Calcitonin Gene Research Articles

Dermal macrophages control tactile perception under physiological conditions via NGF signaling

We demonstrated previously that sorting nexin 25 (SNX25) in nerve-associated macrophages plays critical roles in pain sensation by regulating tissue NGF content under both physiological and neuropathic conditions. In the present study, we apply the SNX25–NGF paradigm to tactile perception by showing that Snx25+/- mice or macrophage-specific Snx25 conditional knock-out (mcKO) mice had weaker responses to tactile stimuli in normal conditions. Snx25 mcKO mice responded poorly to transcutaneous electrical stimuli at a frequency of 5 Hz (C fiber responses), but normally to stimuli at a frequency of 250 Hz (Aδ fiber responses) or of 2000 Hz (Aβ fiber responses). CX3CR1-positive dermal macrophages were frequently found near calcitonin gene–related peptide (CGRP)- positive nerves and, less frequently, tyrosine hydroxylase (TH)-positive nerves. We confirmed that the tissue content of NGF was lower in Snx25 mcKO mice than in wild-type mice, and in turn, dermal NGF injection restored tactile sensitivity in Snx25+/- mice and Snx25 mcKO mice to normal levels. These results indicate that CGRP-positive C-nociceptors (possibly also TH-positive C-LTMRs) associated dermal macrophages control tactile perception by producing NGF and secreting it into the dermis.

TRATAMENTO FARMACOLÓGICO COMO PROFILAXIA DA CEFALEIA PRIMÁRIA DO TIPO MIGRÂNEA: UMA ANÁLISE DA EFICÁCIA DOS MEDICAMENTOS

INTRODUCTION: Migraine headache is a neurological problem, varying in form and intensity, being a disruptive factor in the lives of those affected. OBJECTIVE: To present the main prophylactic pharmacological treatments for migraine, evaluating their effects and safety in comparison to other treatments. METHODS: The search was carried out through the VHL in the MEDLINE and LILACS databases, using studies from the last 5 years and with full text available in English and Portuguese. Of the 200 articles initially evaluated, 61 were selected to compose the final corpus of the study. RESULTS: 32 treatments were found available for migraine prophylaxis, with emphasis on monoclonal antibodies to the peptide related to the calcitonin gene, which reduce the frequency, duration and intensity of migraine attacks, providing a comparative improvement in relation to conventional therapies. Medications such as beta-blockers, angiotensin II antagonists, antiepileptics and onabotulinumtoxinA have also demonstrated efficacy in obtaining positive responses to migraine treatment. CONCLUSION: Evidence suggests that, due to the multiple therapeutic approaches to migraine, personalized treatment is necessary, considering the individual response to the intervention and the risk of damage in the care plan.

The potential role of CGRP in synuclein-associated neurodegenerative disorders

In this hypothesis article, the potential clinicopathological associations of Calcitonin Gene Related Peptide (CGRP) with the development of synuclein-associated neurodegenerative disorders (SAND) are discussed. The presence of α-syn and CGRP in the CNS and the ENS and the intricate role of CGRP and its related pathways in inflammation, apoptosis, metabolism, neuromodulation, and brain-gut communication are analyzed. Since this hypothesis is confirmed, modulating CGRP-potential related pathways may lead to novel disease-modifying therapies.

Loss of Calcitonin Gene Related Receptor component protein (RCP) in nervous system can bias "gepant" antagonism.

Research in calcitonin gene-related peptide (CGRP) has primarily focused on ligand- receptor interactions at the calcitonin-like receptor (CLR) and receptor activity-modifying unit 1 (RAMP1) subunits. However, the role of receptor component protein (RCP), which mediates signaling via the Gα-stimulatory pathway, is less understood. A novel tamoxifen-inducible mouse model, nestinRCP (-/-), was generated to study loss of RCP in CGRP signaling in the nervous system, and behavioral changes to motion-induced nausea and postural sway were studied after systemic injections of CGRP or CGRP co-delivered with migraine drugs. Findings from this study suggest the loss of CGRP-RCP can bias "gepant" antagonists like olcegepant, and may promote development of therapies to inhibit the RCP-CLR interactions.

