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Journal of Translational Medicine
Published in: Journal of Translational Medicine 1/2021

Open Access 01-12-2021 | Migraine | Review

Anti-migraine agents from an immunological point of view

Author: Mushref Bakri Assas

Published in: Journal of Translational Medicine | Issue 1/2021

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Abstract

The new wave of anti-migraine agents is nothing less than a milestone in our battle to manage this devastating disease. However, concerns have recently increased regarding the safety of these drugs. CGRP, while known as a potent vasodilator, is also a key neural and immune modulator. The roles of CGRP in immune determination, have been studied in depth, with particular focus on its functional significance with respect to common immune challenges i.e., bacterial, viral, fungal and parasitic infections. This review discusses many potential areas of concern in regard to blocking CGRP function and its potential influence on immune milieus during infection, and the risk of adverse effects. Finally, this review recommends specific measures to be taken into consideration when administering anti-CGRP/CGRPR agents.
Literature
1.
Rosenfeld MG, Mermod JJ, Amara SG, Swanson LW, Sawchenko PE, Rivier J, et al. Production of a novel neuropeptide encoded by the calcitonin gene via tissue-specific RNA processing. Nature. 1983;304(5922):129–35.PubMedCrossRef
2.
Inaba M, Nishizawa Y, Morii H. Tissue distribution and physiologic role of calcitonin and CGRP. Nihon Rinsho. 1990;48(5):1011–5.PubMed
3.
Connor KM, Aurora SK, Loeys T, Ashina M, Jones C, Giezek H, et al. Long-term tolerability of telcagepant for acute treatment of migraine in a randomized trial. Headache. 2011;51(1):73–84.PubMedCrossRef
4.
Conner AC, Hay DL, Howitt SG, Kilk K, Langel U, Wheatley M, et al. Interaction of calcitonin-gene-related peptide with its receptors. Biochem Soc Trans. 2002;30(4):451–5.PubMedCrossRef
5.
6.
Hilairet S, Belanger C, Bertrand J, Laperriere A, Foord SM, Bouvier M. Agonist-promoted internalization of a ternary complex between calcitonin receptor-like receptor, receptor activity-modifying protein 1 (RAMP1), and beta-arrestin. J Biol Chem. 2001;276(45):42182–90.PubMedCrossRef
7.
Moreno MJ, Cohen Z, Stanimirovic DB, Hamel E. Functional calcitonin gene-related peptide type 1 and adrenomedullin receptors in human trigeminal ganglia, brain vessels, and cerebromicrovascular or astroglial cells in culture. J Cereb Blood Flow Metab. 1999;19(11):1270–8.PubMedCrossRef
8.
Maggi CA. Tachykinins and calcitonin gene-related peptide (CGRP) as co-transmitters released from peripheral endings of sensory nerves. Prog Neurobiol. 1995;45(1):1–98.PubMedCrossRef
9.
Assas BM, Miyan JA, Pennock JL. Cross-talk between neural and immune receptors provides a potential mechanism of homeostatic regulation in the gut mucosa. Mucosal Immunol. 2014;7(6):1283–9.PubMedCrossRef
10.
Breeze AL, Harvey TS, Bazzo R, Campbell ID. Solution structure of human calcitonin gene-related peptide by 1H NMR and distance geometry with restrained molecular dynamics. Biochemistry. 1991;30(2):575–82.PubMedCrossRef
11.
Negro A, Lionetto L, Simmaco M, Martelletti P. CGRP receptor antagonists: an expanding drug class for acute migraine? Expert Opin Investig Drugs. 2012;21(6):807–18.PubMedCrossRef
12.
Olesen J, Diener HC, Husstedt IW, Goadsby PJ, Hall D, Meier U, et al. Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004;350(11):1104–10.PubMedCrossRef
13.
Robbins MS, Lipton RB. The epidemiology of primary headache disorders. Semin Neurol. 2010;30(2):107–19.PubMedCrossRef
14.
Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343–9.PubMedCrossRef
15.
16.
May A, Schulte LH. Chronic migraine: risk factors, mechanisms and treatment. Nat Rev Neurol. 2016;12(8):455–64.PubMedCrossRef
17.
Goadsby PJ, Edvinsson L. The trigeminovascular system and migraine: studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats. Ann Neurol. 1993;33(1):48–56.PubMedCrossRef
18.
Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990;28(2):183–7.PubMedCrossRef
19.
Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies-successful translation from bench to clinic. Nat Rev Neurol. 2018;14(6):338–50.PubMedCrossRef
20.
Olesen J, Burstein R, Ashina M, Tfelt-Hansen P. Origin of pain in migraine: evidence for peripheral sensitisation. Lancet Neurol. 2009;8(7):679–90.PubMedCrossRef
21.
Traynor K. FDA approves licensing of erenumab-aooe to prevent migraine. Am J Health Syst Pharm. 2018;75(13):929–30.PubMed
22.
Khan S, Olesen A, Ashina M. CGRP, a target for preventive therapy in migraine and cluster headache: systematic review of clinical data. Cephalalgia. 2019;39(3):374–89.PubMedCrossRef
23.
Bigal ME, Dodick DW, Rapoport AM, Silberstein SD, Ma Y, Yang R, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of high-frequency episodic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015;14(11):1081–90.PubMedCrossRef
24.
Bigal ME, Edvinsson L, Rapoport AM, Lipton RB, Spierings EL, Diener HC, et al. Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of chronic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study. Lancet Neurol. 2015;14(11):1091–100.PubMedCrossRef
25.
Sun H, Dodick DW, Silberstein S, Goadsby PJ, Reuter U, Ashina M, et al. Safety and efficacy of AMG 334 for prevention of episodic migraine: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol. 2016;15(4):382–90.PubMedCrossRef
26.
Dodick DW, Goadsby PJ, Silberstein SD, Lipton RB, Olesen J, Ashina M, et al. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol. 2014;13(11):1100–7.PubMedCrossRef
27.
Dodick DW, Goadsby PJ, Spierings EL, Scherer JC, Sweeney SP, Grayzel DS. Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: a phase 2, randomised, double-blind, placebo-controlled study. Lancet Neurol. 2014;13(9):885–92.PubMedCrossRef
28.
Deen M, Correnti E, Kamm K, Kelderman T, Papetti L, Rubio-Beltran E, et al. Blocking CGRP in migraine patients-a review of pros and cons. J Headache Pain. 2017;18(1):96.PubMedPubMedCentralCrossRef
29.
Christensen CE, Younis S, Deen M, Khan S, Ghanizada H, Ashina M. Migraine induction with calcitonin gene-related peptide in patients from erenumab trials. J Headache Pain. 2018;19(1):105.PubMedPubMedCentralCrossRef
30.
Hosoi J, Murphy GF, Egan CL, Lerner EA, Grabbe S, Asahina A, et al. Regulation of Langerhans cell function by nerves containing calcitonin gene-related peptide. Nature. 1993;363(6425):159–63.PubMedCrossRef
31.
Assas BM, Wakid MH, Zakai HA, Miyan JA, Pennock JL. Transient receptor potential vanilloid 1 expression and function in splenic dendritic cells: a potential role in immune homeostasis. Immunology. 2016;147(3):292–304.PubMedPubMedCentralCrossRef
32.
Engel MA, Becker C, Reeh PW, Neurath MF. Role of sensory neurons in colitis: increasing evidence for a neuroimmune link in the gut. Inflamm Bowel Dis. 2011;17(4):1030–3.PubMedCrossRef
33.
Blalock JE. Shared ligands and receptors as a molecular mechanism for communication between the immune and neuroendocrine systems. Ann N Y Acad Sci. 1994;741:292–8.PubMedCrossRef
34.
Fernandez S, Knopf MA, Bjork SK, McGillis JP. Bone marrow-derived macrophages express functional CGRP receptors and respond to CGRP by increasing transcription of c-fos and IL-6 mRNA. Cell Immunol. 2001;209(2):140–8.PubMedCrossRef
35.
Harzenetter MD, Novotny AR, Gais P, Molina CA, Altmayr F, Holzmann B. Negative regulation of TLR responses by the neuropeptide CGRP is mediated by the transcriptional repressor ICER. J Immunol. 2007;179(1):607–15.PubMedCrossRef
36.
Bauer O, Razin E. Mast Cell-Nerve Interactions. News Physiol Sci. 2000;15:213–8.PubMed
37.
Blennerhassett MG, Tomioka M, Bienenstock J. Formation of contacts between mast cells and sympathetic neurons in vitro. Cell Tissue Res. 1991;265(1):121–8.PubMedCrossRef
38.
Blennerhassett MG, Bienenstock J. Sympathetic nerve contact causes maturation of mast cells in vitro. J Neurobiol. 1998;35(2):173–82.PubMedCrossRef
39.
