Calcitonin gene-related peptide: potent peripheral inhibitor of gastric acid secretion in rats and dogs

Calcitonin gene-related peptide is a 37-residue peptide recently characterized in central and peripheral nervous system. The pharmacologic or physiologic importance of this peptide is not known. We studied the effect of calcitonin gene-related peptide on exogenously stimulated gastric acid secretion (pentagastrin, histamine, bethanechol, and intracisternal thyrotropin-releasing hormone) in the urethane-anesthetized rat. Calcitonin gene-related peptide (2.6 nmol/kg X h) caused a 63%-78% inhibition of gastric acid secretion with all secretagogues tested. The inhibition of gastric acid response to pentagastrin was dose-dependent (2.6-2630 pmol/kg X h), rapid in onset, quickly reversible upon cessation of calcitonin gene-related peptide infusion, and not modified by acute vagotomy or indomethacin pretreatment. In conscious dogs, gastric fistula acid response to pentagastrin was inhibited in a dose-dependent manner by calcitonin gene-related peptide (2.6-260 pmol/kg X h). The acid response of the Heidenhain pouch to pentagastrin was also inhibited by calcitonin gene-related peptide (260 pmol/kg X h). These results show that calcitonin gene-related peptide is a potent inhibitor of gastric acid secretion in the rat as well as in the dog. Its inhibitory action could be demonstrated against various stimuli and appears to be independent of prostaglandin or vagal pathways.     

Calcitonin gene-related peptide as inflammatory mediator

Sensory neuropeptides have been proposed to play a key role in the pathogenesis of a number of respiratory diseases such as asthma, chronic obstructive pulmonary disease or chronic cough. Next to prominent neuropeptides such as tachykinins or vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP) has long been suggested to participate in airway physiology and pathophysiology. CGRP is a 37 amino-acid peptide which is expressed by nerve fibers projecting to the airways and by pulmonary neuroendocrine cells. The most prominent effects of CGRP in the airways are vasodilatation and in a few instances bronchoconstriction. A further pulmonary effect of CGRP is the induction of eosinophil migration and the stimulation of beta-integrin-mediated T cell adhesion to fibronectin at the site of inflammation. By contrast, CGRP inhibits macrophage secretion and the capacity of macrophages to activate T-cells, indicating a potential anti-inflammatory effect. Due to the complex pulmonary effects of CGRP with bronchoconstriction and vasodilatation and diverse immunomodulatory actions, potential anti-asthma drugs based on this peptide have not been established so far. However, targeting the effects of CGRP may be of value for future strategies in nerve modulation.     

降钙素基因相关肽与糖尿病微血管病变

降钙素基因相关肽(CGRP)是目前已知体内最强的舒血管多肽,参与许多重要功能的调节.糖尿病微血管病变是糖尿病常见的慢性并发症,主要累及肾脏和眼,CGRP强大的扩张血管、抑制血管平滑肌细胞增殖、保护内皮细胞、抑制内皮素收缩血管的作用参与了糖尿病肾病的发展过程及糖尿病视网膜病变新生血管的发生并在两者的发生、发展中起了重要作用.通过研究CGRP在微血管病变中的变化趋势,可以为糖尿病微血管病变的早期诊治提供依据.     

降钙素基因相关肽与基因治疗

降钙素基因相关肽(calcitoningene-related peptide,CGRP)是Rosenfeld等于1983年发现的一种生物活性肽,它与降钙素(calcitonin,CT)均来源于位于11号染色体的CT/CGRP基因,由于CT/CGRP基因不同的RNA编码而翻译成CGRP和CT。CGRP是应用DNA基因重组和分子生物技术研究发现的一种由37个氨基酸组成的生物活性多肽,相对分     

Calcitonin gene-related peptide: a potent and selective stimulator of gastrointestinal somatostatin secretion

