Radioimmunoassay for calcitonin gene-related peptide and its measurement in sera of patients with thyroid disease.

To investigate serum levels of calcitonin gene-related peptide (CGRP), we developed a sensitive radioimmunoassay (RIA). RIA for CGRP in serum can present some problems: the serum may degradate the tracer during incubation and suppress the antigen-antibody reaction. We avoided these problems by using aprotinin and CGRP-free serum instead of a buffer for the standard curve. We detected serum CGRP in all 39 healthy subjects when CGRP-free serum was not used for the standard curve, but 34 of these subjects had serum CGRP levels below the detection limit (less than 80 pmol/l) when CGRP-free serum was used for the standard curve. We defined the normal range for serum CGRP as below 100.8 pmol/l, which was the maximum level found in the healthy subjects. We studied serum levels of this peptide in patients with thyroid diseases, because the thyroid may be one origin of circulating CGRP. Four of 10 patients with medullary thyroid carcinoma had elevated serum levels of CGRP. Seven of 24 patients with subacute thyroiditis had elevated serum levels of CGRP, but at least one year after clinical recovery, CGRP was undetectable in all. Seven of the 37 patients with hypothyroidism had elevated serum levels of CGRP. None of the patients with hyperthyroidism, adenomatous goiter, thyroid adenoma, or thyroid carcinoma had elevated serum CGRP levels. It is necessary to use a standard curve obtained by the addition of aprotinin and CGRP-free serum to the assay standards to measure serum CGRP levels. Some patients with subacute thyroiditis, hypothyroidism, or medullary thyroid carcinoma had elevated serum CGRP levels.     

Evaluation of a peptide family encoded by the calcitonin gene in selected healthy pregnant women. A longitudinal study

We conducted a longitudinal study on serum levels of peptides encoded by the calcitonin gene before conception, every month during pregnancy, and 24 h and 5 days after delivery in 26 healthy women. Only subjects fulfilling optimality criteria according to the literature were included. Blood samples for ionized calcium, total (tCT) and extractable (exCT) calcitonin, katacalcin, and calcitonin gene-related peptide (CGRP) were collected. We found no significant changes of ionized calcium, tCT, exCT, and katacalcin levels, while CGRP serum levels showed a significant increase during pregnancy and a fall to preconceptional values after delivery. Since variations of calcitonin levels did not occur in our selected pregnant women, we conclude that thyroidal C cell secretion is not increased during pregnancy. Our data suggest that calcitonin is not involved in the modifications of mineral homeostasis occurring in pregnancy. In addition, the variations of CGRP serum levels we found suggest that such a hormone participates in circulation modifications of pregnant women.     

血清CGRP、MMP-9和T、NK细胞 及免疫球蛋白对脑卒中并发肺部感染患者的诊断价值

摘要：目的 应用ROC曲线评价血清降钙素基因相关肽（CGRP）、基质金属蛋白酶-9（MMP-9）和T淋巴细胞亚群、自然杀伤细胞（NK细胞）及免疫球蛋白对脑卒中并发肺部感染患者的诊断价值。方法 选择2015年11月至2019年3月在我院神经内科接受治疗的68例老年脑卒中并发肺部感染患者作为感染组,另选取同期未并发肺部感染的46例老年脑卒中患者作为非感染组。比较两组患者的临床资料,检测并比较两组患者血清降钙素原（PCT）、超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、CGRP、MMP-9和T细胞、NK细胞及免疫球蛋白水平,应用受试者工作特征（ROC）曲线分析各指标对脑卒中并发肺部感染的诊断价值。结果 （1）感染组与非感染组患者年龄、性别、病种、基础疾病比较差异均无统计学意义（均P＞0.05）,感染组患者神经功能缺损评分（NIHSS）、急性生理功能和慢性健康状况评分系统（APACHE）Ⅱ评分均显著高于非感染组（均P＜0.05）。（2）感染组患者血清hs-CRP、PCT、IL-6水平均显著高于非感染组,CD3+、CD4+、CD4+/CD8+、CD16++CD56++NK细胞水平均显著低于非感染组（均P＜0.05）,两组患者CD8+细胞水平比较差异无统计学意义（P＞0.05）;感染组患者IgG水平显著低于非感染组（P＜0.05）,两组患者IgA、IgM水平比较差异无统计学意义（均P＞0.05）;感染组患者血清CGRP水平显著低于非感染组,MMP-9水平则显著高于非感染组（均P＜0.05）。（3）ROC曲线分析显示血清CGRP、MMP-9、PCT和CD16++CD56++NK细胞对脑卒中并发肺部感染的诊断效能较高,4个指标联合检测的AUC为0.937,其灵敏度和特异度为92.5%和96.3%。结论 脑卒中合并肺部感染患者血清IL-6、PCT、hs-CRP、MMP-9水平升高,CGRP、T细胞、NK细胞及免疫球蛋白水平降低。血清PCT、CGRP、MMP-9和CD16++CD56++NK细胞对脑卒中并发肺部感染的诊断效能较高,4项指标联合检测能显著提高疾病早期诊断的敏感度和特异度。     

