TEACHABLE MEDICAL NEWS

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Tag: CGRP

Can we relieve migraine pain by changing neurotransmitter balance in the brain?

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On December 26, 2022

In nervous system, somatic senses, tissues

TeachableMedicalNews article 12262022

Teachable moment in classrooms:

  1. nervous tissue chapter – conduction of nerve impulses by axons of neurons
  2. nervous tissue chapter – starting a new nerve impulse by neurotransmitters
  3. brain chapter – anatomical location of thalamus and postcentral gyrus
  4. brain chapter – anatomy and function of trigeminal nerve, cranial nerve V
  5. somatic senses chapter – nerve impulse pathway from pain receptors (nociceptors)

The news item:  Recently the following report appeared online:

New migraine medication given the green light

Migraine sufferers are excited when a new anti-migraine option is available. In this case, it’s medicine called Reyvow.

The article states that migraine is a neurological disorder that causes recurring pain, sensitivity to light, and nausea. Migraine affects 30 million people worldwide, and it is the leading cause of disability. While there are approved medications to treat migraine, this new option, called Reyvow, can be taken by people who have heart disease, high blood pressure, or a history of stroke. The article also states that Reyvow activates the (5-HT) 1F receptors that increase serotonin neurotransmitters and inhibit pain pathways.

So, Why Do I Care??  According to the American Migraine Foundation over 10 million adults in the US suffer from migraine, causing each year over $11 billion economic loss from lost workdays and lost productivity.  Because existing migraine treatment do not work for all patients, new treatments are welcome, because they widen the circle of patients who can be effectively treated.

Plain English, Please!!! First, let’s talk about how migraine occurs. This disorder is characterized by sudden onset feeling (perception) of headache pain, sensitivity to light, or nausea. These symptoms appear suddenly and repeatedly, and can distract and disable people from carrying out daily functions. At first it was thought that abnormal dilation (widening) of blood vessels of the brain caused it, but recently migraine has been linked to the malfunctioning of our nervous system.  According to that during migraine the neurons that make up the pain pathways create unwanted nerve impulses.

Second, let’s talk about what pain pathways are. In our nervous system the word “pathway” means a bundle of axons that carry and deliver nerve impulses to their destination. The pain-carrying nerve

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Can an injectable treatment reduce cluster headaches?

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On November 30, 2019

In cellular basis of life, lymphatic and immune system, nervous system

TeachableMedicalNews article 11302019

Teachable moment in classrooms:

  1. Cellular basis of life chapter – receptors on cell membranes bind ligands
  2. general senses chapter – unconventional types of pain
  3. general senses chapter – pharmaceuticals of pain control
  4. immune system chapter – antibodies as pharmaceuticals

The news item:  A new injectable treatment for cluster headaches has recently been in the news:

Emgality Receives First FDA Approval for Treating Cluster Headache

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The article mentions the similarity of the pain of cluster headaches to that of migraines, and the approval of the drug Emgality (galcanazumab).

So, Why Do I Care??

About 1 million people suffer from a debilitating disorder, cluster headaches, in the USA.  While there are several therapeutic approaches to cluster headaches, but their effectiveness varies, and many of those treatments have unpleasant side effects.

Plain English, Please!!!  First, let’s talk about cluster headache.  Cluster headache a quick onset and intensely painful type of headache.  That pain makes patients disfunctional, and many cases the pain wakes them up at night, and, so, that is why this disorder is so debilitating.  The headaches happen during a particular time of the day, because these headaches are linked to the body’s own internal clock.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain

Third, let’s talk about this new treatment for cluster headache.  Because cluster headache is not the result of tissue damage, common pain killers don’t work well on cluster headache pain.  Many years of research identified a chemical that trigger cluster headache pain; that chemical is called calcitonin gene related peptide (CGRP).  Cluster headaches happen when CGRP reaches receptors on neurons in the brain.   So, how can you block the action of that peptide?  Imagine a football game where the defensive tackle wraps his arms around the running back to keep him out of the end zone.  The drug mentioned in the article, galcanezumab, acts like a defensive tackle wrapping arms around the running back CGRP, and keeping it away from receptors on neurons in the brain.  The defensive tackle, galcanezumab, can target CGRP only, because galcanezumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

Can an injectable treatment work for migraines?

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On July 31, 2019

In lymphatic and immune system, nervous system

TeachableMedicalNews article 07312019

Teachable moment in classrooms:

  1. general senses chapter – unconventional types of pain
  2. general senses chapter – pharmaceuticals in of pain control
  3. immune system chapter – antibodies as pharmaceuticals

 

Can an injectable treatment work for migraines?

 The news item:  New injectable preventions and treatments for migraine were in the news recently. One of them is Aimovig (erenumab):

FDA approves new drug that stops chronic migraines

The FDA approves, Erenumab, a new migraine treatment, that blocks chronic and disabling headaches, without causing many side effects.

The article mentions migraine statistics, the calcitonin gene related peptide (CGRP) as the culprit in migraines, and that the new drug is an antibody.

 

So, Why Do I Care??  There are about 39 million migraine sufferers in the USA.  Among them about 4 million who suffers from chronic migraine lasting for 10-14 days.  The impact of migraine is more than the personal suffering; the US economy loses $36 billion yearly because of lost productivity linked to migraine.  While occasional migraine can be successfully treated with common medications, the chronic migraine sufferers don’t have a reliable treatment.

 

Plain English, Please!!!  First, let’s talk about migraine.  Migraine is a disorder of the central nervous system, and during a migraine attack the malfunctioning nervous system creates pain in the head area, visual disturbances (auras), and sometimes dizziness and nausea.   So, that’s why this disorder is so debilitating.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain.  Everyday pain killer drugs either block the action of chemical released during tissue damage, or they block the movement of the nerve impulse to the brain.

Third, let’s talk about this new treatment for migraine. Because migraine is not the result of tissue damage, common pain killers don’t work on chronic migraine pain.  Many years of research identified a chemical that trigger migraine pain; that chemical is called calcitonin gene related peptide (CGRP).  Migraine happens when CGRP reaches receptors on the neurons in the brain.   The receptor is like a wide receiver in football; the peptide has to be caught by the receptor to start migraine pain, like the wide receiver has to catch the football for a touchdown.  So, how can you block the action of that migraine-triggering peptide?  Imagine a football game where the arms of the wide receiver are duct taped to his body.  The drug erenumab does that to the receptor, so the CGRP peptide can not be caught by the receptor, so there is no more triggering of pain.  The duct tape, erenumab, can target CGRP receptors only, because erenumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

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