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Published on: August 11, 2021
PACAP38: Emerging Drug Target in Migraine and Cluster Headache
Anne Luise Haulund Vollesen1, Messoud Ashina1
1Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Copenhagen, 2600, Denmark.
Abstract:
Here, we review the role of pituitary adenylate cyclase-activating peptide-38 (PACAP38) in migraine and cluster headache (CH). Mounting evidence implicates signaling molecule PACAP38 in the pathophysiology of migraine. Human provocation studies show PACAP38 induces migraine attacks in migraine patients without aura and marked and sustained dilation of extracerebral arteries. PACAP38 selectively targets the PAC1 receptor making this receptor a promising candidate for targeted migraine therapy. Randomized clinical trials are warranted to pursue this possible treatment pathway. PACAP38 provocation studies in CH could elucidate possible involvement of PACAP38 in CH pathophysiology and predict efficacy of PACAP38 antagonists in this primary headache.
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