Calcitonin gene-related peptide (CGRP) exists in nerves throughout the gastrointestinal tract and pancreas, and exogenous CGRP has been reported to inhibit many endocrine and exocrine secretions of the gut and pancreas. Because somatostatin also has widespread inhibitory actions and because both gut and pancreatic somatostatin secretion may be under peptidergic control, we examined the influence of CGRP on circulating levels of somatostatin-like immunoreactivity (SLI) and on hormone output from the duodenal lobe of the dog pancreas in situ. Intravenous infusion of human CGRP in anesthetized dogs increased arterial SLI in a dose-dependent manner. During iv infusion of CGRP at 500 pmol/min, the increment of circulating SLI (change at 20 min, +175 +/- 24 fmol/ml) was composed of nearly equimolar amounts of SLI-14 and SLI-28, suggesting an effect of CGRP on both gastric and intestinal somatostatin secretion. The effect of iv CGRP (500 pmol/min) on arterial SLI exceeded those of iv CCK-8 (440 pmol/min), iv isoproterenol (10 nmol/min), and intragastric administration of acidified liver extract. In contrast, salmon calcitonin (500 pmol/min, iv) was without effect. CGRP did not stimulate pancreatic SLI output when infused iv (500 pmol/min) or when infused directly into a pancreatic artery (5 pmol/min). The pancreatic infusion of CGRP decreased insulin output slightly (change at 20 min, -21 +/- 8%), but did not affect glucagon output. We conclude that CGRP is a most effective yet selective stimulator of gastrointestinal somatostatin release, with little influence on islet function. We suggest that exogenous and possibly endogenous neuronal CGRP could exert inhibitory effects on gastrointestinal function via the release of somatostatin.     

Calcitonin gene-related peptide: an inhibitor of bullfrog (Rana catesbeiana) gallbladder contraction in vitro.

The presence of a calcitonin gene-related peptide (CGRP)-like material was demonstrated in the gallbladder of the bullfrog, Rana catesbeiana, using immunocytochemistry and confirmed by radioimmunoassay. An intense immunocytochemical reaction was observed in nerves located in the smooth muscle layers and associated with blood vessels. No immunoreactive nerve fibers were associated with ganglia, nor were immunoreactive cell bodies observed. Radioimmunoassay showed that 25.03 +/- 2.5 pmol/g tissue of CGRP-like material was present. In vitro tension studies using gallbladder strips showed that CGRP exerted an inhibitory effect on both acetylcholine- and cholecystokinin octapeptide-induced tension but had no effect on KCl-, norepinephrine-, or cerulein-induced tension. CGRP may act directly on the gallbladder smooth muscle to inhibit contraction.     

Calcitonin gene-related peptide in small cell lung carcinomas

OBJECTIVE Calcitonin gene-related peptide (CGRP) is a regulatory peptide encoded by the calcitonin gene. CGRP is expressed in increased amounts by the cells of medullary thyroid carcinomas and has been demonstrated by immunohistochemistry to occur in neuroendocrine cells and nerve fibres of lung tissue. MEASUREMENTS Serum CGRP levels were measured in patients with small cell lung carcinomas before treatment (n= 74) and immediately before the second course of chemotherapy (n= 30). In-situ hybridization and immunohistochemistry were performed on tumour tissue and CGRP was extracted from two tumours and characterized by gel chromatography and high pressure liquid chromatography. RESULTS Serum CGRP levels were elevated in small cell lung carcinomas when compared with healthy controls of similar age and sex (median values 55.0 vs 36.6 pmol/l, P<0.001), and 27% had levels above the upper normal range. Serum CGRP levels decreased following the initial course of chemotherapy (P < 0.05) but remained elevated when compared to the controls (P < 0.001). In-situ hybridization for CGRP mRNA was positive in three of 17 tumours and immunohistochemistry was positive in seven of 31 tumours investigated. CGRP immunoreactivity extracted from two tumours was characterized by gel chromatography and high pressure liquid chromatography. A major part of the immunoreactivity was demonstrated to represent the intact molecule. CONCLUSIONS We found that patients with small cell lung carcinomas had elevated concentration of serum calcitonin gene-related peptide but only 27% had values above the upper normal range. Serum CGRP is therefore of limited value as a tumour marker. Intact CGRP can be extracted from tumour tissue, but in-situ hybridization and immunohistochemistry showed positive reactions in only a few of the tumours investigated. The elevated serum CGRP levels are therefore likely to be largely of extratumoral origin.     

