The role of calcitonin gene-related peptide (CGRP) in ischemic preconditioning in isolated rat hearts

Brief coronary artery occlusion can protect the heart against damage during subsequent prolonged coronary artery occlusion; ischemic preconditioning. The role of calcitonin gene-related peptide (CGRP) in ischemic preconditioning is investigated in isolated perfused rat hearts, by measuring CGRP release during ischemic preconditioning and mimicking this by exogenous CGRP infusion, either in the absence or presence of the CGRP antagonist BIBN4096BS. CGRP increased left ventricular pressure and coronary flow in a concentration dependent manner, which was effectively antagonized by BIBN4096BS. Rat hearts (n=36) were subjected to 45 min coronary artery occlusion and 180 min reperfusion, which was preceded by: (1) sham pretreatment, (2) BIBN4096BS infusion (1 microM), (3) preconditioning by 15 min coronary artery occlusion and10 min reperfusion, (4) as 3, but with BIBN4096BS, (5) 15 min CGRP infusion (5 nM) and 10 min washout, (6) as 5, but with BIBN4096BS. Cardiac protection was assessed by reactive hyperaemia, creatine kinase release, infarct size related to the area at risk (%), and left ventricular pressure recovery. Preconditioning increased CGRP release into the coronary effluent from 88+/-13 to 154+/-32 pg/min/g, and significantly protected the hearts by decreasing reactive hyperaemia (35%), reducing creatine kinase release (53%), limiting infarct size (48%), and improving left ventricular pressure recovery (36%). Exogenous CGRP induced preconditioning-like cardioprotection. BIBN completely abolished the cardioprotection induced by preconditioning as well as by exogenous CGRP. In conclusion, since cardioprotection of preconditioning-induced CGRP release can be mimicked by exogenous CGRP, and both can be blocked by a CGRP antagonist, results indicate an important role for CGRP in ischemic preconditioning.     

降钙素基因相关肽在前列腺素介导豚鼠心脏缺血预适应中的作用(英文)

目的:研究降钙素基因相关肽与前列腺素在豚鼠心脏缺血预适应中的相互作用。方法:采用Langen-dorff方法灌注豚鼠离体心脏。记录心率、冠脉流量、左室内压以及最大变化速率,并测定冠脉流出液中降钙素基因相关肽(CGRP)与6-酮-PGF_(1α)的释放量。结果:内皮素-1(200 pmoL)引起心功能下降,表现为冠脉流量、心率、左室内压及其最大变化速率降低。缺血预适应可明显减轻内皮素-1引起的心脏损伤,同时预适应期间CGRP与6-酮-PGF_(1α)的释放量明显增加。应用辣椒素耗竭内源性CGRP后,缺血预适应的保护作用被取消。选择性CGRP_1受体拮抗剂CGRP_(8-37)100nmol/L也能取消缺血预适应的保护作用。环氧化酶抑制剂吲哚美辛(10μmol/L)可取消缺血预适应的保护作用,同时缺血预适应促进CGRP与6-酮-PGF_(1α)释放的作用也被取消。结论:前列腺素参与了缺血预适应对豚鼠心脏的保护作用,前列腺素的作用是由CGRP所介导。     

Role of calcitonin gene-related peptide in ischaemic preconditioning in diabetic rat hearts

1. It has been suggested that calcitonin gene-related peptide (CGRP) is involved in the protection provided by ischaemic preconditioning in rat hearts and that ischaemic preconditioning is absent in diabetic rat hearts. 2. In the present study, we tested the relationship between sensory nerve function and ischaemic preconditioning in diabetic rats. 3. In 4- and 8-week diabetic rats and age-matched non- diabetic controls, 30 min global ischaemia and 40 min reperfusion caused a significant decrease in cardiac function and a marked increase in creatine kinase (CK) release. Ischaemic preconditioning, by three cycles of 5 min ischaemia and 5 min reperfusion, improved the recovery of cardiac function and decreased CK release during reperfusion in 4-week diabetic rat hearts. However, the cardioprotection afforded by ischaemic preconditioning was lost in 8-week diabetic rat hearts. Pretreatment with CGRP for 5 min also significantly improved the recovery of cardiac function and decreased CK release in rats subjected to 4 or 8 weeks of diabetes. 4. The content of CGRP in the coronary effluent during ischaemic preconditioning was significantly increased in 4-week diabetic rat hearts (P < 0.05). However, only a slight increase in the release of CGRP was shown in 8-week diabetic rat hearts (P > 0.05). 5. In summary, the present results suggest that the protection afforded by ischaemic preconditioning is attenuated in diabetic rats and that the change may be related to the reduction in CGRP release in diabetic rat hearts.     