Effect of fasting-induced headache on calcitonin gene related peptide (CGRP) and other clinical biomarkers on the first day of Ramadan: Sub-analysis from a randomized open label clinical trial

BackgroundFasting-induced headaches (FIHs) have been shown to occur on the first day of Ramadan and clearly decline thereafter. Despite the wealth of knowledge about different types of headaches (e.g., migraine-, cluster-, and tension-type headaches), research on the mechanism underlying FIHs, as well as their treatment, remains scarce. Our study aimed to investigate any association between FIHs during the first day of Ramadan and potential headache-related biomarkers, including fasting blood glucose (FBG), C-reactive protein (CRP), magnesium, vitamin B9, vitamin B12, homocysteine, and calcitonin gene related peptide (CGRP), and to assess whether a prophylactic use of paracetamol may influence these biomarkers.MethodsAs part of a randomized, open-label clinical trial that evaluated the effect of paracetamol as a prophylactic therapy for FIH, blood samples from stratified subjects in the prophylaxis and control groups were withdrawn while fasting after the 1st dose of paracetamol (in the prophylaxis group) and prior to reporting headache occurrence.ResultsPlasma and serum were separated for 61 subjects; 31 and 30 subjects from the prophylaxis and control groups, respectively. Overall, no significant differences were found in the levels of FBG, CRP, magnesium, vitamin B9, and vitamin B12 in headache-suffering subjects compared to those without headache despite the use of paracetamol for prophylaxis. Homocysteine, however, was significantly reduced in all subjects who experienced FIH compared to those without headache (median 6.9 [1.6] vs. 7.7 [2.7] umol/L; p = 0.041). On the contrary, when the CGRP was measured using immunoassay, it was found to be significantly elevated in all headache-suffering subjects compared to those without headache (median 126.1 [17.7] vs. 105.8 [19.6] pg/mL; p ≤ 0.0001). This difference was maintained upon comparing the headache to non-headache subjects in both the prophylaxis (median 121.5 [15.4] vs. 105.8 [9.4] pg/mL; p < 0.01) and control groups (median 128.5 [28.3] vs. 105.8 [23.8] pg/mL; p < 0.01). Additionally, an elevated CGRP level was found to increase the odds of having a FIH [OR = 1.32; 95%CI 1.06–1.22].ConclusionsOur findings revealed the role of CGRP in FIHs for the first time and suggest further investigation in signaling pathways downstream CGRP receptors. Furthermore, the modulation CGRP or CGRP receptors could have a clinical application in the prevention of FIHs.Trial registrationThis study was registered with the Saudi Food and Drug Authority in the Saudi Clinical Trials Registry (SCTR; No. 22122102).

Advances in migraine treatment - a review

Introduction Migraine is a heavily debilitating disease that ranks second place in Global Burden Disease. It is estimated that around 1 billion of people suffer from it. It also has a significant negative impact on health-related quality of life (HRQoL) of patients and can affect their social, occupational, academic and familial life. Thus, it is crucial that all of the patients receive an effective treatment. Objectives This article aims to review the most recent advances in treatment of migraine. Methods A Literature review of articles published in Pubmed between 2000 and 2024 using the following words ‘migraine’, ‘treatment advances’, ‘CGRP receptor antagonists’, ‘serotonin receptor agonists’, ‘lasmiditan’, ‘zavegepant’, ‘rimegepant’. Results Literature search provides several concepts of advances in migraine treatment. Apart from behavioral treatment, new drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists are emerging. Conclusion Migraine is a debilitating disease which significantly reduces health related quality of life in patients. New drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists give a chance for more effective and tailored treatment.

