Targeted Nitric Oxide Synthase Inhibitors for Migraine

Neurotherapeutics. 2018 Apr;15(2):391-401. doi: 10.1007/s13311-018-0614-7.

Abstract

Nitric oxide (NO) is a small gaseous signaling molecule that has important biological effects. It has been heavily implicated in migraine; and the NO donor, nitroglycerin, has been used extensively as a human migraine trigger. Correspondingly, a number of components of the NO signaling cascade have been shown to be upregulated in migraine patients. NO is endogenously produced in the body by NO synthase (NOS), of which there are three isoforms: neuronal NOS (nNOS), endothelial NOS (eNOS), and inducible NOS (iNOS). Based on the accumulating evidence that endogenous NO regulation is altered in migraine pathogenesis, global and isoform-selective inhibitors of NOS have been targeted for migraine drug development. This review highlights the evidence for the role of NO in migraine and focuses on the use of NOS inhibitors for the treatment of this disorder. In addition, we discuss other molecules within the NO signaling pathway that may be promising therapeutic targets for migraine.

Keywords: Guanylyl cyclase; Headache; Migraine; Nitric oxide synthase; Pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Cortical Spreading Depression / drug effects
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Migraine Disorders / drug therapy
  • Migraine Disorders / metabolism*
  • Nitric Oxide Synthase / antagonists & inhibitors*
  • Nitric Oxide Synthase / metabolism*
  • Signal Transduction / drug effects

Substances

  • Enzyme Inhibitors
  • Nitric Oxide Synthase