降钙素基因相关肽介导缓激肽预处理对离体大鼠心脏的保护作用

目的：研究降钙素基因相关肽（ＣＧＲＰ）在缓激肽预处理保护离体大鼠心脏中的调节作用。方法：Ｌａｎｇｅｎｄｏｒｆｆ法灌流心脏观测心功能与肌酸激酶（ＣＫ）释放。结果：缓激肽显著改善再灌时心功能（ＣＫ）释放。缓激肽作用可被缓激肽受体拮抗剂Ｈｏｅ１４０（１μｍｏｌ．Ｌ＾－１）或ＣＧＲＰ受体拮抗剂ＣＧＲＰ８－３７（０．１μｍｏｌ．Ｌ＾－１）所取消预先用辣椒素处理也能取水缓蚀激肽的作用。结论：缓激肽诱导预处理的     

Protective effects of nitroglycerin-induced preconditioning mediated by calcitonin gene-related peptide in rat small intestine

Previous studies of myocardium have shown that ischemic preconditioning could be mimicked by nitroglycerin through stimulating the release of calcitonin gene-related peptide (CGRP). The present study examined whether nitroglycerin could also provide a preconditioning stimulus in the peripheral vascular bed (the anse intestinalis of rat), and whether endogenous CGRP is involved in this process. The model of in situ perfusion was prepared with rat small intestine. One hour of ischemia and 15 min of reperfusion caused a significant impairment of intestinal morphology and an increase in the release of both lactate dehydrogenase and malondialdehyde. Pretreatment with nitroglycerin, 10⁻⁷, 3×10⁻⁷, 10⁻⁶ M for 5 min produced a significant improvement of intestinal tissue morphology and a decrease in the release of both lactate dehydrogenase and malondialdehyde. However, the protection afforded by nitroglycerin was abolished by CGRP-(8-37), a selective CGRP acceptor antagonist. Pretreatment with capsaicin, which specifically depletes the transmitter content of sensory nerves, also abolished the protection by nitroglycerin. In addition, the content of CGRP-like immunoreactivity in the effluent was increased during nitroglycerin perfusion. On the other hand, the results from the in vivo experiment showed that nitroglycerin (i.v. 0.13 mg/kg) injected 5 min before prolonged ischemia could provide significant protection against the injury caused by 30-min ischemia and 1-h reperfusion in the rat small intestine, but would also cause a significant increase in the levels of CGRP in the plasma. All these findings suggest that nitroglycerin-induced preconditioning is related to stimulation of CGRP release in the rat small intestine.     

Monophosphoryl lipid A-induced delayed preconditioning is mediated by calcitonin gene-related peptide

The delayed preconditioning of the heart by monophosphoryl lipid A is mediated by endogenous nitric oxide (NO), and the cardioprotection afforded by nitroglycerin is related to stimulation of calcitonin gene-related peptide (CGRP) release. The objective of this study was to explore whether improvement of preservation with cardioplegia by monophosphoryl lipid A is mediated by CGRP. In addition, we examined the effect of monophosphoryl lipid A on the tumor necrosis factor-alpha (TNF-alpha) content of myocardial tissues. The isolated rat heart was perfused in the Langendorff mode. Heart rate, coronary flow, left-ventricular pressure, and its first derivatives (+/-dp/dt(max)) were recorded, and plasma levels of NO and CGRP, the release of creatine kinase in coronary effluent and the content of TNF-alpha in myocardial tissues were measured. Hypothermic ischemia for 4 h caused a decline in cardiac function, and an increase in the release of creatine kinase and in the content of TNF-alpha. Pretreatment with monophosphoryl lipid A (500 microg/kg, i.p.) for 24 h improved the recovery of cardiac function and reduced the release of creatine kinase concomitantly with a decrease in the content of cardiac TNF-alpha. Monophosphoryl lipid A markedly increased plasma concentrations of CGRP and NO. After pretreatment with L-nitroarginine methyl ester (L-NAME), the cardioprotection and the increased release of NO and CGRP induced by monophosphoryl lipid A were abolished. Capsaicin also abolished the cardioprotection and the increased release of CGRP induced by monophosphoryl lipid A, but did not affect the content of NO. The results suggest that monophosphoryl lipid A-induced preconditioning enhances preservation with cardioplegia and that the protective effects of monophosphoryl lipid A are related to stimulation of CGRP release.     