The nociceptive inputs of the paraventricular hypothalamic nucleus in formalin stimulated mice

The paraventricular hypothalamic nucleus (PVH) is an important neuroendocrine center involved in pain regulation, but the nociceptive afferent routes for the nucleus are still unclear. We examined the profile of PVH receiving injurious information by a combination of retrograde tracing with Fluoro-Gold (FG) and FOS expression induced by formalin stimuli. The result showed that formalin injection induced significantly increased expression of FOS in the PVH, among which oxytocin containing neurons are one neuronal phenotype. Immunofluorescent staining of FG and FOS revealed that double labeled neurons were strikingly distributed in the area 2 of the cingulate cortex (Cg2), the lateral septal nucleus (LS), the periaqueductal gray (PAG), the posterior hypothalamic area (PH), and the lateral parabrachial nucleus (LPB). In the five regions, LPB had the biggest number and the highest ratio of FOS expression in FG labeled neurons, with main subnuclei distribution in the external, superior, dorsal, and central parts. Further immunofluorescent triple staining disclosed that about one third of FG and FOS double labeled neurons in the LPB were immunoreactive for calcitonin gene related peptide (CGRP). In conclusion, the present study demonstrates the nociceptive input profile of the PVH area under inflammatory pain and suggests that neurons in the LPB may play essential roles in transmitting noxious information to the PVH.

Benzofuran Iboga-Analogs Modulate Nociception and Inflammation in an Acute Mouse Pain Model.

Pain management following acute injury or post-operative procedures is highly necessary for proper recovery and quality of life. Opioids and non-steroidal anti-inflammatory drugs (NSAIDS) have been used for this purpose, but opioids cause addiction and withdrawal symptoms whereas NSAIDS have several systemic toxicities. Derivatives of the naturally occurring iboga alkaloids have previously shown promising behavior in anti-addiction of morphine by virtue of their interaction with opioid receptors. On this frontier, four benzofuran analogs of the iboga family have been synthesized and their analgesic effects have been studied in formalin induced acute pain model in male Swiss albino mice at 30 mg/kg of body weight dose administered intraperitoneally. The antioxidant, anti-inflammatory and neuro-modulatory effects of the analogs were analyzed. Reversal of tail flick latency, restricted locomotion and anxiogenic behavior were observed in iboga alcohol, primary amide and secondary amide. Local neuroinflammatory mediators' substance P, calcitonin gene related peptide, cyclooxygenase-2 and p65 were significantly decreased whereas the depletion of brain derived neurotrophic factor and glia derived neurotrophic factor was overturned on iboga analog treatment. Behavioral patterns after oral administration of the best analog were also analyzed. Taken together, these results show that the iboga family of alkaloid has huge potential in pain management.

Serum levels of biomarkers related to severity staging of Raynaud’s phenomenon, neurosensory manifestations, and vibration exposure in patients with hand-arm vibration injury

Our aim was to explore possible relationships between serum levels of biomarkers in patients with hand-arm vibration injury in relation to the severity of the vascular, i.e., Raynaud’s phenomenon (RP), and neurosensory manifestations, the current exposure level, and the duration of exposure. This study was of case series design and involved 92 patients diagnosed with hand-arm vibration injury. Jonckheere’s trend test was used to assess any association between serum levels of biomarkers and RP as well as neurosensory manifestations, graded by the International Consensus Criteria. Generalized linear models with adjustment for possible confounders were also used for associations between serum levels of biomarkers and; (1) severity of RP recorded as the extent of finger blanching calculated with Griffin score, (2) vibration perception thresholds, (3) magnitude of current exposure as [A(8); (m/s2)] value, and (4) the duration of exposure in years. Serum levels of thrombomodulin, von Willebrand factor, calcitonin gene related peptide (CGRP), heat shock protein 27, and caspase-3 were positively associated with severity of RP. Serum levels of CGRP were positively associated with the neurosensory component. No associations with exposure were shown for these biomarkers. For Intercellular adhesion molecule 1 and monocyte chemoattractant protein 1, no associations were found with neither severity nor exposure. Levels of serum biomarkers associated with endothelial injury or dysfunction, inflammation, vasodilation, neuroprotection, and apoptosis were positively associated with the severity of hand-arm vibration injury.

