Iyengar Smriti, Ossipov Michael H, Johnson Kirk W
Eli Lilly and Company, Indianapolis, IN, USA.
inVentiv Health Clinical, LLC, Ann Arbor, MI, USA.
Pain. 2017 Apr;158(4):543-559. doi: 10.1097/j.pain.0000000000000831.
Calcitonin gene-related peptide (CGRP) is a 37-amino acid peptide found primarily in the C and Aδ sensory fibers arising from the dorsal root and trigeminal ganglia, as well as the central nervous system. Calcitonin gene-related peptide was found to play important roles in cardiovascular, digestive, and sensory functions. Although the vasodilatory properties of CGRP are well documented, its somatosensory function regarding modulation of neuronal sensitization and of enhanced pain has received considerable attention recently. Growing evidence indicates that CGRP plays a key role in the development of peripheral sensitization and the associated enhanced pain. Calcitonin gene-related peptide is implicated in the development of neurogenic inflammation and it is upregulated in conditions of inflammatory and neuropathic pain. It is most likely that CGRP facilitates nociceptive transmission and contributes to the development and maintenance of a sensitized, hyperresponsive state not only of the primary afferent sensory neurons but also of the second-order pain transmission neurons within the central nervous system, thus contributing to central sensitization as well. The maintenance of a sensitized neuronal condition is believed to be an important factor underlying migraine. Recent successful clinical studies have shown that blocking the function of CGRP can alleviate migraine. However, the mechanisms through which CGRP may contribute to migraine are still not fully understood. We reviewed the role of CGRP in primary afferents, the dorsal root ganglion, and in the trigeminal system as well as its role in peripheral and central sensitization and its potential contribution to pain processing and to migraine.
降钙素基因相关肽（CGRP）是一种由37个氨基酸组成的肽，主要存在于源自背根神经节和三叉神经节的C类和Aδ类感觉纤维以及中枢神经系统中。研究发现降钙素基因相关肽在心血管、消化和感觉功能中发挥重要作用。尽管CGRP的血管舒张特性已有充分记载，但其在调节神经元敏化和疼痛增强方面的躯体感觉功能最近受到了相当多的关注。越来越多的证据表明，CGRP在周围敏化的发展和相关的疼痛增强中起关键作用。降钙素基因相关肽与神经源性炎症的发展有关，并且在炎症性疼痛和神经性疼痛的情况下会上调。很可能CGRP促进伤害性感受的传递，并不仅对初级传入感觉神经元，而且对中枢神经系统内的二级疼痛传递神经元的敏化、高反应状态的发展和维持都有贡献，从而也导致中枢敏化。敏感化神经元状态的维持被认为是偏头痛的一个重要潜在因素。最近成功的临床研究表明，阻断CGRP的功能可以缓解偏头痛。然而，CGRP可能导致偏头痛的机制仍未完全了解。我们综述了CGRP在初级传入神经、背根神经节和三叉神经系统中的作用，以及它在周围和中枢敏化中的作用及其对疼痛处理和偏头痛的潜在贡献。
