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PACAP and its role in primary headaches.

Abstract
Pituitary adenylate cyclase-activating peptide (PACAP) is a neuropeptide implicated in a wide range of functions, such as nociception and in primary headaches. Regarding its localization, PACAP has been observed in the sensory trigeminal ganglion (TG), in the parasympathetic sphenopalatine (SPG) and otic ganglia (OTG), and in the brainstem trigeminocervical complex. Immunohistochemistry has shown PACAP-38 in numerous cell bodies of SPG/OTG, co-stored with vasoactive intestinal peptide (VIP), nitric oxide synthase (NOS) and, to a minor degree, with choline acetyltransferase. PACAP has in addition been found in a subpopulation of calcitonin gene-related peptide (CGRP)-immunoreactive cells in the trigeminal system. The PACAP/VIP receptors (PAC1, VPAC1, and VPAC2) are present in sensory neurons and in vascular smooth muscle related to the trigeminovascular system. It is postulated that PACAP is involved in nociception. In support, abolishment of PACAP synthesis or reception leads to diminished pain responses, whereas systemic PACAP-38 infusion triggers pain behavior in animals and delayed migraine-like attacks in migraine patients without marked vasodilatory effects. In addition, increased plasma levels have been documented in acute migraine attacks and in cluster headache, in accordance with findings in experimental models of trigeminal activation. This suggest that the activation of the trigeminal system may result in elevated venous levels of PACAP, a change that can be reduced when headache is treated. The data presented in this review indicate that PACAP and its receptors may be promising targets for migraine therapeutics.
AuthorsLars Edvinsson, János Tajti, Levente Szalárdy, László Vécsei
JournalThe journal of headache and pain (J Headache Pain) Vol. 19 Issue 1 Pg. 21 (Mar 09 2018) ISSN: 1129-2377 [Electronic] England
PMID29523978 (Publication Type: Journal Article, Review)
Chemical References
  • ADCYAP1 protein, human
  • Pituitary Adenylate Cyclase-Activating Polypeptide
  • Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide
  • Receptors, Vasoactive Intestinal Polypeptide, Type I
  • VIPR1 protein, human
  • Vasoactive Intestinal Peptide
Topics
  • Animals
  • Ganglia, Parasympathetic (chemistry, metabolism)
  • Headache Disorders, Primary (diagnosis, metabolism, therapy)
  • Humans
  • Neurons, Afferent (chemistry, metabolism)
  • Pituitary Adenylate Cyclase-Activating Polypeptide (metabolism)
  • Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide (analysis, metabolism)
  • Receptors, Vasoactive Intestinal Polypeptide, Type I (analysis, metabolism)
  • Trigeminal Ganglion (chemistry, metabolism)
  • Vasoactive Intestinal Peptide (analysis, metabolism)

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