TY - JOUR

T1 - ATP-Sensitive Potassium Channels in Migraine

T2 - Translational Findings and Therapeutic Potential

AU - Clement, Amalie

AU - Guo, Song

AU - Jansen-Olesen, Inger

AU - Christensen, Sarah Louise

PY - 2022

Y1 - 2022

N2 - Globally, migraine is a leading cause of disability with a huge impact on both the work and private life of affected persons. To overcome the societal migraine burden, better treatment options are needed. Increasing evidence suggests that ATP-sensitive potassium (K-ATP) channels are involved in migraine pathophysiology. These channels are essential both in blood glucose regulation and cardiovascular homeostasis. Experimental infusion of the K-ATP channel opener levcromakalim to healthy volunteers and migraine patients induced headache and migraine attacks in 82-100% of participants. Thus, this is the most potent trigger of headache and migraine identified to date. Levcromakalim likely induces migraine via dilation of cranial arteries. However, other neuronal mechanisms are also proposed. Here, basic K-ATP channel distribution, physiology, and pharmacology are reviewed followed by thorough review of clinical and preclinical research on K-ATP channel involvement in migraine. K-ATP channel opening and blocking have been studied in a range of preclinical migraine models and, within recent years, strong evidence on the importance of their opening in migraine has been provided from human studies. Despite major advances, translational difficulties exist regarding the possible anti-migraine efficacy of K-ATP channel blockage. These are due to significant species differences in the potency and specificity of pharmacological tools targeting the various K-ATP channel subtypes.

AB - Globally, migraine is a leading cause of disability with a huge impact on both the work and private life of affected persons. To overcome the societal migraine burden, better treatment options are needed. Increasing evidence suggests that ATP-sensitive potassium (K-ATP) channels are involved in migraine pathophysiology. These channels are essential both in blood glucose regulation and cardiovascular homeostasis. Experimental infusion of the K-ATP channel opener levcromakalim to healthy volunteers and migraine patients induced headache and migraine attacks in 82-100% of participants. Thus, this is the most potent trigger of headache and migraine identified to date. Levcromakalim likely induces migraine via dilation of cranial arteries. However, other neuronal mechanisms are also proposed. Here, basic K-ATP channel distribution, physiology, and pharmacology are reviewed followed by thorough review of clinical and preclinical research on K-ATP channel involvement in migraine. K-ATP channel opening and blocking have been studied in a range of preclinical migraine models and, within recent years, strong evidence on the importance of their opening in migraine has been provided from human studies. Despite major advances, translational difficulties exist regarding the possible anti-migraine efficacy of K-ATP channel blockage. These are due to significant species differences in the potency and specificity of pharmacological tools targeting the various K-ATP channel subtypes.

KW - K-ATP channels

KW - provoked migraine

KW - SUR

KW - Kir6

KW - x

KW - levcromakalim

KW - glibenclamide

KW - human migraine model

KW - in vivo models

KW - migraine

KW - PANCREATIC BETA-CELLS

KW - GENE-RELATED PEPTIDE

KW - K-ATP

KW - NITRIC-OXIDE

KW - INSULIN-SECRETION

KW - SULFONYLUREA RECEPTOR

KW - NEUROPATHIC PAIN

KW - IN-VITRO

KW - ACTIVATION

KW - HYPERPOLARIZATION

U2 - 10.3390/cells11152406

DO - 10.3390/cells11152406

M3 - Review

C2 - 35954249

VL - 11

JO - Cells

JF - Cells

SN - 2073-4409

IS - 15

M1 - 2406

ER -