4.4 Review

Beyond its anti-migraine properties, sumatriptan is an anti-inflammatory agent: A systematic review

Journal

DRUG DEVELOPMENT RESEARCH
Volume 82, Issue 7, Pages 896-906

Publisher

WILEY
DOI: 10.1002/ddr.21819

Keywords

5-HT1B/ 1D receptor; anti-inflammation; inflammation; migraine; nitric oxide; sumatriptan

Funding

  1. Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran [99-1-209-46994]
  2. Iran National Science Foundation (INSF) [96002757]

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Sumatriptan, a medication for migraine and cluster headaches, has been shown to possess anti-inflammatory properties and can protect against various inflammatory conditions by modulating inflammatory markers.
Sumatriptan is the first available medication from triptans family that was approved by the U.S. Food and Drug Administration for migraine attacks and cluster headaches in 1991. Most of its action is mediated by selective 5-HT1B/1D receptor agonism. Recent investigations raised the possibility of repositioning of this drug to other indications beyond migraine, as increasing evidence suggests for an anti-inflammatory property of sumatriptan. We performed a literature search using PubMed, Web of Science, Scopus, and Google Scholar using inflammation AND sumatriptan or inflammation AND 5HT1B/D as the keywords. Then, articles were screened for their relevance and those directly discussing the correlation between inflammation and sumatriptan or 5HT1B/D were included. Total references reviewed or inclusion/exclusion were 340 retrieved full-text articles (n = 340), then based on critical assessment 66 of them were included in this systematic review. Our literature review indicates that at low doses, sumatriptan can reduce inflammatory markers (e.g., interleukin-1 beta, tumor necrosis factor-alpha, and nuclear factor-kappa B), affects caspases and changes cells lifespan. Additionally, nitric oxide synthase and nitric oxide signaling seem to be regulated by this drug. It also inhibits the release of calcitonin gene-related peptide. Sumatriptan protects against many inflammatory conditions including cardiac and mesenteric ischemia/reperfusion, skin flap, pruritus, peripheral, and central nervous system injuries such as spinal cord injury, testicular torsion-detorsion, oral mucositis, and other experimental models. Considering the safety and potency of low dose sumatriptan compared to corticosteroids and other immunosuppressive medications, it is worth to take advantage of sumatriptan in inflammatory conditions.

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