Calcitonin gene-related peptide and substance P contribute to reduced blood pressure in sympathectomized rats

CGRP and substance P (SP) are produced in dorsal root ganglia (DRG) sensory neurons and modulate vascular tone. Sympathetic and sensory nerves compete for NGF, a potent stimulator of CGRP and SP, and it has been suggested that sympathetic hyperinnervation in spontaneously hypertensive rats may reduce the availability of NGF to sensory nerves, thus reducing CGRP and SP. The purpose of this study was to determine whether destruction of peripheral sympathetic nerves in normal rats would increase the availability of NGF for sensory neurons and enhance expression of CGRP and SP. Sympathectomy was produced in rats by guanethidine sulfate administration. Control rats received saline. Sympathectomized rats displayed reductions in blood pressure (BP) and atria norepinephrine levels, whereas NGF levels in the DRG, spleen, and ventricles were increased. Sympathectomy also enhanced CGRP and SP mRNA and peptide content in DRG. Administration of CGRP and SP receptor antagonists increased the BP in sympathectomized rats but not in the controls. Thus sympathectomy enhances sensory neuron CGRP and SP expression that contributes to the BP reduction.     

Effects of pregnancy and female sex steroid hormones on calcitonin gene-related peptide content of mesenteric artery in rats

Calcitonin gene-related peptide (CGRP) levels in plasma and the dorsal root ganglia (DRG) are increased during pregnancy and in ovariectomized rats injected with ovarian hormones. Vasodilatory responses to CGRP are also increased in these animals. In the present study, we hypothesized that pregnancy and ovarian hormones elevate the contents of CGRP in perivascular nerves. We assessed CGRP-dependent mesenteric vascular relaxation induced by electrical field stimulation (EFS) and arterial content of CGRP. Because the mesenteric artery represents resistance vessels, segments of mesenteric arteries collected from female rats at different stages of the estrous cycle, pregnancy, or postpartum and from male rats were used in this study. The EFS-induced relaxation in the presence and absence of CGRP(8-37), an antagonist of CGRP, was used to measure CGRP-dependent relaxation, and radioimmunoassay (RIA) of tissue homogenates was used to assess changes in CGRP content in mesenteric branch arteries. The results show that CGRP-dependent, EFS-induced relaxation response was lower in female rats at diestrus and proestrus than in male rats, and no statistically significant differences were observed between Gestational Day 20 and Postpartum Day 2. The RIA revealed significantly lower mesenteric artery CGRP levels in female rats at proestrus, gestation, and postpartum than in female rats at diestrus or in male rats. We conclude that no correlation exists between CGRP-dependent, EFS-induced relaxation and CGRP content in the mesenteric arteries of these animal groups. Because both CGRP levels in DRG and serum are reported to be elevated, the reduced CGRP content in the vasculature during pregnancy and proestrus implicate enhanced basal release of CGRP at the nerve terminal in these animals.     

Age-related increase of calcitonin gene-related peptide in rat thyroid and circulation.