Calcitonin gene-related peptide in normotensive and spontaneously hypertensive rats

Using specific radioimmunoassay, radioimmunoreceptor analysis and gel filtration, we found that calcitonin gene-related peptides (CGRP) were distributed in various tissues of normotensive rat (WKY) and spontaneously hypertensive rat (SHR), the highest content was in the lumbar spinal cord (1197 +/- 94.8 pg/mg tissue), the lowest in the auricle (15.0 +/- 2.1 pg/mg tissue). Compared with WKY, the plasma CGRP concentration decreased and the CGRP content in abdominal aorta and hypothalamus increased in SHR. By gel filtration, it showed that only one major molecular form of CGRP was present in the tissues. The CGRP specific binding sites were present both in SHR and WKY hearts, but the number of CGRP binding sites in SHR heart was higher and the binding affinity lower than those in WKY heart. Besides, CGRP can reduce the mean arterial pressure (MAP) in the SHR in a dose-dependent way. The above data indicated that CGRP may play an important role in the pathogenesis of hypertension and exert possibly a therapeutic effect on hypertension.     

Calcitonin gene-related peptide mediates acid-induced lung injury in mice

BACKGROUND AND OBJECTIVE: Acid-induced lung injury from aspiration is one of the most important causes of ARDS. Calcitonin gene-related peptide (CGRP) is a neuropeptide that has various biological actions. The current study investigated whether CGRP might have pathophysiological roles in acid-induced lung injury. METHODS: The investigations employed CGRP gene-disrupted mice--mutant mice (CGRP(-/-)) and their littermate controls (CGRP(+/+)). Anaesthetized and mechanically ventilated mice received 2 mL/kg HCl (pH = 1.5) intratracheally. Lung wet-to-dry weight ratios were calculated to assess pulmonary oedema, total and differential cell counts of the BALF were determined, and measurements of myeloperoxidase activity were performed. RESULTS: Acid-induced lung injury was characterized by an increase in lung permeability and respiratory failure. Disruption of the CGRP gene significantly attenuated acid-induced injury, oedema and respiratory failure. CONCLUSIONS: This study suggests that CGRP is involved in the pathogenesis of acute lung injury caused by acid aspiration and CGRP mutant mice may provide an appropriate model to study molecular mechanisms in this context.     

Calcitonin gene-related peptide stimulates proliferation of human endothelial cells.

The effects of the vasoactive perivascular neuropeptides calcitonin gene-related peptide (CGRP), neurokinin A (NKA), neuropeptide Y (NPY), and vasoactive intestinal polypeptide (VIP) on proliferation of cultured human umbilical vein endothelial cells (HUVECs) were investigated. CGRP was shown to increase both cell number and DNA synthesis, whereas NKA, NPY, and VIP were ineffective. 125I-labeled CGRP was shown to bind to HUVECs and this binding was displaced by addition of unlabeled CGRP, suggesting the existence of specific CGRP receptors. The effect of CGRP on formation of adenosine 3',5'-cyclic monophosphate (cAMP) and inositol phosphates (InsP), two intracellular messengers known to be involved in regulation of cell proliferation, was investigated. CGRP stimulated cAMP formation but was without effect on the formation of InsP. Proliferation, as well as cAMP formation, was also stimulated by cholera toxin. Basic fibroblast growth factor stimulated growth without affecting cAMP or InsP formation, whereas thrombin, which increased InsP formation, did not stimulate proliferation. We thus suggest that CGRP may act as a local factor stimulating proliferation of endothelial cells; that the mechanism of action is associated with cAMP formation; and that this effect of CGRP may be important for formation of new vessels during physiological and pathophysiological events such as ischemia, inflammation, and wound healing.     

