Sayak Banerjee, Amity University Kolkata
Migraine and its chronification:
Migraine is a significant primary headache disorder as it ranks the sixth most prevailing disease and the second cause of disability worldwide. This widespread neurological disease is distinguished by headaches which might take place with or without aura. An aura is a kind of sensory disturbance which occurs shortly before a migraine attack proceeds. It generally involves neurological symptoms such as sensory, speech, visual, motor, retinal, and brainstem, that lead up to hours or days.
Migraines fall under the class of chronic diseases which are depicted by episodic manifestations (CDEM). It can undergo chronification and the prevention of episodic attacks is essential for evading chronification. The chronification is characterized as cephalic at the initial stage and extracephalic or generalized at a later stage. Among the vasodilatory neuropeptides associated with dural neurogenic inflammation, calcitonin gene-related peptide (CGRP) is effectively responsible for vasodilation acting on its receptor.
SNP influencing Migraine Susceptibility:
Many single-nucleotide polymorphisms (SNPs) are linked with differences in migraine susceptibility, clinical features, and treatment response. Although a growing interest has been seen over the last few years, very little is known regarding the significance of these polymorphisms and their effect on anti-migraine treatment.
Recently, a group of four scientists (three from Germany and one from Italy) have identified the SNPs that affect various segments of the CGRP pathway. They determined how SNPs can affect the development of migraine with the presence of aura and the efficiency of the treatment.
Novel therapeutics like pants, antagonists of the CGRP receptor, and the anti-CGRP(R) monoclonal antibodies (mAbs) target the CGRP signaling. Despite being the first specific preventive therapy that can provide pain relief to difficult-to-treat patients, the anti-CGRP(R) mAbs renders 40 % of the patients to be non-responders. For acute treatment of attacks, certain anti-migraine drugs such as triptans inhibit the release of CGRP during migraine attacks. Some SNPs have been observed to show responsiveness to drugs and the propensity to chronification with overuse and medications overuse headache (MOH).
Monoclonal Antibodies as a Fundamental approach:
The mAbs are the elementary tool in the weaponry of migraine therapy, even for difficult-to-treat patients devoid of relief from the treatment. The mAbs targeting CGRP provide positive results rather than anti-mAbs antibodies with considerably less safety and efficacy. However, the researchers mentioned that more investigation is required for the genetic variants along with the CGRP signaling. Due to these, the pathway is not completely inhibited in action, although fully blocked. This results in a percentage of non-responders to the mAB treatment.
Further research is necessary to understand how genetic variants influence the CGRP signaling on migraine susceptibility. In the future genetic profiling will be fundamental to predict the effectiveness and safety of therapy, depending on individual genetic variability. The scientists stated that this study has opened the doors to the association between inhibiting primary headache and familial Alzheimer’s disease. Moreover, an aged group of people needs to be focused on migraine genetic association studies.
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Reference:
- Scuteri, D., Corasaniti, M. T., Tonin, P., Nicotera, P., & Bagetta, G. (2021). Role of CGRP pathway polymorphisms in migraine: A systematic review and impact on CGRP mAbs migraine therapy. The Journal of Headache and Pain, 22(1), 87. https://doi.org/10.1186/s10194-021-01295-7
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Author info:
Sayak Banerjee is a 3rd year Biotechnology Engineering Student with great interest in Immunology and Molecular genetics. He is a creative scientific writer in Bioxone with an inclination towards gaining knowledge regarding vast sections of Biotechnology and emphasizing himself in various wet lab skills.
Publications:
- https://bioxone.in/news/worldnews/car-t-cells-scientists-discover-on-off-switches-for-cell-immunotherapy/
- https://bioxone.in/news/worldnews/neutrophil-derived-nanovesicles-a-novel-drug-delivery-system/
- https://bioxone.in/news/worldnews/pig-to-human-heart-transplantation-a-solution-to-the-rarity-of-donor-organs/
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