Elevated calcitonin levels in thyroid gland extracts and in plasma accompanied by C-cell hyperplasia are frequently found in old rats, in particular those raised in laboratory conditions. In parallel with calcitonin, we demonstrate here that the thyroidal content and plasma levels of immunoreactive calcitonin gene-related peptide (i-CGRP) significantly increase with age in rats (p less than 0.0001). C18 Sep-Pak-extractable i-CGRP level in plasma was 35% of the total i-CGRP. Gel permeation chromatography and rp-HPLC studies revealed a number of immunoreactive molecular forms of CGRP and only 40-50% of the acid-extracted immunoreactivity was coeluted with the synthetic CGRP(1-37). The i-CGRP level measured in plasma was highly correlated with the thyroidal content of CGRP (p less than 0.001) and also with the age of the rat (p less than 0.001), suggesting an age-related increase of contribution of CGRP from thyroid gland into the circulation.     

Effect of age on alpha-calcitonin gene-related peptide-mediated delayed cardioprotection induced by intestinal preconditioning in rats

In the present study, we examined whether age-related reduction in cardioprotection of intestinal ischemic preconditioning is related to stimulation of the release and synthesis of calcitonin gene-related peptide (CGRP) in rats. Ischemia-reperfusion injury was induced by a 45-min coronary artery occlusion and 180-min reperfusion, and ischemic preconditioning was induced by six cycles of 4-min ischemia and 4-min reperfusion of the small intestine. The serum concentration of creatine kinase, infarct size, the expression of CGRP isoforms (alpha- and beta-CGRP) mRNA in lumbar dorsal root ganglia and CGRP concentration in plasma were measured. Pretreatment with intestinal ischemic preconditioning for 24 h significantly reduced infarct size and creatine kinase release concomitantly with a significant increase in the expression of alpha-CGRP mRNA, but not beta-CGRP mRNA, and plasma concentrations of CGRP at 6 months of age but not at 24 months of age. These results suggest that the delayed cardioprotective effect of intestinal ischemic preconditioning is decreased in senescent rats, and the age-related change is related to reduction of the synthesis and release of alpha-CGRP.     

Calcitonin gene-related peptide in human obesity.

We studied plasma calcitonin gene-related peptide (CGRP) levels in obese women before (n = 24) and after (n = 13) weight loss, and in normal weight controls (n = 15). Furthermore, the influence of two isocaloric meals (high carbohydrate vs. high fat) on plasma CGRP concentrations was studied. The CGRP concentration in the obese group (32.26 +/- 2.01 pg/ml) was significantly (p less than 0.0001) higher than in the control group (21.64 +/- 0.15 pg/ml). After weight loss (14.3 +/- 0.72% of original weight) CGRP concentrations remained unchanged. Only the high-fat meal caused a significant (p less than 0.02) rise in CGRP levels. Our results indicate that elevated plasma CGRP levels may constitute a primary phenomenon in obese women, and that fat intake may be associated with increased CGRP secretion.     

银杏达莫注射液联合地塞米松治疗突发性耳聋的疗效及对血清sVCAM-1、CGRP水平的影响

目的:探讨银杏达莫注射液联合地塞米松治疗突发性耳聋的的疗效及对血清可溶性血管细胞间黏附因子-1(sVCAM-1)、降钙素基因相关肽(CGRP)水平的影响。方法:选择2017年10月到2019年3月于我院进行治疗的突发性耳聋患者70例作为研究对象,根据随机数表法将其分为观察组(n=36)和对照组(n=34)。对照组使用地塞米松治疗,观察组在对照组的基础上加用银杏达莫进行治疗。比较两组的临床疗效、治疗前后血清s VCAM-1、CGRP水平、平均听阀比、耳鸣残疾量表(THI)评分的变化及并发症的发生情况。结果:治疗后,观察组总有效率为94.44%,显著高于对照组(73.53%,P0.05)。两组患者治疗后血清s VCAM-1、CGRP水平、平均听阀比、THI评分均较治疗前显著改善,且观察组患者血清s VCAM-1水平、平均听阀比、THI评分均显著低于对照组,血清CGRP水平显著高于对照组(P0.05)。治疗期间,观察组患者并发症总发生率为11.11%,显著低于对照组(32.35%,P0.05)。结论:银杏达莫联合地塞米松治疗突发性耳聋的效果显著优于单用地塞米松治疗,这可能与其显著改善患者血清s VCAM-1、CGRP水平有关。     

