ABSTRACT

Introduction

Interest is growing in the role of pituitary adenylate cyclase-activating polypeptide (PACAP) and its specific PAC1 receptor in migraine and in their antagonism as a strategy for migraine prevention.

Areas covered

We discuss and critically evaluate (i) the evidence of the role of PACAP in migraine pathophysiology and (ii) the first clinical trials in migraine prophylaxis with monoclonal antibodies AMG 301 and ALD1910 which act against PAC1 and PACAP38 respectively. We examined PubMed, Scopus, and ClinicalTrials.gov electronic databases to examine the relevant material.

Expert opinion

There is much proof of the ability of PACAP to cause migraine, but there is limited evidence that blocking PACAP or PAC1 receptor can prevent migraine. However, the potential of anti-PACAP antibodies in migraine prophylaxis is high. Theoretically, if these antibodies block the activation of the trigeminovascular system, they will prevent the onset of migraine attacks. There are still knowledge gaps in the role of PACAP in migraine and the risk/benefit ratio of anti-PACAP antibodies must be carefully studied.

中文翻译：

---

用单克隆抗体靶向垂体腺苷酸环化酶激活多肽 (PACAP) 预防偏头痛：简要回顾。

摘要

介绍

人们越来越关注垂体腺苷酸环化酶激活多肽 (PACAP) 及其特异性 PAC1 受体在偏头痛中的作用以及它们作为偏头痛预防策略的拮抗作用。

涵盖的领域

我们讨论并批判性地评估（i）PACAP 在偏头痛病理生理学中作用的证据和（ii）分别针对 PAC1 和 PACAP38 的单克隆抗体 AMG 301 和 ALD1910 预防偏头痛的首次临床试验。我们检查了 PubMed、Scopus 和 ClinicalTrials.gov 电子数据库以检查相关材料。

专家意见

有很多证据表明 PACAP 能够引起偏头痛，但只有有限的证据表明阻断 PACAP 或 PAC1 受体可以预防偏头痛。然而，抗 PACAP 抗体在偏头痛预防中的潜力很高。从理论上讲，如果这些抗体阻断三叉神经血管系统的激活，它们将防止偏头痛发作。关于 PACAP 在偏头痛中的作用仍然存在知识空白，必须仔细研究抗 PACAP 抗体的风险/收益比。