Asahina A, Hosoi J, Murphy GF, Granstein RD. Calcitonin gene-related peptide modulates Langerhans cell antigen-presenting function. Proc Assoc Am Physicians. 1995;107(2):242–4.PubMed
40.
Asahina A, Moro O, Hosoi J, Lerner EA, Xu S, Takashima A, et al. Specific induction of cAMP in Langerhans cells by calcitonin gene-related peptide: relevance to functional effects. Proc Natl Acad Sci USA. 1995;92(18):8323–7.PubMedPubMedCentralCrossRef
41.
Asahina A, Hosoi J, Grabbe S, Granstein RD. Modulation of Langerhans cell function by epidermal nerves. J Allergy Clin Immunol. 1995;96(6 Pt 2):1178–82.PubMedCrossRef
42.
Dunzendorfer S, Kaser A, Meierhofer C, Tilg H, Wiedermann CJ. Cutting edge: peripheral neuropeptides attract immature and arrest mature blood-derived dendritic cells. J Immunol. 2001;166(4):2167–72.PubMedCrossRef
43.
Steinman L. Elaborate interactions between the immune and nervous systems. Nat Immunol. 2004;5(6):575–81.PubMedCrossRef
44.
Levite M. Neuropeptides, by direct interaction with T cells, induce cytokine secretion and break the commitment to a distinct T helper phenotype. Proc Natl Acad Sci USA. 1998;95(21):12544–9.PubMedPubMedCentralCrossRef
45.
Blalock JE. The syntax of immune-neuroendocrine communication. Immunol Today. 1994;15(11):504–11.PubMedCrossRef
46.
Wang H, Xing L, Li W, Hou L, Guo J, Wang X. Production and secretion of calcitonin gene-related peptide from human lymphocytes. J Neuroimmunol. 2002;130(1–2):155–62.PubMedCrossRef
47.
Rola-Pleszczynski M, Bolduc D, St-Pierre S. The effects of vasoactive intestinal peptide on human natural killer cell function. J Immunol. 1985;135(4):2569–73.PubMedCrossRef
48.
Benschop RJ, Schedlowski M, Wienecke H, Jacobs R, Schmidt RE. Adrenergic control of natural killer cell circulation and adhesion. Brain Behav Immun. 1997;11(4):321–32.PubMedCrossRef
49.
50.
Mikami N, Matsushita H, Kato T, Kawasaki R, Sawazaki T, Kishimoto T, et al. Calcitonin gene-related peptide is an important regulator of cutaneous immunity: effect on dendritic cell and T cell functions. J Immunol. 2011;186(12):6886–93.PubMedCrossRef
51.
Fox FE, Kubin M, Cassin M, Niu Z, Hosoi J, Torii H, et al. Calcitonin gene-related peptide inhibits proliferation and antigen presentation by human peripheral blood mononuclear cells: effects on B7, interleukin 10, and interleukin 12. J Invest Dermatol. 1997;108(1):43–8.PubMedCrossRef
52.
Guedon JM, Yee MB, Zhang M, Harvey SA, Goins WF, Kinchington PR. Neuronal changes induced by Varicella Zoster Virus in a rat model of postherpetic neuralgia. Virology. 2015;482:167–80.PubMedCrossRef
53.
Maratou K, Wallace VC, Hasnie FS, Okuse K, Hosseini R, Jina N, et al. Comparison of dorsal root ganglion gene expression in rat models of traumatic and HIV-associated neuropathic pain. Eur J Pain. 2009;13(4):387–98.PubMedPubMedCentralCrossRef
54.
Flowerdew SE, Wick D, Himmelein S, Horn AK, Sinicina I, Strupp M, et al. Characterization of neuronal populations in the human trigeminal ganglion and their association with latent herpes simplex virus-1 infection. PLoS ONE. 2013;8(12):e83603.PubMedPubMedCentralCrossRef
55.
Itzhaki R. Herpes simplex virus type 1, apolipoprotein E and Alzheimer’ disease. Herpes. 2004;11(Suppl 2):77A–82A.PubMed
56.
Itzhaki RF, Tabet N. Herpes simplex encephalitis and Alzheimer’s disease: is there a link? J Neurol Sci. 2017;380:20–1.PubMedCrossRef
57.
Itzhaki RF, Lathe R. Herpes Viruses and Senile Dementia: first Population Evidence for a Causal Link. J Alzheimers Dis. 2018;64(2):363–6.PubMedCrossRef
58.
