, however, not without potential side effects, due to the wide range of intracellular signaling pathways activated by NGF that are not limited to the nociceptive system. Compounds targeting BDNF should also be considered with caution due to the emerging evidence of its dual pronociceptive and antinociceptive effects.