Delayed cardioprotection by intestinal preconditioning is mediated by calcitonin gene-related peptide

Previous studies have shown that nitric oxide and calcitonin gene-related peptide (CGRP) are involved in mediation of the delayed cardioprotection of ischemic or pharmacological preconditioning, and nitric oxide can evoke the release of CGRP. In the present study, we examined the role of CGRP in nitric oxide-mediated delayed cardioprotection by brief intestinal ischemia in rats. The serum concentration of creatine kinase and infarct size were measured after 45-min coronary artery occlusion and 180-min reperfusion. Ischemic preconditioning was induced by six cycles of 4-min ischemia and 4-min reperfusion of the small intestine. Pretreatment with intestinal ischemic preconditioning for 24, 48, or 72 h significantly reduced infarct size and creatine kinase release, and the effects of ischemic preconditioning were completely abolished by L-nitroarginine methyl ester (L-NAME, 10 mg/kg, i.p.), an inhibitor of nitric oxide synthase, or by pretreatment with capsaicin (50 mg/kg, s.c.), which selectively depletes transmitters in capsaicin-sensitive sensory nerves. Intestinal preconditioning caused a significant increase in plasma concentrations of CGRP, and the effect was also abolished by L-NAME or capsaicin. These results suggest that the delayed cardioprotection afforded by intestinal ischemic preconditioning is mediated by endogenous CGRP via the nitric oxide pathway.     

Inhibition of cardiac tumor necrosis factor-alpha production by calcitonin gene-related peptide-mediated ischemic preconditioning in isolated rat hearts

Previous investigations have demonstrated that calcitonin gene-related peptide (CGRP) plays an important role in the mediation of ischemic preconditioning in rats. In the present study, we examined signal transduction pathways of CGRP-mediated ischemic preconditioning. Thirty minutes of global ischemia and 40 min of reperfusion caused a dramatic decrease in myocardial function, and a significant increase in the release of cardiac creatine kinase in the coronary effluent and in the content of tumor necrosis factor-alpha (TNF-alpha) in myocardial tissues. However, ischemic preconditioning (three cycles of 5-min ischemia and 5-min reperfusion) or pretreatment with CGRP for 5 min dramatically improved the recovery of cardiac function, and reduced the release of cardiac creatine kinase and the TNF-alpha content. The effect of ischemic preconditioning was abolished by CGRP-(8-37), the selective CGRP receptor antagonist, and by capsaicin, which depletes sensory nerve neurotransmitter content, but was unaltered by treatment with glibenclamide, a blocker of the ATP-sensitive potassium (K(ATP)) channel. The protective effects of exogenous CGRP-induced preconditioning were also not blocked by glibenclamide. These results suggest that the cardioprotective effects afforded by CGRP-mediated ischemic preconditioning are related to inhibition of cardiac TNF-alpha production, but not to activation of the K(ATP) channel.     