Atogepant (Qulipta)

CADTH recommends that atogepant (Qulipta) be reimbursed by public drug plans for the prevention of migraine if certain conditions are met. For migraine prevention, Qulipta should only be covered in adult patients who have tried at least 2 other types of treatments for the prevention of migraine. Qulipta should only be reimbursed if it is prescribed by a prescriber with experience managing chronic migraine (CM) headaches and if the cost of Qulipta is not more than the least costly calcitonin gene–related peptide (CGRP) inhibitor currently funded for this population. Qulipta should not be reimbursed for use in combination with other CGRP inhibitors for the prevention of migraine in adult patients with CM.

Nape seven needles combined with pressing moxibustion for cervical vertigo: a randomized controlled trial

To observe the clinical effect of nape seven needles combined with pressing moxibustion for cervical vertigo (CV). A total of 70 patients with CV were randomized into an observation group and a control group, 35 cases in each group. In the observation group, nape seven needles combined with pressing moxibustion was delivered, once a day, 6 times a week, for consecutive 2 weeks. In the control group, betahistine hydrochloride tablet and aceclofenac dispersible tablet were given orally, for 2 weeks and 3 days respectively. Before and after treatment, the evaluation scale for cervical vertigo (ESCV) score was observed, the plasma levels of neuropeptide Y (NPY), endothelin-1 (ET-1) and calcitonin gene related peptide (CGRP) were detected, the hemorheologic and hemodynamic indexes were measured, and the clinical efficacy was evaluated after treatment in the two groups. After treatment, the scores of dizziness, daily life and work ability, psychological and social adaptability, and headache, as well as the total scores of ESCV were increased compared with those before treatment (P<0.01, P<0.05) in the two groups, and the score and total score of neck and shoulder pain of ESCV was increased compared with that before treatment (P<0.01) in the observation group; each sub-item score and total score of ESCV in the observation group were higher than those in the control group (P<0.01, P<0.05). After treatment, the plasma levels of NPY and ET-1 were decreased compared with those before treatment (P<0.01), while the plasma levels of CGRP were increased compared with those before treatment (P<0.01, P<0.05) in the two groups; the plasma levels of NPY and ET-1 in the observation group were lower than those in the control group (P<0.01), the plasma level of CGRP in the observation group was higher than that in the control group (P<0.01). After treatment, the whole blood high shear viscosity, plasma viscosity and whole blood low shear viscosity were decreased compared with those before treatment (P<0.01, P<0.05), the mean velocity of basilar artery (BA), left vertebral artery (LVA) and right vertebral artery (RVA) were increased compared with those before treatment (P<0.05) in the two groups; the whole blood high shear viscosity, plasma viscosity and whole blood low shear viscosity in the observation group were lower than those in the control group (P<0.01), and the mean velocity of BA, LVA and RVA in the observation group were higher than those in the control group (P<0.05). The total effective rate in the observation group was 91.4% (32/35), which was superior to 71.4% (25/35) in the control group (P<0.05). Nape seven needles combined with pressing moxibustion can effectively alleviate the clinical symptoms, and improve the hemorheology and hemodynamics in CV patients.

Aromatase inhibitors evoke periorbital allodynia in mice via calcitonin gene-related peptide and its receptors in Schwann cells