Yaraee R, Ebtekar M, Ahmadiani A, Sabahi F. Neuropeptides (sp and CGRP) augment IL-1 Beta production in hsv-infected macrophages. Iran J Allergy Asthma Immunol. 2003;2(2):95–100.PubMed
59.
Bomsel M, Ganor Y. Calcitonin Gene-Related Peptide Induces HIV-1 Proteasomal Degradation in Mucosal Langerhans Cells. J Virol. 2017;91(23).
60.
Ganor Y, Drillet-Dangeard AS, Bomsel M. Calcitonin gene-related peptide inhibits human immunodeficiency type 1 transmission by Langerhans cells via an autocrine/paracrine feedback mechanism. Acta Physiol. 2015;213(2):432–41.CrossRef
61.
Bomsel M, Lopalco L, Uberti-Foppa C, Siracusano G, Ganor Y. Short communication: decreased plasma calcitonin gene-related peptide as a novel biomarker for HIV-1 disease progression. AIDS Res Hum Retroviruses. 2019;35(1):52–5.PubMedCrossRef
62.
El Karim IA, Linden GJ, Orr DF, Lundy FT. Antimicrobial activity of neuropeptides against a range of micro-organisms from skin, oral, respiratory and gastrointestinal tract sites. J Neuroimmunol. 2008;200(1–2):11–6.PubMedCrossRef
63.
Lyte M, Arulanandam BP, Frank CD. Production of Shiga-like toxins by Escherichia coli O157:H7 can be influenced by the neuroendocrine hormone norepinephrine. J Lab Clin Med. 1996;128(4):392–8.PubMedCrossRef
64.
Bernard GW, Shih C. The osteogenic stimulating effect of neuroactive calcitonin gene-related peptide. Peptides. 1990;11(4):625–32.PubMedCrossRef
65.
N’Diaye AR, Leclerc C, Kentache T, Hardouin J, Poc CD, Konto-Ghiorghi Y, et al. Skin-bacteria communication: involvement of the neurohormone Calcitonin Gene Related Peptide (CGRP) in the regulation of Staphylococcus epidermidis virulence. Sci Rep. 2016;6:35379.PubMedPubMedCentralCrossRef
66.
Scharschmidt TC, Vasquez KS, Truong HA, Gearty SV, Pauli ML, Nosbaum A, et al. A wave of regulatory T cells into neonatal skin mediates tolerance to commensal microbes. Immunity. 2015;43(5):1011–21.PubMedPubMedCentralCrossRef
67.
Pinho-Ribeiro FA, Baddal B, Haarsma R, O’Seaghdha M, Yang NJ, Blake KJ, et al. Blocking Neuronal Signaling to Immune Cells Treats Streptococcal Invasive Infection. Cell. 2018;173(5):1083-97 e22.
68.
Benguettat O, Jneid R, Soltys J, Loudhaief R, Brun-Barale A, Osman D, et al. The DH31/CGRP enteroendocrine peptide triggers intestinal contractions favoring the elimination of opportunistic bacteria. PLoS Pathog. 2018;14(9):e1007279.PubMedPubMedCentralCrossRef
69.
Augustyniak D, Roszkowiak J, Wisniewska I, Skala J, Gorczyca D, Drulis-Kawa Z. Neuropeptides SP and CGRP Diminish the Moraxella catarrhalis Outer Membrane Vesicle- (OMV-) Triggered Inflammatory Response of Human A549 Epithelial Cells and Neutrophils. Mediators Inflamm. 2018;2018:4847205.PubMedPubMedCentralCrossRef
70.
Namai F, Yamamoto Y, Sato T, Ogita T, Shimosato T. Recombinant mouse calcitonin gene-related peptide secreted by Lactococcus lactis inhibits lipopolysaccharide-induced inflammatory response in macrophages. Anim Sci J. 2018;89(12):1707–11.PubMedCrossRef
71.
Zhou Y, Zhang H, Zhang G, He Y, Zhang P, Sun Z, et al. Calcitonin generelated peptide reduces Porphyromonas gingivalis LPSinduced TNFalpha release and apoptosis in osteoblasts. Mol Med Rep. 2018;17(2):3246–54.PubMed
72.
De Jonge F, Van Nassauw L, Adriaensen D, Van Meir F, Miller HR, Van Marck E, et al. Effect of intestinal inflammation on capsaicin-sensitive afferents in the ileum of Schistosoma mansoni-infected mice. Histochem Cell Biol. 2003;119(6):477–84.PubMedCrossRef
73.
