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Open Access 01-12-2018 | Review article

PACAP and migraine headache: immunomodulation of neural circuits in autonomic ganglia and brain parenchyma

Authors: James A. Waschek, Serapio M. Baca, Simon Akerman

Published in: The Journal of Headache and Pain | Issue 1/2018

Abstract

The discovery that intravenous (IV) infusions of the neuropeptide PACAP-38 (pituitary adenylyl cyclase activating peptide-38) induced delayed migraine-like headaches in a large majority of migraine patients has resulted in considerable excitement in headache research. In addition to suggesting potential therapeutic targets for migraine, the finding provides an opportunity to better understand the pathological events from early events (aura) to the headache itself. Although PACAP-38 and the closely related peptide VIP (vasoactive intestinal peptide) are well-known as vasoactive molecules, the dilation of cranial blood vessels per se is no longer felt to underlie migraine headaches. Thus, more recent research has focused on other possible PACAP-mediated mechanisms, and has raised some important questions. For example, (1) are endogenous sources of PACAP (or VIP) involved in the triggering and/or propagation of migraine headaches?; (2) which receptor subtypes are involved in migraine pathophysiology?; (3) can we identify specific anatomical circuit(s) where PACAP signaling is involved in the features of migraine? The purpose of this review is to discuss the possibility, and supportive evidence, that PACAP acts to induce migraine-like symptoms not only by directly modulating nociceptive neural circuits, but also by indirectly regulating the production of inflammatory mediators. We focus here primarily on postulated extra-dural sites because potential mechanisms of PACAP action in the dura are discussed in detail elsewhere (see X, this edition).

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Title: PACAP and migraine headache: immunomodulation of neural circuits in autonomic ganglia and brain parenchyma
Authors: James A. Waschek
Serapio M. Baca
Simon Akerman
Publication date: 01-12-2018
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2018
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-018-0850-6

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Springer Medicine

PACAP and migraine headache: immunomodulation of neural circuits in autonomic ganglia and brain parenchyma

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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