Calcitonin gene-related peptide in neural tissues: a phylogenetic study

A heterologous radioimmunoassay using a rabbit antiserum raised against human calcitonin gene-related peptide (CGRP) was used to measure levels of immunoreactive CGRP (IR-CGRP) in the brain, pituitary, and spinal cord in species representing all classes of vertebrates from cyclostomes to mammals, except amphibians. All the brain extracts except those from the trout, goldfish, and iguana demonstrated the presence of IR-CGRP. Pituitary extracts from all animals, except the ratfish, goldfish and trout, contained IR-CGRP. CGRP was present in all classes of animals tested and seems to be highly conserved in the nervous system, where it may act as a neurotransmitter or neuromodulator.     

血糖波动及降钙素基因相关肽对糖尿病微血管病变影响的研究进展

随着动态血糖监测系统（CGMS）的广泛使用,使人们注意到波动性高血糖比持续性高血糖更易促进糖尿病微血管病变的发生和发展。降钙素基因相关肽是目前知道的舒血管活性最强的多肽,在糖尿病微血管病变中起着重要的作用。相信对血糖波动危害的正确认识及降钙素基因相关肽对糖尿病微血管病变影响机制的深入研究,能够为糖尿病（DM）的诊治提供依据和手段,改善患者的预后。     

Calcitonin gene-related peptide protects against hypertension-induced heart and kidney damage

Calcitonin gene-related peptide is a potent vasodilator neuropeptide that is localized in perivascular sensory nerves. To determine whether alpha-calcitonin gene-related peptide possesses protective activity against hypertension-induced end organ damage, hypertension was induced in alpha-calcitonin gene-related/calcitonin peptide knockout and wild-type mice by uninephrectomy, deoxycorticosteroid administration, and 0.9% saline drinking water. These mice were instrumented previously for long-term telemetric blood pressure recording. Control groups were sham-operated and given tap water. Mean arterial pressures were determined, and 3 weeks after initiation of each protocol, tissues were taken for histopathologic studies. The deoxycorticosteroid-salt protocol produced a significant 35% mean arterial pressure increase in both mouse strains. No pathological changes were observed in sections of aortas and femoral arteries from any of the groups studied. Likewise, heart and kidney sections from the hypertensive wild-type mice showed no pathological changes compared with their normotensive counterparts. In contrast, marked vasculitis was seen in the heart sections from the deoxycorticosteroid-salt-treated alpha-calcitonin gene-related peptide knockout mice with thickening and inflammation of the vessel walls. In addition, myocarditis and focal epicarditis with areas of myocardial necrosis were present. Kidneys of these mice exhibited prominent glomerular changes including congestion of the capillary loops, focal mesangial and crescent proliferation, and focal histocytic infiltration. Urinary microalbumin was significantly higher in the hypertensive alpha-calcitonin gene-related peptide knockout compared with hypertensive wild-type mice. These data suggest that deletion of the alpha-calcitonin gene-related peptide gene makes the heart and kidneys more vulnerable to hypertension-induced end organ damage.     

Calcitonin gene-related peptide modulates adrenal hormones in conscious dogs.

The effects of a small dose (2 pmol/kg) of human calcitonin gene-related peptide I on plasma renin activity and hormones, including, aldosterone, ACTH, cortisol, AVP and ANH, were investigated in 14 conscious dogs. In addition, we studied the effects of calcitonin gene-related peptide on aldosterone secretion when it is stimulated by angiotensin II and ACTH. An intravenous bolus injection of 2 pmol/kg of calcitonin gene-related peptide raised plasma renin activity (by 216%, p less than 0.05), ACTH (by 85%, p less than 0.05), AVP (by 89%, p less than 0.05), and ANH (by 36%, p less than 0.05). Despite the elevation of plasma renin activity, aldosterone was decreased (by 52%, p less than 0.05). Cortisol did not change significantly. Infusion of 1 pmol.kg-1.min-1 of angiotensin II produced an elevation of aldosterone (by 186%, p less than 0.01), which was completely inhibited by pretreatment with an injection of 2 pmol/kg of calcitonin gene-related peptide. On the other hand, aldosterone secretion stimulated by ACTH was not altered significantly by pretreatment with an injection of 2 pmol/kg of calcitonin gene-related peptide. These results suggest that calcitonin gene-related peptide inhibits aldosterone secretion, especially when aldosterone is stimulated by angiotensin II. In addition, calcitonin gene-related peptide may be involved as an endocrine modulator in the physiological control of other several hormones closely related to the hemodynamics.     

