Zusammenfassung
Die durch Freisetzung vasoaktiver Neuropeptide, z. B. Calcitonin Gene-Related Peptide (CGRP), aus nozizeptiven perivaskulären Nervenfasern hervorgerufene neurogene Entzündung
ist an der Pathogenese des akuten Migräneschmerzes beteiligt. Wie kürzlich gezeigt
werden konnte, ist BIBN 4096 BS der erste CGRP-Rezeptorantagonist, der den akuten
Migräneschmerz beim Menschen effizient mindert. Dies ist ein weiterer Hinweis dafür,
dass das Neuropeptid CGRP mit zur Entstehung der akuten Schmerzattacke bei der Migräne
beiträgt. Da BIBN 4096 BS keine vasokonstriktorischen Eigenschaften an meningealen
und extrakraniellen Gefäßen besitzt, stellt dieser nichtpeptidische CGRP-Antagonist
eine gute Alternative zur Behandlung der akuten Migräneattacke dar, insbesondere bei
Patienten mit Kontraindikationen für Triptane und Ergotaminderivate.
Abstract
Neurogenic inflammation caused by the release of vasoactive neuropeptides such as
calcitonin gene-related peptide (CGRP) from nociceptive perivascular nerve fibres
has been implicated in the development of acute migraine pain. It has recently been
demonstrated that the CGRP receptor antagonist BIBN 4096 BS significantly reduces
acute pain in migraine. This therapeutic efficacy provides further evidence for a
critical role of CGRP in the pathophysiology of migraine. Given the apparent absence
of vasoconstrictor activity both in meningeal and extracranial vessels, BIBN 4096
BS may provide an alternative for the treatment of migraine in those patients where
triptans and ergotamine derivatives are contraindicated due to their side effects.
Schlüsselwörter
CGRP-Rezeptorantagonist - BIBN 4096 BS - Migräne - Neurogene Entzündung - Triptane
Key words
CGRP receptor antagonist - BIBN 4096 BS - migraine - neurogenic inflammation - triptans
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Prof. Dr. Michael K. Herbert
Klinik und Poliklinik für Anästhesiologie der Universität Würzburg ·
Oberdürrbacher Straße 6 · 97080 Würzburg
Email: herbert_m@klinik.uni-wuerzburg.de
