1. 5‐hydroxytryptamine in migraine: The puzzling role of ionotropic 5‐HT 3 receptor in the context of established therapeutic effect of metabotropic 5‐HT 1 subtypes
- Author
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Rashid Giniatullin
- Subjects
Pharmacology ,biology ,business.industry ,medicine.disease ,5-HT3 receptor ,Metabotropic receptor ,Migraine ,biology.protein ,Medicine ,Serotonin ,Migraine treatment ,business ,Receptor ,Neuroscience ,5-HT receptor ,Ionotropic effect - Abstract
5-hydroxytryptamine (5-HT; serotonin) is traditionally considered as a key mediator implicated in migraine. Multiple 5-HT receptor subtypes contribute to a variety of region-specific functional effects. The raphe nuclei control nociceptive inputs by releasing 5-HT in the brainstem, whereas dural mast cells provide the humoral source of 5-HT in the meninges. Triptans (5-HT1B/D agonists) and ditans (5-HT1F agonists) are the best established 5-HT anti-migraine agents. However, activation of meningeal afferents via ionotropic 5-HT3 receptors results in long-lasting excitatory drive suggesting a pro-nociceptive role for these receptors in migraine. Nevertheless, clinical data do not clearly support the applicability of currently available 5-HT3 antagonists to migraine treatment. The reasons for this might be the presence of 5-HT3 receptors on inhibitory interneurons dampening the excitatory drive, a lack of 5-HT3 A-E subunit-selective antagonists and gender/age-dependent effects. This review is focusing on the controversial role of 5-HT3 receptors in migraine pathology and related pharmacological perspectives of 5-HT ligands.
- Published
- 2021
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