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Amylin and calcitonin gene related peptide (CGRP) are related to the same peptide family. Both share 16 out of 37 amino acids and can activate each others receptor. CGRP is implicated in migraine pathophysiology but the role of Amylin and its receptor in migraine is not fully clarified.
Amylin is a peptide hormone that binds to a G-protein coupled receptor (GPCR). amylin was originally found in the pancreas (Beta Cell of Islets of Langerhans) but also shown to be present in the trigeminal ganglion, hind horn ganglia and perivascular nerve fibers.
Amylin has many similarities with CGRP. Amylin and CGRP share 16 out 37 amino acids. Both peptides can activate the amylin 1 subtype (AMY1)receptor with high affinity and reported to have more similar physiological and pharmacological effects.
In addition, both peptides increase the intracellular concentration of cyclic AMP (cAMP) which has a central role in migraine pathophysiology.
The aim of the study is pin point the role of amylin and amylin receptor compare to CGRP in migraine pathophysiology.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Amylin (Pramlintide) | Other | Pramlintide intravenous infusion 120 micrograms over 20 minutes |
|
| CGRP | Other | CGRP intravenous infusion 30 micrograms over 20 minutes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Amylin (Pramlintide) | Other | Pramlintide is a amylin analog. It will be given intravenously at the rate of 120 micrograms over 20 minutes . |
|
| Measure | Description | Time Frame |
|---|---|---|
| Migraine incidence | Before (-10 min) and after infusion (+12 hours) of amlyin compared with before and after infusion of CGRP based on questionnaire reported headache and associated symptoms | 12 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Dilatation of Arteria radialis and arteria temporalis superficialis | Dermascan will be used to measure the above mentioned Radial and temporal arteries diameter. | 2 hours |
| Facial flushing | Flushing will measured by laser contrast imaging |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Danish Headache Center | Glostrup Municipality | 2600 | Denmark |
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| ID | Term |
|---|---|
| D020326 | Migraine without Aura |
| ID | Term |
|---|---|
| D008881 | Migraine Disorders |
| D051270 | Headache Disorders, Primary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
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| ID | Term |
|---|---|
| D058228 | Islet Amyloid Polypeptide |
| C105254 | pramlintide |
| ID | Term |
|---|---|
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
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In a Randomized, double blind, cross over experiment. Migraine without aura patients will received amylin or CGRP in two separate days apart by a week.
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| CGRP | Other | CGRP It will be given intravenously at the rate of 30 microgram over 20 minutes. |
|
| 2 hours |
| Plasma blood samples | Measumrent of amylin and CGRP peptides in the plasma in picomol/L | 2 hours |
| Headache intensity | Measured by visual analog score (VAS) ( 0 to 10). Change in area under curve (AUC) | 12 hours |
| D002493 |
| Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D058227 | Amyloidogenic Proteins |
| D000682 | Amyloid |
| D011506 | Proteins |