难治的偏头痛让科学家头痛

Researchers also have isolated certain genes that might be linked to a predisposition for migraines, Dr. Dodick says.
多迪克医生说，研究人员已经把某些与易患偏头痛体质相关的基因分离出来。

Triptans, which promote blood-vessel constriction and inflammation, block the release of CGRP in the trigeminal nerve. While CGRP does aid the blood-vessel dilation process, its role activating the nerves in the brain appears to be the key when it comes to migraine pain.
引起血管收缩和发炎的曲坦类药物可以阻止三叉神经中CGRP的释放。虽然CGRP的确促进了血管的扩张进程，但在偏头痛问题上，它对激活大脑神经所起的作用似乎才是最关键的。

In the mid-1980s, Peter Goadsby, a neurologist and headache specialist at the University of California San Francisco, and his colleagues found that CGRP is released in migraines and that triptans decreased CGRP action.
20世纪80年代中期，加州大学旧金山分校（University of California San Francisco）的神经病学家和头痛治疗专家彼得•戈德比（Peter Goadsby）和他的同事发现，CGRP在偏头痛发生时被释放出来，而曲坦类药物减少了CGRP的活动。

Several researchers and companies have been trying to develop drugs that bind to the CGRP receptors to prevent the chemical from activating the pain network. But because CGRP has a complex receptor - the slot where the molecule must bind in order to initiate actions in the body - it took chemists 15 years to figure out how to block the effects of CGRP, and even longer to develop a compound that could be taken orally, says Dr. Goadsby.
好几家研究机构和公司一直在努力研发可以作用于CGRP感应器官的药物，从而阻止这种化学物质激活疼痛网络。但是戈德比医生说，由于CGRP的感应器官非常复杂──药物分子必须作用于这种感应器官才能激发身体的行动──药物学家用了15年时间来研究如何阻止CGRP起效，而研制可以口服的药物还要更长时间。

Bringing to market CGRP blockers, or antagonists - the most advanced of the new drugs in development for migraines - has proved challenging. Several investigational compounds have been shown to be toxic to the liver, a challenge that highlights the difficulty in developing drugs for conditions that affect the brain.
事实证明，面向市场推出CGRP阻滞药物或者拮抗物──最先进的偏头痛治疗新药──难度很大。好几种正在研制中的药物都被发现对肝脏有毒害作用，这项挑战突显了针对可影响大脑的病症开发药物的难度有多大。

CGRP antagonists don't appear to work as well as triptans, but the blockers have an advantage in they don't appear to cause cardiovascular complications, says Stephen Silberstein, a neurology professor and director of Thomas Jefferson University's Headache Center in Philadelphia.
费城托马斯•杰斐逊大学头痛病研究中心（Thomas Jefferson University's Headache Center）的神经病学教授兼主任史蒂芬•西尔伯斯坦（Stephen Silberstein）说，CGRP拮抗药物的疗效似乎不如曲坦类药物，但是阻滞类药物的优点是它们似乎不会引起心血管并发症。

'You trade one kind of risk for another,' says Dr. Silberstein, who has served as an investigator on several companies' clinical trials.
“你是以一种风险来替代了另一种风险，”西尔伯斯坦医生说。他担任了好几家公司产品临床试验的调研员。

Merck & Co. had a promising CGRP-receptor antagonist under development but discovered in late-stage clinical-trial testing that some patients experienced liver enzyme changes. In July of last year, the company said it was discontinuing development of the compound, telcagepant, after looking at all its trial data. Germany's Boehringer Ingelheim GmbH was also working on a CGRP antagonist but canceled development. A spokesman declined to comment.
默克公司（Merck & Co.）曾经研制了一种让人看好的CGRP感受器官拮抗药，但是在后期的临床测试中发现，有些患者出现了肝脏 改变的情况。去年7月，该公司称，在查看了所有试验数据之后，公司不再继续研制这种名为telcagepant的化学药物。德国的勃林格殷格翰制药公司（Boehringer Ingelheim GmbH）也曾研制过一种CGRP拮抗药，但后来终止了该产品的开发。一名发言人拒绝置评。

Bristol-Myers Squibb Co. is conducting several early stage studies on CGRP antagonists and other companies are testing or may begin development of similar compounds as well.
百时美施贵宝公司（Bristol-Myers Squibb Co.）正在进行几种CGRP拮抗药的早期研究，其它公司也在对类似药物进行测试或者准备开始进行开发。

Researchers and companies also are trying to develop artificial antibodies that, when injected, would glom onto CGRP in the bloodstream or brain, before it reaches the receptors in the brain, or by blocking the receptors.
研究人员和企业也在努力开发人工抗体，注射进人体后，人工抗体会在CGRP抵达感应器官之前拦截血液或大脑中的CGRP，或者屏蔽感应器官。

Research into these biologic antibody-based approaches is at an earlier stage than the testing of antagonist drugs, but antibodies eventually might be able to block CGRP action regularly so that migraines don't ever begin.
对于这类基于生物抗体的方法的研究处于早期，还未达到拮抗药物的测试阶段，但是抗体也许最终能够规律性地阻止CGRP的活动，使偏头痛无从发作。

'The CGRP story is a story of developing an acute treatment for migraine,' says Dr. Goadsby. 'But the antibody story is testing the larger idea [that] if you blocked continuously CGRP, would you have a preventive treatment.'
“CGRP之说涉及到偏头痛紧急治疗方法的开发，”戈德比医生说，“但是对抗体的研究实际上是就更重要的理念展开测试，即如果不断阻止CGRP，就会是一种预防性的治疗手段。”