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- W2024704465 abstract "In this issue of Cephalalgia Tuka and colleagues examine and compare levels of pituitary adenylate cyclaseactivating polypeptide-38 (PACAP-38) with calcitonin gene-related peptide (CGRP) in blood from the cubital vein of 87 migraineurs (ictal and interictal) and of 40 healthy controls. The authors report that both peptides are elevated in the peripheral circulation during migraine attacks as compared to their levels between attacks. There was no association with gender, age, attack frequency, allodynia, visual analogue scale score or migraine type (1). PACAP-38 was lower in interictal blood of the patients than in healthy controls. The reason behind this is not clear but we should realize that any analysis of peptides in the peripheral circulation reflects PACAP-38 levels that may come from the entire body, and therefore it is difficult to link it directly to the brain or to cranial structures. Since both PACAP-38 and CGRP are elevated during migraine attacks, the authors suggest a role in migraine. Another interesting finding is the observation of significant release of PACAP-38 during migraine attacks (i) in nonmenstrual migraine and (ii) in subjects without chronic back pain. The implication is so far not clear but opens the way for more research. In support of this study, the Copenhagen group has revealed that intravenous administration of PACAP-38 results in headache in healthy individuals and in migraine-like effects (after a mean of six hours) in migraine without aura patients (2). This group has in addition reported that PACAP-38 results in a related increase in the diameter of cranial arteries (2,3). They propose that PACAP-38 caused vasodilation, which resulted in the headache, providing support for the vascular theory of migraine (4). Because the closely related peptide vasoactive intestinal peptide (VIP) elicits the same degree of vasodilatation via the same type of receptors but lacks the migraine-inducing response (5), we are awaiting the head-to-head comparison study and an explanation of this interesting observation." @default.
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- W2024704465 date "2013-04-10" @default.
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- W2024704465 title "Role of VIP/PACAP in primary headaches" @default.
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- W2024704465 doi "https://doi.org/10.1177/0333102413483929" @default.
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