Calcitonin gene-related peptide: functional role in cerebrovascular regulation.

Distribution studies disclosed that all major cerebral arteries and cortical arterioles of the cat were invested with fine varicose nerve fibers that contained calcitonin gene-related peptide (CGRP)-like immunoreactivity; the trigeminal ganglia likewise contained CGRP immunoreactivity. Sequential immunostaining with antibodies to CGRP and to substance P (SP) revealed identical distributions of these two peptides in trigeminal ganglia and cerebrovascular nerve fibers, suggesting that CGRP and SP are colocalized in these nerves. CGRP completely disappeared from ipsilateral blood vessels after unilateral section of the trigeminal nerve. Exogenous CGRP was a potent relaxant of feline middle cerebral arteries in vitro (maximum relaxation, 10.5 +/- 1.5 mN; concentration eliciting half-maximal response, 9.6 +/- 1.3 nM). Perivascular microapplication of CGRP to individual cortical arterioles of chloralose-anesthetized cats provoked dose-dependent dilatations (maximum increase in diameter, 38 +/- 5%; concentration eliciting half-maximal response, approximately equal to 3 nM). CGRP was significantly more potent than SP as a cerebrovascular dilator, both in vitro and in situ. Chronic division of the ipsilateral trigeminal nerve in cats did not modify the magnitude of arteriolar responses to perivascular microapplication of either vasoconstrictor or vasodilator agents, but the duration of vasoconstrictor responses to norepinephrine (0.1 mM) or alkaline solutions (pH 7.6) was significantly increased. The cerebrovascular trigeminal neuronal system, in which CGRP is the most potent vasoactive constituent, may participate in a reflex or local response to excessive cerebral vasoconstriction that restores normal vascular diameter.     

Calcitonin gene-related peptide: endocrine distribution and characterization of circulating forms

This study reports the application of a highly sensitive and specific extraction-based radioimmunoassay for determining levels of calcitonin gene-related peptide (CGRP) in endocrine tissues and plasma of normal rats. In addition, we have characterized the immunoreactive material found in plasma using gel filtration and high performance liquid chromatography. The CGRP content of the thyroid was 100- to 1000-fold higher than that of the adrenals, pituitary or pancreas, while the gonads and kidneys contained appreciably smaller amounts of CGRP. There was no age- and sex-related difference in tissue content, with the exception of a subgroup of 450 g rats. These had a significantly raised thyroidal CGRP content compared to other rats of the same group. A significant correlation between thyroidal content and plasma levels was noted only in old (450 g) rats. CGRP-like immunoreactivity in plasma pooled from young adult (150 g) rats was found to be heterogeneous. Only 8% of the total immunoreactivity recovered from a Sephadex G50 column was found to coelute with synthetic rat CGRP when freeze-dried plasma was chromatographed and a significantly greater proportion (approximately 67%) eluted in the void volume. The void volume peak was markedly reduced when acid-methanol extracts of plasma were chromatographed under similar conditions. A major proportion of the immunoreactive material co-eluting with synthetic CGRP on gel filtration was also found to elute at a position corresponding to the monomer on HPLC: this was consistent with, though not proof of, structural identity.     

急性脑梗死患者血浆降钙素基因相关肽分析

目的　了解急性脑梗死患者血浆降钙素基因相关肽 ( CGRP)动态变化及与病情的关系。方法　脑梗死患者按病情分为轻、中、重三组 ,分别在发病 3d内、 2 w末、 4 w末采血 ,放免法测定血浆 CGRP浓度 ,并与对照组比较。　结果　血浆 CGRP浓度脑梗死发病 3d内显著降低 ,2 w末、 4 w末依次增高接近对照组 ,急性期病情重者比轻者的 CGRP浓度低。　结论　脑梗死患者存在着血浆 CGRP水平的规律性变化 ,其浓度与脑梗死病理过程以及病变程度有关。     

Calcitonin gene-related peptide in pregnancy and its emerging receptor heterogeneity.

