rethinkPeptides Search
Menu
Home / Research library
Study breakdown

Highly sensitive PACAP and CGRP assays could enable migraine diagnosis and treatment monitoring through blood tests

RPEP-138472025Tzara, Ourania; Søderberg, Josefine Nielsen; Bahl, Justyna; Andersson, Emelie; Damlund, Dina Silke Malling; Vestergaard-Klewe, Ib; Harndahl, Mikkel Nors; Jensen, Allan; Asuni, Ayodeji A
evidence
The takeaway

Novel highly sensitive immunoassays for PACAP and CGRP enable detection at clinically relevant levels for potential migraine diagnosis, treatment monitoring, and patient stratification for anti-CGRP or anti-PACAP therapy selection.

Blood test for migraine

Highly sensitive PACAP and CGRP assays could transform migraine from symptom-based to biomarker-guided diagnosis, enabling personalized neuropeptide-targeting therapy selection

What the researchers found

Highly sensitive PACAP + CGRP immunoassays developed. Clinical applications: migraine diagnosis, treatment monitoring, therapy selection. No current validated migraine biomarkers exist. Blood-based detection at clinically relevant levels.

Why it matters

Migraine diagnosis is entirely clinical (symptom-based) with no blood test. Having validated biomarkers could transform migraine from a subjective diagnosis to an objective, measurable condition.

How the study worked

Development and validation of highly sensitive immunoassays for PACAP and CGRP detection in blood samples.

What this study cannot tell us

Assay development—clinical validation in large populations needed. Blood levels may not reflect brain levels. Multiple neuropeptides involved in migraine. Assay cutoffs not established.

How to read the evidence

Assay development and validation study. Technology proof of concept.

When this study was published

Published in 2025.

The bigger picture

Biomarker-guided migraine management could personalize treatment: CGRP-high patients get anti-CGRP drugs, PACAP-high patients get anti-PACAP drugs, patients with both elevated get combination therapy.

Questions still open

  • Can these assays distinguish migraine from tension headache?
  • Would serial testing guide dose adjustment of anti-CGRP/PACAP drugs?
  • Should combined CGRP+PACAP panels replace clinical migraine diagnosis?

Common questions

Could a blood test diagnose migraines?
These new highly sensitive tests can measure two key migraine-related neuropeptides (CGRP and PACAP) in blood. If validated in large studies, they could become the first objective blood-based migraine diagnostic—replacing the current symptom-only diagnosis approach.
Could this help choose the right migraine drug?
Yes—that is a key application. Patients with high CGRP levels might respond best to anti-CGRP drugs (erenumab, fremanezumab), while those with high PACAP might respond better to emerging anti-PACAP therapies. Measuring both peptides could guide personalized drug selection for each patient.

Read the original research

Highly Sensitive Assays for detection of headache inducing neuropeptides, Pituitary adenylate cyclase-activating polypeptide (PACAP) and Calcitonin gene-related peptide (CGRP).

medRxiv : the preprint server for health sciences

View on PubMed ↗Publisher’s paper ↗

Citation

Tzara, Ourania; Søderberg, Josefine Nielsen; Bahl, Justyna; Andersson, Emelie; Damlund, Dina Silke Malling; Vestergaard-Klewe, Ib; Harndahl, Mikkel Nors; Jensen, Allan; Asuni, Ayodeji A. (2025). Highly Sensitive Assays for detection of headache inducing neuropeptides, Pituitary adenylate cyclase-activating polypeptide (PACAP) and Calcitonin gene-related peptide (CGRP).. medRxiv : the preprint server for health sciences. https://doi.org/10.1101/2025.03.04.25323177