降钙素基因相关肽对大鼠小肠缺血预适应的保护作用

目的探讨降钙素基因相关肽(CGRP)在大鼠小肠缺血预适应中的作用及意义。方法①健康Wistar雄性大鼠,体质量(280±30)g,分为3组(各8只),对照组(CON):仅分离肠系膜上动脉(SMA),不夹闭,观察90 min;缺血再灌组(I/R):分离SMA,夹闭30 min,再灌注60 min,结束实验;缺血预适应组(IP):分离SMA,夹闭SMA 5 min反复3次,然后再夹闭30 min,再灌注60 min,结束实验。②利用放射免疫法测定CGRP含量,以乳酸脱氢酶(LDH)、丙二醛(MDA)含量变化和形态学变化为指标,评价缺血再灌注损伤。结果缺血预适应可明显抑制大鼠小肠缺血再灌注损伤后LDH的水平增高,降低MDA的含量(P<0.01),保护小肠黏膜不受损伤。结论CGRP为大鼠小肠缺血再灌注损伤中关键性介质之一,缺血预适应可提高大鼠小肠缺血再灌注后CGRP的水平,对抗缺血再灌注损伤。     

The cardioprotective effects of nitroglycerin-induced preconditioning are mediated by calcitonin gene-related peptide

Previous investigations have shown that endogenous calcitonin gene-related peptide (CGRP) may play an important role in the mediation of ischemic preconditioning and that nitroglycerin evokes the release of CGRP. In the present study, we examined whether nitroglycerin provides a preconditioning stimulus, and whether the cardioprotective effects of nitroglycerin-induced preconditioning involve endogenous CGRP. Thirty minutes of global ischemia and 30 min of reperfusion caused a significant impairment of cardiac contractile function and an increased release of creatine kinase. Pretreatment with nitroglycerin at the concentration of 3x10(-7) or 10(-6) M for 5 min produced a significant improvement of cardiac function and a decrease in the release of creatine kinase. The content of CGRP-like immunoreactivity in coronary effluent was increased during nitroglycerin perfusion. However, the cardioprotection afforded by nitroglycerin was abolished by CGRP-(8-37) (10(-7) M), a selective CGRP receptor antagonist. Pretreatment with capsaicin (50 mg/kg, s.c.), which specifically depletes the transmitter content of sensory nerves, also abolished the protective effects of nitroglycerin and markedly reduced the release of CGRP from the heart during nitroglycerin perfusion. These findings suggest that nitroglycerin-induced preconditioning is related to stimulation of CGRP release in rat hearts.     

The cardioprotection of calcitonin gene-related peptide-mediated preconditioning

Preconditioning induced by brief ischemia or hyperthermia or some drugs shows two phases, early and delayed protection. The cardioprotection afforded by preconditioning is related to stimulation of endogenous mediators release. Calcitonin gene-related peptide (CGRP), a major transmitter of capsaicin-sensitive sensory nerves, has recently been shown to play an important role in mediation of the preconditioning induced by brief ischemia or hyperthermia or by some drugs, and alpha-CGRP seems to play a major role in the mediation of delayed preconditioning. It has been shown that the cardioprotection afforded by CGRP-mediated preconditioning is due to inhibition of cardiac tumor necrosis factor-alpha (TNF-alpha) production, but not to the activation of the K(ATP) channel.     

Multiple affinity forms of the calcitonin gene-related peptide receptor in rat cerebellum.

Binding of 125I-calcitonin gene-related peptide (125I-CGRP) to rat cerebellum membranes and the sensitivity to guanine nucleotides of binding were investigated. Cerebellum binding sites labeled by 125I-CGRP appear to be highly specific, inasmuch as CGRP inhibited binding with an IC50 of 100 pM but other peptides were inactive or much less active in displacing 125I-CGRP from these sites. 125I-CGRP binding sites in cerebellum membranes were saturable and of high affinity. Scatchard analysis of the saturation binding data revealed a homogeneous population of binding sites, with a KD of 224 +/- 28 pM and Bmax of 131 +/- 15 fmol/mg of protein. In the presence of guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) (100 microM), a single population of binding sites, with a KD of 464 +/- 77 pM and Bmax of 100 +/- 14 fmol/mg of protein, was observed. The kinetics of association of 125I-CGRP with cerebellum membranes were monophasic at all ligand concentrations tested. However, the observed association rate constant (kobs) was not dependent on [125I-CGRP] in a linear fashion in either the absence or the presence of GTP gamma S (100 microM). The kinetics of dissociation of 125I-CGRP from cerebellum membranes were multiexponential, with fast and slow dissociating components having rate constants of 0.34 +/- 0.01 and 0.025 +/- 0.001 min-1, respectively. The fast dissociating component represented 60 +/- 2% of the total specific binding sites. Dissociation of 125I-CGRP from cerebellum sites was much faster in the presence of GTP gamma S (100 microM) but still exhibited dissociation from two affinity components. The rate constants for these components of dissociation were 0.67 +/- 0.03 and 0.077 +/- 0.007 min-1, with the faster dissociating component representing 66 +/- 1% of the total specific binding sites. These findings provide the first evidence that CGRP receptors exist in multiple affinity states and that cerebellum CGRP receptors are regulated by guanine nucleotides. Our results also suggest the existence of two affinity states of the CGRP-receptor-guanine nucleotide-binding protein ternary complex.     