Calcitonin gene-related peptide and α-CGRP mRNA expression in cranial motoneurons after hypoglossal nerve injury during postnatal development

Changes in calcitonin gene-related peptide (CGRP) immunoreactivity and α-CGRP mRNA expression were determined in the hypoglossal nucleus after the nerve was crushed or transected in rats at 10, 14 and 21 days postnatal. α-CGRP mRNA expression was determined in normal, noninjured, hypoglossal nuclei at the three ages and after both injuries in 10 and 21 days postnatal rats. Reinnervation and neuronal survival were assayed. Although the three age groups expressed comparable levels of α-CGRP mRNA and its peptide in intact, hypoglossal nuclei, axonal injury produced age-dependent alterations in α-CGRP mRNA and CGRP. In the 21 days postnatal rats, changes in α-CGRP mRNA and peptide mimicked those reported in adult motoneurons after the same injuries. CGRP was elevated until reinnervation after nerve crush, whereas biphasic elevations occurred after nerve transection. In 21 days postnatal rats, increases in α-CGRP mRNA preceded elevations of the peptide but a greater increase resulted initially after nerve transection. An upregulation of α-CGRP mRNA also developed initially after both injuries in 10 days postnatal rats but subsequent elevations of α-CGRP mRNA did not materialize. In contrast, CGRP immunoreactivity did not increase after either injury in 10 days postnatal rats and, in fact decreased. Levels of CGRP immunoreactivity did not differ from normal amounts after either nerve injury in 14 days postnatal rats. Substantial neuronal cell loss occurred after each injury in 10 and 14 days postnatal rats but was not found in 21 days postnatal rats. Tongue reinnervation by surviving motoneurons was established after all injury paradigms except 10 days postnatal transection. The current findings demonstrate an age-dependent correlation between injury-induced expression of CGRP and hypoglossal motoneuron survival.     

Inhibition of gastric acid secretion by intracerebral injection of calcitonin gene related peptide in rats

Calcitonin gene related peptide (CGRP), a 37 amino acid peptide recently characterized from the rat brain, injected into the cisterna magna or the lateral hypothalamus, inhibited gastric acid secretion and increased serum gastrin levels in conscious pylorus-ligated rats. CGRP suppressed pentagastrin- and histamine-induced stimulation of gastric secretion in urethane-anesthetized gastric fistula rats. Peptide action was dose-dependent, not modified by adrenalectomy and peripheral sympathectomy induced by guanethidine pretreatment and reversed by vagotomy. These results demonstrate that intracisternal or intralateral hypothalamic injection of CGRP inhibits stimulated gastric acid secretion. The mechanism of action is vagal dependent and unrelated to modification of gastrin secretion or activation of sympathetic outflow.     

Abnormal nociception and opiate sensitivity of STOP null mice exhibiting elevated levels of the endogenous alkaloid morphine

