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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

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Volume 4, Issue 4

Vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP) in the circulation after sumatriptan

Jakob Møller Hansen
  • Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, DK-2600 Copenhagen, Denmark
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/ Jan Fahrenkrug
  • Department of Clinical Biochemistry, Bispebjerg Hospital, Faculty of Health Sciences, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark
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/ Jesper Petersen
  • Department of Anesthesiology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, DK-2600 Glostrup, Denmark
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/ Troels Wienecke
  • Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, DK-2600 Copenhagen, Denmark
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/ Karsten Skovgaard Olsen
  • Department of Anesthesiology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, DK-2600 Glostrup, Denmark
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/ Messoud Ashina
  • Corresponding author
  • Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, DK-2600 Copenhagen, Denmark
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Published Online: 2013-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2013.04.002

Abstract

Background and purpose

The origin of migraine pain is still elusive, but increasingly researchers focus on the neuropeptides in the perivascular space of cranial vessels as important mediators of nociceptive input during migraine attacks. The parasympathetic neurotransmitters, pituitary adenylate cyclase activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) may be released from parasympathetic fibres and activate sensory nerve fibres during migraine attacks. Triptans are effective and well tolerated in acute migraine management but the exact mechanism of action is still debated. Triptans might reduce circulating neuropeptides. To examine this question, we examined the effect of sumatriptan on VIP and PACAP levels in vivo, under conditions without trigeminovascular system activation.

Methods

In 16 healthy volunteers we measured VIP and PACAP levels before and after administration of subcutaneous sumatriptan. We simultaneously collected blood samples from the internal and external jugular, the cubital veins and the radial artery, thereby covering both the cerebral and systemic circulation. VIP and PACAP determinations were assayed blindly with respect to timing and vascular compartments, but with all samples of a patient in the same assay, to minimize the influence of interassay variation.

Results

We found no difference in VIP and PACAP concentrations between the internal and external jugular, the cubital veins and the radial artery, (P>0.05), and the circulating levels of VIP and PACAP did not change over time (P>0.05). We found excellent agreement between neuropeptide levels in the internal and the external jugular system.

Conclusion

Sumatriptan did not change the levels of circulating VIP and PACAP in the intra or extra cerebral circulation in healthy volunteers. Under baseline conditions, without trigeminovascular activation, sumatriptan does not affect the release of neuropeptides VIP and PACAP.

Implications

Our results indicate no effect of 5-HT1B/D receptor activation on circulating levels of VIP and PACAP in humans without trigeminovascular activation. Given that neuropeptides play an important role for migraine it would be interesting to conduct a similar study in a migraine population.

Keywords: Migraine; Neuropeptides; PACAP; Triptan; VIP; 5-HT1-receptor

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About the article

Danish Headache Center and Department of Neurology, Glostrup Hospital, University of Copenhagen, Faculty of Health Sciences, Nordre Ringvej 57, DK-2600 Glostrup, Copenhagen, Denmark. Tel.: +45 38 63 20 62


Received: 2013-02-05

Revised: 2013-04-22

Accepted: 2013-04-23

Published Online: 2013-10-01

Published in Print: 2013-10-01


Conflict of interestThe authors have no conflict of interest to declare.


Citation Information: Scandinavian Journal of Pain, Volume 4, Issue 4, Pages 211–216, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2013.04.002.

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