Background: Treatment with the currently recommended aromatase inhibitors (AIs) for adjuvant endocrine treatment of estrogen receptorpositive breast cancer is associated with debilitating musculoskeletal pain symptoms (AIMS) and headache. Recent evidence suggests that the proalgesic channel transient receptor potential ankyrin 1 (TRPA1) is implicated in AIMS. Here, we investigated the cellular and molecular mechanisms, including TRPA1, implicated in periorbital mechanical allodynia (PMA), a surrogate of headache-like pain, evoked by AIs in mice. Methods: C57BL6/J mice were treated with intragastric letrozole (0.05-0.5 mg/kg), exemestane (1-5 mg/kg) or anastrozole (0.02-0.2 mg/kg) and were evaluated by applying von Frey filaments to the periorbital region over the rostral portion of the eye. Some mice were pretreated (subcutaneous in the periorbital area) with receptor, channel, or enzyme inhibitors. PMA was also investigated in mice with selective silencing of Trpa1 and receptor activity modifying protein 1 [Ramp1, the component of calcitonin gene related peptide (CGRP) receptor required for its functioning] in Schwann cells (Plp-Cre+-Trpa1fl/fl and Plp-Cre+-Ramp1fl/fl mice, respectively) or trigeminal neurons (Adv-Cre+- Trpa1fl/fl and Adv- Cre+- Ramp1fl/fl mice, respectively). Results: Letrozole dose-dependently produced PMA that was attenuated by a TRPA1 antagonist (A967079) or a CGRP receptor antagonist (olcegepant), whereas indomethacin was ineffective. Selective silencing of Trpa1 in both Schwann cells and trigeminal neurons reduced letrozole- evoked PMA. Silencing of Ramp1 in Schwann cells, but not in trigeminal neurons, attenuated PMA. Inhibition of the intracellular pathway known to promote PMA by CGRP action in Schwann cells, including adenylyl cyclase (SQ-22536), nitric oxide synthase (L-NG-Nitro arginine methyl ester), and oxidative stress (N-tert-butyl-a-phenylnitrone) inhibitors reduced letrozole-evoked PMA. PMA evoked by exemestane (1, 5, 10 mg/kg i.g.) or anastrozole (0.02, 0.1, 0.2 mg/kg i.g.) Was also markedly reduced in mice with selective silencing of TRPA1 in Schwann cells and nociceptors. Conclusions: Data indicate that letrozole, targeting TRPA1 in peptidergic nerve terminals, releases CGRP that engages its receptor in adjacent Schwann cells to trigger a complex intracellular pathway that results in TRPA1 activation and the ensuing ROS release to sustain PMA. Should these mechanisms be present in patients, their inhibition may ameliorate cephalic mechanical allodynia associated with aromatase inhibitors-induced headaches.

Sustained response to atogepant in episodic migraine: post hoc analyses of a 12-week randomized trial and a 52-week long-term safety trial

BackgroundAtogepant is an oral calcitonin gene–related peptide receptor antagonist approved for the preventive treatment of migraine in adults. These analyses evaluated the proportions of clinical trial participants who experienced sustained responses to atogepant over 12 or 52 weeks of treatment.MethodsThese were post hoc analyses of ADVANCE, a 12-week, double-blind, randomized trial of atogepant 10, 30, and 60 mg once daily vs. placebo for the preventive treatment of episodic migraine, and a separate open-label long-term safety (LTS) trial of atogepant 60 mg once daily over 52 weeks. The 60 mg dose of atogepant was used to detect safety issues. An initial response was defined as ≥50%, ≥75%, or 100% reduction from baseline in MMDs in month 1 for ADVANCE or quarter 1 for the LTS trial. The proportions of participants who continued to experience a response above each response-defining threshold through each subsequent month (for ADVANCE) or each quarter (for LTS) were calculated.ResultsIn ADVANCE, sustained response rates during months 2 and 3 varied with dose and were as follows: 70.8–81.1% following an initial ≥50% response, 47.3–61.9% following an initial ≥75% response, and 34.8–41.7% following an initial 100% response. Of those who experienced an initial ≥75% or 100% response during month 1, more than 79% continued to experience at least a 50% response during both months 2 and 3. During the LTS trial, sustained response rates through quarters 2, 3, and 4 were 84.7% following an initial ≥50% response, 72.6% following an initial ≥75% response, and 37.8% following an initial 100% response. Of those who experienced an initial ≥75% or 100% response during quarter 1, more than 90% continued to experience at least a 50% response through quarters 2, 3, and 4.ConclusionOver 70% of participants who experienced an initial response with atogepant treatment had a sustained response with continued treatment.Trial registrationClinicalTrials.gov: NCT03777059 (submitted: December 13, 2018); NCT03700320 (submitted: September 25, 2018).

Neuroimmunological effects of omega-3 fatty acids on migraine: a review.