Calcitonin gene-related peptide (CGRP) plays an important role in peripheral and central sensitization. CGRP also is a key molecule in the spino-parabrachial-amygdaloid pain pathway. Blockade of CGRP1 receptors in the spinal cord or in the amygdala has antinociceptive effects in different pain models. Here we studied the electrophysiological mechanisms of behavioral effects of CGRP in the amygdala in normal animals without tissue injury. Whole-cell patch-clamp recordings of neurons in the latero-capsular division of the central nucleus of the amygdala (CeLC) in rat brain slices showed that CGRP (100 nM) increased excitatory postsynaptic currents (EPSCs) at the parabrachio-amygdaloid (PB-CeLC) synapse, the exclusive source of CGRP in the amygdala. Consistent with a postsynaptic mechanism of action, CGRP increased amplitude, but not frequency, of miniature EPSCs and did not affect paired-pulse facilitation. CGRP also increased neuronal excitability. CGRP-induced synaptic facilitation was reversed by an NMDA receptor antagonist (AP5, 50 μM) or a PKA inhibitor (KT5720, 1 μM), but not by a PKC inhibitor (GF109203X, 1 μM). Stereotaxic administration of CGRP (10 μM, concentration in microdialysis probe) into the CeLC by microdialysis in awake rats increased audible and ultrasonic vocalizations and decreased hindlimb withdrawal thresholds. Behavioral effects of CGRP were largely blocked by KT5720 (100 μM) but not by GF109203X (100 μM). The results show that CGRP in the amygdala exacerbates nocifensive and affective behavioral responses in normal animals through PKA- and NMDA receptor-dependent postsynaptic facilitation. Thus, increased CGRP levels in the amygdala might trigger pain in the absence of tissue injury.     

胃溃疡患者血清多肽类激素及胃粘膜中单胺类神经递质的水平及其临床意义

目的:分析胃溃疡患者血清多肽类激素及单胺类神经递质的水平变化及其临床意义。方法:选取2014年8月-2015年8月在我院经胃镜检查确诊为胃溃疡的患者103例作为研究组,另选取54例健康志愿者作为对照组。检测两组血清中胃动素(MTL)、肾上腺髓质素(AM)、胃肠激素胃泌素(Gas)、生长抑素(SS)及降钙素基因相关肽水平(CGRP),以及胃黏膜中血管活性肠肽(VIP)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、P物质(SP)水平。结果:胃溃疡患者血清Gas,AM及MTL明显高于对照组,而SS及CGRP明显低于对照组,差异具有统计学意义(P0.05)。胃溃疡活动期患者血清Gas,AM及MTL明显高于愈合期及瘢痕期患者,而SS及CGRP低于愈合期及瘢痕期患者,差异具有统计学意义(P0.05);胃溃疡愈合期患者血清Gas,AM及MTL高于瘢痕期患者,而SS及CGRP低于瘢痕期患者,差异具有统计学意义(P0.05)。胃溃疡患者胃粘膜内5-HT,SP及NE明显低于对照组,而VIP明显高于对照组,差异具有统计学意义(P0.05)。胃溃疡活动期患者胃粘膜5-HT,SP及NE明显低于愈合期及瘢痕期患者,而VIP明显高于愈合期及瘢痕期患者,差异具有统计学意义(P0.05);胃溃疡愈合期患者胃粘膜5-HT,SP及NE明显低于瘢痕期患者,而VIP明显高于瘢痕期患者,差异具有统计学意义(P0.05)。结论:胃溃疡患者血清多肽类激素及胃黏膜中单胺类神经递质的水平变化与疾病进展密切相关,对胃溃疡的诊断及疗效评价具有指导意义。     

Plasma level of calcitonin gene-related peptide in patients with polycystic ovary syndrome and its relationship to hormonal and metabolic parameters

The aim of the study was to evaluate the plasma level of calcitonin gene-related peptide (CGRP) in patients with polycystic ovary syndrome (PCOS) and its relationship to hormonal and metabolic parameters. We also observed the effect of CGRP on testosterone (T) and estradiol (E(2)) release in cultured human granulosa cells. PCOS subjects (n=215) and matched healthy control women (n=103) at age of 22-38 years were enrolled in this study. We analyzed plasma CGRP concentrations, relationship of plasma CGRP with insulin resistance (IR), body mass index (BMI), luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio and T. The T and E(2) release levels of cultured human granulosa cells treated by CGRP were also measured. The results showed that plasma CGRP concentrations were significantly higher in women with PCOS than those of control subjects. In women with PCOS, there was a strong positive correlation between the plasma CGRP level with HOMA-IR, AUC-insulin, AUC-glucose, the ratio of LH/FSH and plasma T concentration. Human granulosa cells expressed CGRP receptor. Exogenous CGRP caused an elevation of T and E(2) released from the human granulosa cells. These findings suggest that CGRP may participate in the pathophysiological process of PCOS.     

