Insulin sensitizes neural and vascular TRPV1 receptors in the trigeminovascular system

Background Clinical observations suggest that hyperinsulinemia and insulin resistance can be associated with migraine headache. In the present study we examined the effect of insulin on transient receptor potential vanilloid 1 (TRPV1) receptor-dependent meningeal nociceptor functions in rats. Methods The effects of insulin on the TRPV1 receptor stimulation-induced release of calcitonin gene related peptide (CGRP) from trigeminal afferents and changes in meningeal blood flow were studied. Colocalization of the insulin receptor, the TRPV1 receptor and CGRP was also analyzed in trigeminal ganglion neurons. Results Insulin induced release of CGRP from meningeal afferents and consequent increases in dural blood flow through the activation of TRPV1 receptors of trigeminal afferents. Insulin sensitized both neural and vascular TRPV1 receptors making them more susceptible to the receptor agonist capsaicin. Immunohistochemistry revealed colocalization of the insulin receptor with the TRPV1 receptor and CGRP in a significant proportion of trigeminal ganglion neurons. Conclusions Insulin may activate or sensitize meningeal nociceptors that may lead to enhanced headache susceptibility in persons with increased plasma insulin concentration.

Automated summary

This study found that insulin can stimulate meningeal nociceptor functions by activating TRPV1 receptors and increasing dural blood flow. Insulin also sensitizes neural and vascular TRPV1 receptors to stimulation. Insulin receptors colocalize with TRPV1 receptors and CGRP in trigeminal ganglion neurons. These findings suggest a potential link between insulin and susceptibility to migraine headaches.