Calcitonin gene-related peptide (CGRP) is the most potent vasodilator, and there is a growing body of evidence that this peptide might have multiple other functions. During pregnancy, circulating CGRP levels in rats increase up to the time of delivery, followed by a sharp decline at term and postpartum. In addition, the sensitivity of various vascular beds to CGRP in rats appears to increase with advancing pregnancy. This increased sensitivity might be involved in regulating uteroplacental blood flow, in addition to other vascular adaptations that occur during normal pregnancy. Furthermore, the uterine relaxation response to CGRP is elevated during pregnancy and decreased at term. Sex steroid hormones, estrogens and progesterone, regulate CGRP synthesis and its effects on both myometrial and uterine vascular tissues. These changes in smooth muscle relaxation sensitivity to CGRP appear to be a consequence of changes in CGRP-receptor levels in these tissues. There appear to be two receptors for CGRP: the CGRP-A receptor, a well-characterized receptor consisting of calcitonin receptor-like receptor and receptor activity modifying protein 1, and the CGRP-B receptor. The CGRP system might play a role in the maintenance of normal pregnancy, and a defect in this system might lead to complications.     

Calcitonin gene-related peptide stimulates somatostatin release from isolated perfused rat stomach

Effect of calcitonin gene-related peptide (CGRP) on somatostatin release was investigated on the isolated perfused rat stomach. Perfusion with CGRP (0.1 nM-100 nM) caused a significant and dose-dependent increase in effluent somatostatin levels. The somatostatin response to CGRP was rapid in onset and reversible immediately after the cessation of CGRP infusion. These findings suggest that CGRP stimulates the release of gastric somatostatin, thereby modulating gastric functions in rat.     

Calcitonin gene-related peptide in vivo positive inotropy is attributable to regional sympatho-stimulation and is blunted in congestive heart failure

Calcitonin gene-related peptide (CGRP) is a nonadrenergic/noncholinergic (NANC) peptide with vasodilatative/inotropic action that may benefit the failing heart. However, precise mechanisms for its in vivo inotropic action remain unclear. To assess this, dogs with normal or failing (sustained tachypacing) hearts were instrumented for pressure-dimension analysis. In control hearts, CGRP (20 pmol/kg per minute) enhanced cardiac contractility (eg, +33+/-4.2% in end-systolic elastance) and lowered afterload (-14.2+/-2% in systemic resistance, both P<0.001). The inotropic response was markedly blunted by heart failure (+6.5+/-2%; P<0.001 versus control), whereas arterial dilation remained unaltered (-19.3+/-5%). CGRP-positive inotropy was not attributable to reflex activation because similar changes were observed in the presence of a ganglionic blocker. However, it was fully prevented by the beta-receptor antagonist (timolol), identifying a dominant role of sympatho-stimulatory signaling. In control hearts, myocardial interstitial norepinephrine assessed by microdialysis almost doubled in response to CGRP infusion, whereas systemic plasma levels were unchanged. In addition, CGRP receptors were not observed in ventricular myocardium but were prominent in coronary arteries and the stellate ganglia. Ventricular myocytes isolated from normal and failing hearts displayed no inotropic response to CGRP, further supporting indirect sympatho-stimulation as the primary in vivo mechanism. In contrast, the peripheral vasodilatative capacity of CGRP was similar in femoral vascular rings from normal and failing hearts in dogs. Thus, CGRP-mediated positive inotropy is load-independent but indirect and attributable to myocardial sympathetic activation rather than receptor-coupled stimulation in canine hearts. This mechanism is suppressed in heart failure, so that afterload reduction accounts for CGRP-enhanced function in this setting.