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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Headache+Pain
2018 ; 19
(1
): 23
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PACAP and migraine headache: immunomodulation of neural circuits in autonomic
ganglia and brain parenchyma
#MMPMID29536279
Waschek JA
; Baca SM
; Akerman S
J Headache Pain
2018[Mar]; 19
(1
): 23
PMID29536279
show ga
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).