Migraine is a highly prevalent disease worldwide, imposing enormous clinical and economic burdens on individuals and societies. Current treatments exhibit limited efficacy and acceptability, highlighting the need for more effective and safety prophylactic approaches, including the use of nutraceuticals for migraine treatment. Migraine involves interactions within the central and peripheral nervous systems, with significant activation and sensitization of the trigeminovascular system (TVS) in pain generation and transmission. The condition is influenced by genetic predispositions and environmental factors, leading to altered sensory processing. The neuroinflammatory response is increasingly recognized as a key event underpinning the pathophysiology of migraine, involving a complex neuro-glio-vascular interplay. This interplay is partially mediated by neuropeptides such as calcitonin gene receptor peptide (CGRP), pituitary adenylate cyclase activating polypeptide (PACAP) and/or cortical spreading depression (CSD) and involves oxidative stress, mitochondrial dysfunction, nucleotide-binding domain-like receptor family pyrin domain containing-3 (NLRP3) inflammasome formation, activated microglia, and reactive astrocytes. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), crucial for the nervous system, mediate various physiological functions. Omega-3 PUFAs offer cardiovascular, neurological, and psychiatric benefits due to their potent anti-inflammatory, anti-nociceptive, antioxidant, and neuromodulatory properties, which modulate neuroinflammation, neurogenic inflammation, pain transmission, enhance mitochondrial stability, and mood regulation. Moreover, specialized pro-resolving mediators (SPMs), a class of PUFA-derived lipid mediators, regulate pro-inflammatory and resolution pathways, playing significant anti-inflammatory and neurological roles, which in turn may be beneficial in alleviating the symptomatology of migraine. Omega-3 PUFAs impact various neurobiological pathways and have demonstrated a lack of major adverse events, underscoring their multifaceted approach and safety in migraine management. Although not all omega-3 PUFAs trials have shown beneficial in reducing the symptomatology of migraine, further research is needed to fully establish their clinical efficacy and understand the precise molecular mechanisms underlying the effects of omega-3 PUFAs and PUFA-derived lipid mediators, SPMs on migraine pathophysiology and progression. This review highlights their potential in modulating brain functions, such as neuroimmunological effects, and suggests their promise as candidates for effective migraine prophylaxis.

Pulmonary Fibrosis Augments CGRP-Dependent Hyperpolarization and Vasodilation of Mouse Pulmonary Arteries

Calcitonin gene related peptide (CGRP) hyperpolarizes membrane potential (Vm) of pulmonary arterial smooth muscle cells (SMCs) and endothelial cells (ECs) through PKA-dependent activation of KATP channels. CGRP can diminish the severity of pulmonary fibrosis (PF), however, the effects on vascular signaling were poorly defined. We hypothesized that hyperpolarization to CGRP would be augmented in a mouse model of PF. PF was induced by intratracheal delivery of bleomycin (3 wk), and saline was used as a control (sham). Pulmonary arteries (PAs; 100-150 μm diameter) from male C57BL/6J mice (age, ~5 mo), were cannulated, pressurized to 16 cmH2O, and studied at 37°C. Alternatively, intact endothelial tubes were studied at 32°C following dissociation of SMCs. Vm was recorded continuously using intracellular microelectrodes. At rest, Vm was similar for SMCs (bleomycin = -43±3 mV, sham = -44±3 mV; n = 5/group) and ECs (bleomycin = -45±4 mV, sham = -44±3 mV; n=5/group). Increasing concentrations of CGRP (10−10-10−6 M) evoked hyperpolarization of Vm with greater potency in SMCs (EC50: bleomycin = 2 nM, sham = 15 nM) and ECs (EC50: bleomycin = 3 nM, sham = 8 nM) from PF mice, without changing effcacy (SMCs: bleomycin ΔVm = -24±4 mV, sham ΔVm = -21±3 mV; ECs: bleomycin ΔVm = -26±2 mV, sham ΔVm=23±4 mV). Consistently, vasodilation to CGRP in PAs preconstricted with uridine triphosphate (UTP, 5 μM; EC50) was enhanced in PF (92±6% maximum dilation;) vs. sham (83±4% maximum dilation) mice (n=5/group). Greater vasodilation and hyperpolarization of SMCs to CGRP persisted in endothelium-disrupted PAs and during treatment with L-NAME (10−4 M) indicating that ECs are not required for greater responsiveness to CGRP in SMCs. With no effect on resting Vm, inhibition of KATP channels with 1 μM glibenclamide or PKA with protein kinase inhibitor [PKI-(14-22)-amide, myristoylated; 1 μM] significantly attenuated (p&lt;0.05) hyperpolarization of SMCs and ECs (ΔVm ≤5 mV for all groups). Both glibenclamide and PKI attenuated vasodilation to CGRP in PAs and eliminated differences between groups. In a mouse model of PF, CGRP-dependent hyperpolarization of pulmonary arterial SMCs and ECs is augmented through increased PKA-dependent activation of KATP channels leading to increased vasodilator sensitivity. AHA CDA#931652. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex Differences in Alpha Synuclein Gastrointestinal Aggregation