Action of calcitonin gene-related peptide on rat aortic smooth muscle

The effects of rat calcitonin gene-related peptide (CGRP) on superfused rat aortic smooth muscle cells in cell culture were investigated. Exposure of the cells for 10 min to CGRP (10(-7) M), with or without pretreatment with pertussis toxin, stimulated the release of cyclic AMP but not of prostacyclin, as judged by radioimmunoassay of its stable metabolite, 6-keto-PGF1 alpha. Pretreatment of the cells with pertussis toxin did not alter the response to CGRP. The direct action of CGRP on smooth muscle cells and on the CGRP-induced formation of cyclic AMP did not appear to depend on the production of prostacyclin in these vascular smooth muscle cells.     

Morphine-induced modulation of calcitonin gene-related peptide levels.

Calcitonin gene-related peptide (CGRP) is a novel calcium-modulatory product of the gene that encodes for calcitonin. Acute administration of morphine decreases levels of CGRP in rat corpus striatum. Tolerance to morphine did not alter the levels of CGRP in any brain region or in the spinal cord of the rat. CGRP did not alter the tolerance to the antinociceptive effects of morphine. Chronic naltrexone increased the levels of CGRP in the hypothalamus. Concurrent chronic administration of naltrexone plus morphine raised the levels of CGRP in the medulla, midbrain, and spinal cord. CGRP enhances naloxone-precipitated withdrawal jumping in mice. In rats, during withdrawal the levels of CGRP were tripled in the corpus striatum and significantly reduced in the hippocampus and hypothalamus. In the corpus striatum, CGRP enhances forskolin-stimulated cyclic adenosine monophosphate (cAMP) accumulation when such accumulation is suppressed (as with the chronic opiate administration), but conversely depresses forskolin-stimulated cAMP accumulation under normal conditions (as with chronic vehicle administration). These data are consistent with the hypothesis that CGRP acts as a modulatory peptide in opiate-sensitive systems and tonic opioid control of CGRP levels exists in brain.     

降钙素基因相关肽在一氧化氮介导热应激诱导心肌延迟预适应中的作用

目的：研究一氧化氮－降钙素基因相关肽途径是否参与热应激诱导的心肌延迟预适应。方法：采用Langendorff装置灌注离体心脏。心脏低温（4℃）保存4h后,再灌注40min(37℃）。实验前24h大鼠进行高温处理（直肠温度42℃,15min)。记录心率,冠脉流量、左室内压以及最大变化速率,并测定血浆降钙素基因相关肽（CGRP）浓度和冠脉流出液中肌酸激酶（CK）释放量。结果：热应激能显著增强心肌停搏液的保护作用,减少CK释放量,并升高血浆CGRP浓度。这些作用能被预先给予亚硝基精氨酸甲酯及辣椒素所取消。结论：一氧化氮参与了对大鼠心脏的延迟保护,其作用是由内源性CGRP所介导。     