Ahmed AA, Ahmed M, Theodorsson E, Nordlind K. Decreased concentrations of CGRP in Leishmania major murine cutaneous leishmaniasis. Neurosci Lett. 1998;246(3):149–52.PubMedCrossRef
74.
Ahmed AA, Wahbi A, Nordlind K, Kharazmi A, Sundqvist KG, Mutt V, et al. In vitro Leishmania major promastigote-induced macrophage migration is modulated by sensory and autonomic neuropeptides. Scand J Immunol. 1998;48(1):79–85.PubMedCrossRef
75.
Ruiz MR, Quinones AG, Diaz NL, Tapia FJ. Acute immobilization stress induces clinical and neuroimmunological alterations in experimental murine cutaneous leishmaniasis. Br J Dermatol. 2003;149(4):731–8.PubMedCrossRef
76.
Levite M. Nerve-driven immunity. The direct effects of neurotransmitters on T-cell function. Ann N Y Acad Sci. 2000;917:307-21.
77.
Harriott AM, Strother LC, Vila-Pueyo M, Holland PR. Animal models of migraine and experimental techniques used to examine trigeminal sensory processing. J Headache Pain. 2019;20(1):91.PubMedPubMedCentralCrossRef
78.
Zeller J, Poulsen KT, Sutton JE, Abdiche YN, Collier S, Chopra R, et al. CGRP function-blocking antibodies inhibit neurogenic vasodilatation without affecting heart rate or arterial blood pressure in the rat. Br J Pharmacol. 2008;155(7):1093–103.PubMedPubMedCentralCrossRef
79.
Schifter S, Krusell LR, Sehested J. Normal serum levels of calcitonin gene-related peptide (CGRP) in mild to moderate essential hypertension. Am J Hypertens. 1991;4(7 Pt 1):565–9.PubMedCrossRef
80.
Evans RW. Raynaud’s Phenomenon Associated With Calcitonin Gene-Related Peptide Monoclonal Antibody Antagonists. Headache. 2019.
81.
Bussiere JL, Davies R, Dean C, Xu C, Kim KH, Vargas HM, et al. Nonclinical safety evaluation of erenumab, a CGRP receptor inhibitor for the prevention of migraine. Regul Toxicol Pharmacol. 2019;106:224–38.PubMedCrossRef
82.
Bigal ME, Walter S, Rapoport AM. Fremanezumab as a preventive treatment for episodic and chronic migraine. Expert Rev Neurother. 2019.
83.
Giannouchos TV, Mitsikostas DD, Ohsfeldt RL, Vozikis A, Koufopoulou P. Cost-Effectiveness Analysis of Erenumab Versus OnabotulinumtoxinA for Patients with Chronic Migraine Attacks in Greece. Clin Drug Investig. 2019.
84.
Negro A, Martelletti P. Patient selection for migraine preventive treatment with anti-CGRP(r) monoclonal antibodies. Expert Rev Neurother. 2019;19(8):769–76.PubMedCrossRef
85.
Edvinsson L, Goadsby PJ. Neuropeptides in the cerebral circulation: relevance to headache. Cephalalgia. 1995;15(4):272–6.PubMedCrossRef
86.
Williamson DJ, Shepheard SL, Hill RG, Hargreaves RJ. The novel anti-migraine agent rizatriptan inhibits neurogenic dural vasodilation and extravasation. Eur J Pharmacol. 1997;328(1):61–4.PubMedCrossRef
87.
88.
Krymchantowski AV, Krymchantowski AGF, Jevoux CDC. Migraine treatment: the doors for the future are open, but with caution and prudence. Arq Neuropsiquiatr. 2019;77(2):115–21.PubMedCrossRef
89.
Majima M, Ito Y, Hosono K, Amano H. CGRP/CGRP receptor antibodies: potential adverse effects due to blockade of neovascularization? Trends Pharmacol Sci. 2019;40(1):11–21.PubMedCrossRef
90.
91.
Robbins L. CGRP antagonists: physiologic effects and serious side effects. Headache. 2018;58(9):1469–71.PubMedCrossRef
92.
In brief: Erenumab (Aimovig) hypersensitivity. Med Lett Drugs Ther. 2019;61(1568):48.
Metadata
Title
Anti-migraine agents from an immunological point of view
Author
Mushref Bakri Assas
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Migraine
Erenumab
Published in
Journal of Translational Medicine / Issue 1/2021
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-020-02681-6

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