Parkinson’s Disease (PD) is a neurodegenerative disorder with prodromal symptoms often emerging decades before motor issues, including gastrointestinal (GI) symptoms such as constipation and visceral pain. The pathological hallmark of PD is accumulation of misfolded α-synuclein (aSyn) protein in the brain and periphery, including the GI tract. Men have two times the risk of developing PD compared to women. However, disease progression and mortality are higher in women, who also report worse GI symptoms. Gut calcitonin gene related peptide (CGRP) is involved in modulating intestinal contractions and pain, and CGRP receptor antagonists lead to constipation. We hypothesize that sex differences in GI symptoms of PD are the result of sex specific aSyn aggregation and differential enteric CGRP signaling. Intraperitoneal injections of the pesticide rotenone were given to C57BL/6J mice to facilitate aggregation of aSyn. Immunohistochemistry was performed on colon sections using antibodies to aSyn, protein gene product (PGP) 9.5, and CGRP. Quantities of aSyn were analyzed in myenteric PGP9.5+ neuronal fibers. Vehicle treated females had 48% (mean +/- SEM = 0.66 μm2 +/- 0.04) less immunoreactive (ir) enteric aSyn than males (1.3 μm2 +/- 0.13; [F(1,22) = 4.8, p &lt; 0.05). Rotenone treatment increased aSyn-ir by 56% (1.5 μm2 +/- 0.13) in females and 28% (1.08 μm2 +/- 0.14) in males. When interrogated by region, rotenone treatment increased the average precent area of CGRP-ir in the apical crypt (male 9% +/- 0.6; female 10% +/- 0.6) compared to vehicle (male 7% +/- 0.8; female 7% +/- 0.7). This increase was 14% higher in females compared to males (F(1,12) = 5.6, p &lt; 0.05). In males and females, the average percent area of CGRP-ir in the mid-basal crypt region decreased with rotenone treatment (male 4% +/- 0.4; female 2.6% +/- 0.1) compared to vehicle (male 3%+/-0.2, female 1.7%+/-0.06; [F(1,12) = 19.62, p &lt; 0.001). Microbiota have been shown to modulate visceral pain via the release of CGRP, and PD patients have altered microbiotas. The larger increase in CGRP-ir at the apical region of crypts after rotenone treatment in females may contribute to sensitivity to noxious stimuli from the lumen, including microbiota and their metabolites. In addition, decreased mid-basal CGRP-ir and aSyn increases in females after rotenone treatment provide valuable data towards explaining increased GI symptoms seen in PD females. Females are significantly understudied within the context of PD, however, investigating the underlying pathophysiology of GI symptoms while addressing sex as a variable could provide clues to the sex differences seen in clinical outcomes. Since these symptoms often arise years before motor dysfunction and diagnosis, it is critical to determine sex specific mechanisms of aSyn aggregation and influence on enteric neural involvement in prodromal GI symptoms. SCORE MGH ORWH U54-MH118919. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Unlocking the potential of luteolin: A natural migraine management approach through network pharmacology

