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Успехи физиологических наук, 2023, T. 54, № 3, стр. 53-76

Нейрофизиологические и сосудистые механизмы действия серотонинергических средств для купирования приступа мигрени

А. Ю. Соколов a, b, *, Я. Б. Скиба b, **, О. А. Любашина a, b, ***

a Федеральное государственное бюджетное учреждение науки Институт физиологии им. И.П. Павлова РАН
199034 Санкт-Петербург, Россия

b Федеральное государственное бюджетное образовательное учреждение высшего образования “Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова” Минздрава РФ
197022 Санкт-Петербург, Россия

* E-mail: alexey.y.sokolov@gmail.com
** E-mail: yaver-99@mail.ru
*** E-mail: lyubashinaoa@infran.ru

Поступила в редакцию 23.03.2023
После доработки 27.03.2023
Принята к публикации 02.04.2023

Аннотация

Мигрень представляет собой форму первичной головной боли, от которой страдает не менее 10% населения планеты. Кроме рекомендаций по модификации образа жизни пациента, менеджмент мигрени подразумевает купирование уже возникшего приступа и/или профилактику его возникновения. В абортивном лечении этой цефалгии могут использоваться фармакологические агенты как неспецифического (например, ненаркотические анальгетики), так и специфического действия. К числу последних относят, в частности, серотонинергические средства классов триптанов (селективных агонистов 5-НТ1B/1D-рецепторов), дитанов (избирательных 5-НТ1F-миметиков) и алкалоидов спорыньи (неселективных модуляторов различных подтипов 5-НТ-рецепторов). В обзоре представлены известные к настоящему времени результаты множества фундаментально-прикладных исследований препаратов указанных групп, в ходе которых были выявлены нейрональные и сосудистые составляющие их антимигренозной фармакодинамики. Значительная часть этих данных получена in vivo на различных экспериментальных моделях мигрени, основанных на тригемино-васкулярной теории ее патогенеза. Другие сведения являются итогами работы ех vivo на изолированных тканях и клеточных культурах. При анализе результатов этих исследований приводятся доказательства в пользу схожих механизмов реализации антимигренозного потенциала представителей всех перечисленных фармакологических классов, у которых нейротропная активность преобладает над прямым вмешательством в сосудистый тонус. Специальное внимание уделено неоднозначным и дискуссионным вопросам в этой области, успешное решение которых является залогом дальнейшего прогресса в фармакотерапии мигрени.

Ключевые слова: мигрень, головная боль, триптаны, ласмидитан, алкалоиды спорыньи, серотонин, нейрофизиология, механизм действия, вазоконстрикция

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  246. Суматриптан – регистрация в РФ: https://grls.rosminzdrav.ru/GRLS.aspx?RegNumber=&MnnR=% d0%a1%d1%83%d0%bc%d0%b0%d1%82%d1%80%d0%b8%d0%bf%d1%82%d0%b0%d0%bd&lf=&TradeNmR=&OwnerName=&MnfOrg=&MnfOrgCountry=&isfs=0&order=RegDate&orderType=desc&RegType=1%2c6&pageSize=10&pageNum=2 дата обращения 31.01.2023

  247. Элетриптан – регистрация в РФ: https://grls.rosminzdrav.ru/GRLS.aspx?RegNumber=&MnnR= %d0%ad%d0%bb%d0%b5%d1%82%d1%80%d0%b8%d0%bf%d1%82%d0%b0%d0%bd&lf=&TradeNmR=&OwnerName=&MnfOrg=&MnfOrgCountry=&isfs=0&regtype=1%2c6&pageSize=10&order=RegDate&orderType=desc&pageNum=1 дата обращения 31.01.2023

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