TRPM8 channels, cold and headache: data of experimental and clinical studies

Different types of headaches, including migraine, may have a causal relationship with cold exposure, and this relationship can be either positive or negative, i.e. cold can both provoke and alleviate cephalalgia. Various representatives of the transient receptor potential ion channel superfamily, in particular TRPM8, act as molecular thermoreceptors that provide signal transduction in the response to low temperatures. These channels, which are known to mediate the normal cold sensation and play a role in both cold-induced pain and cryoanalgesia, are often considered as a promising target for the development of principally new anti-migraine drugs. This review summarizes recently obtained data on the TRPM8 structure and function, and their role in the pathogenesis of migraine, as well as discusses the intriguingly inconsistent results of studying TRPM8 agonists and antagonists in experimental headache models and clinical trials. Analyzing data from various studies allows to conclude that TRPM8 activation can be both pro- and antinociceptive; this correlates with the reported dual effect of cold exposure on the induction and resolution of headaches, leaving open the question on the vector of the TRPM8 pharmacological modulation required to produce anticephalgic effect.