BackgroundLuteolin, a natural flavonoid, exhibits antioxidant and anti-inflammatory properties and has been investigated for potential health benefits. Its focus on migraine management arises from its ability to mitigate neuroinflammation, a key factor in migraine attacks. MethodspkCSM and Swiss ADME were employed to assess luteolin's pharmacokinetic properties, revealing challenges such as low water solubility and limited skin permeability. OSIRIS Property Explorer is used to check the toxicity. Ligand binding simulations indicated luteolin's potential to interact with calcitonin gene related peptide proteins, crucial in migraine pathophysiology. DisGeNet identified common targets related to migraine, with subsequent network analysis emphasizing promising targets. Results and DiscussionLuteolin demonstrated good intestinal absorption but faced BBB limitations, suggesting a potential for oral administration but questioning direct brain impact. Nanoformulation was proposed to address solubility challenges, emphasizing the need for in vivo validation. The highest binding affinity with CGRP proteins PDBID: 6PFO (−7.63 kcal/mol) suggested a potential for migraine treatment, requiring empirical confirmation. Enrichment network analysis illustrated luteolin's potential in migraine treatment, emphasizing key targets such as PTGS2, AKT1, ESR1, MMP2, and MMP9. Luteolin shows promise for migraine management, evident in its pharmacokinetic, toxicological profiles, and interactions with CGRP proteins. Challenges like low solubility suggest the need for nanoformulations and empirical validation. Target identification and network analysis offer insights, highlighting potential therapeutic avenues in migraine treatment. ConclusionLuteolin holds promise in migraine management, necessitating further research for translation into effective interventions, considering its neuroprotective potential in broader neurological conditions.

Novel Strategies for Acute Relief and Prevention of Migraine

Migraine is a debilitated disorder that is often under diagnosed in clinical practice. Early detection of migraine leads to outstanding improvements in patients’ quality of life. New researchers had developed the central sensitization and cutaneous allodina in chronic migraine which is helpful in early treatment approach with triptans and other agents in acute migraine episodes. Right now, five agents are accepted by US food and drug administration (FDA) for migraine prevention. They are namely Divalporex sodium, Propranolol, Timolol maleate, Topiramate and Methysergide. For so many years, other medications have been used to prevent migraine with not much more success rate. They are Tricyclic anti depressants, anti epileptic agents, Nonsteroidal anti-inflammatory drugs (NSAIDs), Selective serotonin reuptake inhibitors (SSRIS), Calcium channel blockers and muscle relaxants. Calcitonin gene related peptide antagonist, Ditans, Botulinum toxin type A, Orexin receptor antagonists etc were the recent novel agents in the treatment and management of migraine. These novel agents showed more affect than other medications in the acute and prophylactic management of migraines. They play a pivotal role in the standard care for migraine treatment that will improve the patient quality of life with better outcomes.

New treatment for migraines: Use of monoclonal antibodies – Review

Migraine is one of the most prevalent diseases in the population and is also one of the main disabling diseases, having a negative impact on the sufferer's quality of life. Migraine mainly affects people of working age, reducing productivity and impacting the entire labor market. The field of migraine therapies includes monoclonal antibodies that inhibit the Calcitonin Gene Related Peptide (CGRP), which has a strong correlation with the pathophysiology of migraine attacks. Therefore, this study aims to investigate the literature to review the treatment of migraines with the use of monoclonal antibodies, analyzing the prognosis and improvement of patients who have undergone treatment. A systematic review of the literature was carried out between September 2021 and April 2022 by two independent researchers. A total of 1,105 articles were identified, of which 33 met the inclusion criteria and were then analyzed. The use of the monoclonal antibodies Erenumab, Eptinezumab, Fremanezumab and Galcanezumab showed better results in all the parameters analyzed when compared to the placebo groups. They showed a reduction in the average number of migraine days per month, a reduction in the number of days with crises, a reduction in the use of acute medication and an improvement in quality of life assessment scores. In conclusion, monoclonal antibodies are an innovative therapy for migraine and are emerging as preventive options with good tolerability in terms of adverse effects and efficacy. Further research should be carried out with a view to evaluating efficacy and long-term safety, given the recent introduction of this therapy.

Benefit-Risk Assessment Based on Number Needed to Treat and Number Needed to Harm: Atogepant vs Calcitonin Gene–Related Peptide Monoclonal Antibodies (P5-12.007)

Benefit-Risk Assessment Based on Number Needed to Treat and Number Needed to Harm: Atogepant vs Calcitonin Gene–Related Peptide Monoclonal Antibodies (P5-12.007)