Does calcitonin gene-related peptide cause the familial hemiplegic migraine phenotype?
Familial hemiplegic migraine (FHM) patients do not show hypersensitivity of the calcitonin gene-related peptide (CGRP)-cyclic adenosine 3',5'-monophosphate pathway, as characteristically seen in migraine patients without aura. This indicates that the pathophysiologic pathways underlying migraine headache in FHM may be different from the common types of migraine and questions whether CGRP antagonists would be effective in the treatment of FHM patients.
Activation of NADPH-oxidase in cerebral arteries generates superoxide, which is dismutated by Cu(2+)/Zn(2+)-superoxide dismutase to H(2)O(2). H(2)O(2) then elicits vasodilatation via activation of BK(Ca) channels. Upregulation of Nox4 during chronic hypertension is associated with elevated cerebral artery NADPH-oxidase activity.