Hope for a new migraine medication

Headache clipart. Courtesy of ClipArtHut.
Headache. Courtesy of ClipArtHut.

The best current anti-migraine medication are triptans (5-HT1B/1D receptor agonists). Because these medications are contra-indicated in patients with a variety of other diseases (cardiovascular, renal, hepatic, etc.), the search for alternative drugs continues.

The heat- and pain-sensitive TRPV1 receptors (Transient Receptor Potential Vanilloid 1) localized on the trigeminal terminals (the fifth cranial nerve) have been implicated in the production of headaches. That is, if you activate them by, say, capsaicin, the same substance that gives the chili peppers their hotness, you get headaches (you’d have to eat an awful lot of peppers to get the migraine, though). On the other hand, if you block these receptors by triptans, you alleviate the migraines. All good and well, so let’s hunt for some TRPV1 antagonists, i.e. blockers. But, as theory often doesn’t meet practice, the first two antagonists that were tried were dropped in the clinical trials for lack of efficiency.

Meents et al. (2015) are giving another try to two different TRPV1 antagonists, by their fetching names of JNJ-38893777 and JNJ-17203212, respectively. Because you cannot ask a rat if it has a headache, it is very difficult to have a rodent model for migraine. Instead, researchers focused on giving rats some inflammatory soup directly into the subarachnoid space or capsaicin directly into the carotid artery, actions which they have reasons to believe produce severe headaches and some biological changes, like increase in a certain gene expression (c-fos, if you must know) in the trigeminal brain stem complex and release of the neurotransmitter calcitonin gene-related peptide (CGRP).

JNJ-17203212 got rid of all those physiological changes in a dose-dependent manner, presumably of the migraine, too. The other drug, JNJ-38893777, was effective only on the highest dose. Give these drugs a few more tests to pass, and off to the clinical trials with them. I’m joking, it takes a lot more research than just a paper between discovery and human drug trials.

Reference: Meents JE, Hoffmann J, Chaplan SR, Neeb L, Schuh-Hofer S, Wickenden A, & Reuter U (December 2015, Epub 24 June 2015). Two TRPV1 receptor antagonists are effective in two different experimental models of migraine. The Journal of Headache and Pain. 16:57. doi: 10.1186/s10194-015-0539-z. Article | FREE FULLTEXT PDF

By Neuronicus, 8 November 2015

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