• Headache · May 2017

    Review

    PACAP38: Emerging Drug Target in Migraine and Cluster Headache.

    • Anne Luise Haulund Vollesen and Messoud Ashina.
    • Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Copenhagen, 2600, Denmark.
    • Headache. 2017 May 1; 57 Suppl 2: 56-63.

    AbstractHere, we review the role of pituitary adenylate cyclase-activating peptide-38 (PACAP38) in migraine and cluster headache (CH). Mounting evidence implicates signaling molecule PACAP38 in the pathophysiology of migraine. Human provocation studies show PACAP38 induces migraine attacks in migraine patients without aura and marked and sustained dilation of extracerebral arteries. PACAP38 selectively targets the PAC1 receptor making this receptor a promising candidate for targeted migraine therapy. Randomized clinical trials are warranted to pursue this possible treatment pathway. PACAP38 provocation studies in CH could elucidate possible involvement of PACAP38 in CH pathophysiology and predict efficacy of PACAP38 antagonists in this primary headache.© 2017 American Headache Society.

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