The Potentials of Uncariae Ramulus Cum Uncis for the Treatment of Migraine: Targeting CGRP in the Trigeminovascular System

Overview

Journal Curr Neuropharmacol

Publisher Bentham Science Publishers

Date 2020 Oct 30

PMID 33121411

Citations 2

Authors

Cheong-Meng Chong

Zhangfeng Zhong

Chi Teng Vong

Shengpeng Wang

Jin-Jian Lu

Hai-Jing Zhong

Huanxing Su

Yitao Wang

Affiliations

Soon will be listed here.

Abstract

Migraine is a common chronic neurovascular disease characterized by headaches. Calcitonin gene-related peptide (CGRP) signaling in the trigeminovascular system plays a critical role in the development of migraine. The monoclonal antibodies against CGRP and its receptor have been used clinically for the prevention of migraine; however, they may not be a cost-effective option for patients with low-frequency episodic migraine. Thus, it is quite valuable to search for an alternative strategy to downregulate CGRP signaling. Uncariae Ramulus Cum Uncis (UR) has a longterm history for the treatment of cardiovascular and central nervous systems disorders in China and Eastern Asia. Several clinical studies showed that famous herbal formulas comprising UR were able to improve headaches in migraineurs. In addition, increasing in vivo studies further indicated that migraine-related changes, such as CGRP increase, inflammation, nitric oxide increase, and spontaneous behavior problems could be reduced by UR extraction and its active constituents. In this review, we summarize the pathophysiological factors affecting abnormal CGRP release in the trigeminovascular system during a migraine, and for the first time, analyze the effects of UR on these factors and evaluate the potentials of UR for the treatment of migraine.

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References

Berman N, Puri V, Chandrala S, Puri S, MacGregor R, Liverman C . Serotonin in trigeminal ganglia of female rodents: relevance to menstrual migraine. Headache. 2006; 46(8):1230-45. DOI: 10.1111/j.1526-4610.2006.00528.x. View

Iyengar S, Ossipov M, Johnson K . The role of calcitonin gene-related peptide in peripheral and central pain mechanisms including migraine. Pain. 2017; 158(4):543-559. PMC: 5359791. DOI: 10.1097/j.pain.0000000000000831. View

Bellamy J, Bowen E, Russo A, Durham P . Nitric oxide regulation of calcitonin gene-related peptide gene expression in rat trigeminal ganglia neurons. Eur J Neurosci. 2006; 23(8):2057-66. PMC: 1486900. DOI: 10.1111/j.1460-9568.2006.04742.x. View

Messlinger K . The big CGRP flood - sources, sinks and signalling sites in the trigeminovascular system. J Headache Pain. 2018; 19(1):22. PMC: 5847494. DOI: 10.1186/s10194-018-0848-0. View

Lanfumey L, Hamon M . 5-HT1 receptors. Curr Drug Targets CNS Neurol Disord. 2004; 3(1):1-10. DOI: 10.2174/1568007043482570. View

Edvinsson L, Haanes K, Warfvinge K, Krause D . CGRP as the target of new migraine therapies - successful translation from bench to clinic. Nat Rev Neurol. 2018; 14(6):338-350. DOI: 10.1038/s41582-018-0003-1. View

. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38(1):1-211. DOI: 10.1177/0333102417738202. View

Ahn A, Basbaum A . Where do triptans act in the treatment of migraine?. Pain. 2005; 115(1-2):1-4. PMC: 1850935. DOI: 10.1016/j.pain.2005.03.008. View

Goadsby P, Edvinsson L, Ekman R . Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990; 28(2):183-7. DOI: 10.1002/ana.410280213. View

10.

Neeb L, Reuter U . Nitric oxide in migraine. CNS Neurol Disord Drug Targets. 2007; 6(4):258-64. DOI: 10.2174/187152707781387233. View

11.

Oliver K, Wainwright A, Edvinsson L, Pickard J, Hill R . Immunohistochemical localization of calcitonin receptor-like receptor and receptor activity-modifying proteins in the human cerebral vasculature. J Cereb Blood Flow Metab. 2002; 22(5):620-9. DOI: 10.1097/00004647-200205000-00014. View

12.

Dawson T, Dawson V . Nitric oxide synthase: role as a transmitter/mediator in the brain and endocrine system. Annu Rev Med. 1996; 47:219-27. DOI: 10.1146/annurev.med.47.1.219. View

13.

Steiner T, Stovner L, Birbeck G . Migraine: the seventh disabler. Headache. 2013; 53(2):227-9. DOI: 10.1111/head.12034. View

14.

The Lancet Neurology . Complicated decisions on new migraine-prevention therapies. Lancet Neurol. 2019; 18(3):221. DOI: 10.1016/S1474-4422(19)30041-9. View

15.

Juhasz G, Zsombok T, Jakab B, Nemeth J, Szolcsanyi J, Bagdy G . Sumatriptan causes parallel decrease in plasma calcitonin gene-related peptide (CGRP) concentration and migraine headache during nitroglycerin induced migraine attack. Cephalalgia. 2005; 25(3):179-83. DOI: 10.1111/j.1468-2982.2005.00836.x. View

16.

Afroz S, Arakaki R, Iwasa T, Oshima M, Hosoki M, Inoue M . CGRP Induces Differential Regulation of Cytokines from Satellite Glial Cells in Trigeminal Ganglia and Orofacial Nociception. Int J Mol Sci. 2019; 20(3). PMC: 6386987. DOI: 10.3390/ijms20030711. View

17.

Eftekhari S, Warfvinge K, Blixt F, Edvinsson L . Differentiation of nerve fibers storing CGRP and CGRP receptors in the peripheral trigeminovascular system. J Pain. 2013; 14(11):1289-303. DOI: 10.1016/j.jpain.2013.03.010. View

18.

Brain S, Grant A . Vascular actions of calcitonin gene-related peptide and adrenomedullin. Physiol Rev. 2004; 84(3):903-34. DOI: 10.1152/physrev.00037.2003. View

19.

Edvinsson L, Haanes K, Warfvinge K . Does inflammation have a role in migraine?. Nat Rev Neurol. 2019; 15(8):483-490. DOI: 10.1038/s41582-019-0216-y. View

20.

Kanatani H, Kohda H, Yamasaki K, HOTTA I, Nakata Y, Segawa T . The active principles of the branchlet and hook of Uncaria sinensis Oliv. examined with a 5-hydroxytryptamine receptor binding assay. J Pharm Pharmacol. 1985; 37(6):401-4. DOI: 10.1111/j.2042-7158.1985.tb03023.x. View