降钙素基因相关肽介导缺血预适应对溶血性磷脂酰胆碱损伤心肌的保护作用

研究心脏缺血预适应(PC)对溶血性磷脂酰胆碱(LPC)损伤心肌作用的影响，并探讨降钙素基因相关肽(CGRP)在PC中的作用. 离体大鼠心脏Langendorff法灌流，记录心率，冠脉流量，左室压和左室压最大上升速率(+dp/dt_max)，并测定灌流液中肌酸磷酸激酶(CPK)含量. 结果显示，LPC能降低各项心功能指标，并使CPK释放增加；PC(缺血5 min， 再灌5min，重复3次)能减轻LPC的损伤作用；PC的心肌保护作用可被选择性CGRP受体拮抗剂CGRP_8-37所取消；预先给予CGRP或辣椒素能产生与PC相同的心肌保护作用. 对照组, LPC, PC+LPC, CGRP_8-37, CGRP_8-37+PC+LPC, CGRP+LPC, CGRP_8-37+CGRP+LPC, 辣椒素+LPC组CPK释放量分别为0.26±0.05, 2.30±0.22, 0.25±0.03, 0.30±0.08, 2.60±0.15, 0.24±0.05, 2.70±0.20和0.25±0.07 μmol·min^-1·g^-1湿组织. 这些结果提示：1) PC对LPC所致心肌损伤具有保护作用；2) PC的保护作用是由CGRP所介导；3) CGRP或辣椒素可模拟PC的保护作用.     

Nitric oxide synthesis inhibitors attenuate calcitonin gene-related peptide endothelium-dependent vasorelaxation in rat aorta.

The effect of inhibitors of nitric oxide synthesis were examined on the endothelium-dependent relaxation induced by acetylcholine and human alpha-calcitonin gene-related peptide (CGRP) on rat isolated aortic rings preconstricted with noradrenaline. The endothelium-dependent vasorelaxation induced by acetylcholine and CGRP was inhibited by NG-monomethyl-L-arginine (L-NMMA) and NG-nitro-L-arginine (L-NOARG) in a concentration-related fashion. The inhibition of endothelium-dependent relaxation by L-NMMA and L-NOARG was partially reversed by L-arginine but not by D-arginine for both acetylcholine and CGRP. The data presented suggests that CGRP, like acetylcholine; relaxes the rat aorta via the release of nitric oxide.     

内毒素引起离体大鼠脊髓降钙素基因相关肽释放

本文在离体灌流大鼠脊髓片观察内毒素对感觉神经元中枢端末梢降钙素基因相关肽（ＣＧＲＰ）释放的影响．结果显示内毒素及其主要毒性成分Ａ脂均能浓度依赖性地引起ＣＧＲＰ释放，内毒素的作用可被内毒素抑制剂与钠通道阻断剂河豚毒素所阻断．采用辣椒素预温育使感觉神经末梢递质耗竭，或用辣椒素受体阻断剂ｃａｐｓａｚｅｐｉｎｅ均能显著抑制内毒素引起ＣＧＲＰ释放的作用．上述结果提示内毒素是通过其主要毒性成分＃ＦＳＡ＃ＦＫ脂，刺激辣椒素敏感的感觉神经末梢而释放ＣＧＲＰ的     

Delayed preconditioning by cardiac ischemia involves endogenous calcitonin gene-related peptide via the nitric oxide pathway

Previous investigations have shown separately that calcitonin gene-related peptide (CGRP) or nitric oxide (NO) is involved in mediation of ischemic preconditioning. In the present study, we tested interactions of CGRP with NO in mediation of delayed preconditioning. In Sprague-Dawley rats, ischemia-reperfusion injury was induced by 45-min occlusion followed by 3-h reperfusion of coronary artery, and preconditioning was induced by four cycles of 3-min ischemia and 5-min reperfusion. Infarct size, plasma creatine kinase activity, the plasma level of NO and CGRP, and the expression of CGRP mRNA in dorsal root ganglion were measured. Pretreatment with preconditioning significantly reduced infarct size and the release of creatine kinase during reperfusion, and caused a significant increase in the expression of CGRP mRNA, concomitantly with an elevation in the plasma level of CGRP and NO. The effects of preconditioning were completely abolished by administration of L-nitroarginine methyl ester (L-NAME, 10 mg/kg, i.p.), an inhibitor of NO synthase. Pretreatment with capsaicin (50 mg/kg, s.c.), which depletes transmitters in capsaicin-sensitive sensory nerves, also blocked the cardioprotection of preconditioning and reduced the synthesis and release of CGRP, but did not affect the concentration of NO. The present results suggest the delayed protection afforded by ischemic preconditioning is also mediated by endogenous CGRP via the NO pathway in rat heart.