Diagnostic relevance of the amino-terminal cleavage peptide of procalcitonin (PAS-57), calcitonin and calcitonin gene-related peptide in medullary thyroid carcinoma patients

We have identified the amino-terminal cleavage peptide of procalcitonin (PAS-57) in the plasma of normal human subjects and of medullary thyroid carcinoma (MTC) patients together with calcitonin (CT) and CT gene-related peptide (CGRP). Major components on reversed-phase high-pressure liquid chromatography had the retention times of synthetic PAS-57, CT and CGRP as well as of precursor proteins. Plasma levels of PAS-57 (290 +/- 50 pgeq/ml; mean +/- S.E.M.), CT (27 +/- 8 pgeq/ml) and CGRP (8.4 +/- 0.8 pgeq/ml) were respectively 2.3-, 1.6- and 1.5-fold higher in normal men (n = 10) than in women (n = 8). In response to 1 min intravenous calcium infusions (2 mg per kilogram body weight) PAS-57 and CT were increased 3.5- and 2.7-fold (P less than 0.001), respectively, but CGRP remained unchanged. In MTC patients (n = 57) with raised levels of PAS-57 and CT, the molar ratio between PAS-57 and CT was 1.7-times higher than in normal subjects (P less than 0.01). We have found that PAS-57 is a predominant CT/CGRP gene derived product in the circulation of normal subjects and of MTC patients and a potential new MTC tumor marker.     

High levels of Mn-superoxide dismutase in serum of patients with neuroblastoma and in human neuroblastoma cell lines.

Levels of serum manganese superoxide dismutase (Mn-SOD) in normal children aged from 1 to 14 years and children with various hematological and malignant diseases were determined by enzyme-linked immunosorbent assay (ELISA). In the normal children, the serum Mn-SOD levels gradually increased in proportion to age. By 8 years of age, the Mn-SOD level was nearly at the adult level. The normal values of serum Mn-SOD (mean +/- SD) of children below 4 and above 8 years old were 48 +/- 10.2 ng/ml and 84 +/- 22.5 ng/ml, respectively. Assuming the upper limit of normal Mn-SOD level in serum to be the mean value +/- 2 SD of children at each age, high serum levels of Mn-SOD were found for 8 of 12 patients with neuroblastoma, three of four patients with Wilms tumor, and four of five patients with acute myeloid leukemia. The patients with neuroblastoma exhibited a transient increase in Mn-SOD following chemotherapy, but after 1 week the levels decreased markedly to the control levels. The changes in serum Mn-SOD levels in the patients with neuroblastoma correlated well with the levels of neuron-specific enolase. Mn-SOD was intensely stained in bone marrow cells of patients whose cancer cells had moved into the bone marrow. High levels of Mn-SOD were also found in cultured human neuroblastoma cells. These data indicate that Mn-SOD is expressed in neuroblastoma cells, may serve as one of the diagnostic and prognostic markers for the neuroblastoma, and may be useful to predict the effectiveness of chemotherapy for neuroblastoma and the recurrence of this disease.     

降钙素基因相关肽对人支气管上皮细胞E-钙粘素表达的影响

目的:探讨降钙素基因相关肽(CGRP)对臭氧(O3)应激后人支气管上皮细胞(HBECs)中E-钙粘素(E-cd)表达的影响及机制。方法:采用RT-PCR检测E-cd mRNA的表达,免疫细胞化学染色法检测E-cd蛋白的表达。结果:CGRP呈剂量依赖性增加正常以及O3应激后HBECs胞膜上E-cd的表达,而对胞浆内E-cd的表达无明显影响;CGRP对HBECs胞膜上E-cd表达的上调作用可分别被H-89(PKA抑制剂)、H-7(PKC抑制剂)及W-7(CaM抑制剂)部分逆转。结论:CGRP可剂量依赖性增加正常和O3应激后HBECs胞膜E-cd的表达,而对胞浆内E-cd的表达无影响。