Calcitonin gene-related peptide and other neuropeptides in the plasma of patients with soft tissue injury

Calcitonin gene-related peptide [CGRP] - a powerful vasodilator, is a 37 am ino acid peptide that is find primarily in the central and peripheral nervo us system. It affects the regulation of local blood flow, smooth muscle ton e and glandular secretion. It is an endocrine regulator and in the, lungs i t also exerts a bronchoconstricting effect. CGRP has a proliferative effect on human endothelial cells. Therefore, it is important for the formation o f new vessels, example, in ischemia, inflammations, and in the healing of w ounds. Plasma levels of CGRP are increase in patients with chronic cardiac failure and sepsis, indicating that CORP may be another important peptide i n chronic illness. We have therefore measured the release of this peptide a nd another sensory peptide [Substance P (SP)I; a vasoconstrictor peptide [E ndothelin (ET)I; and:a perivascular peptide [Neuropeptide Y (NPY)], within 24 hours of injury, in the plasma of patients with soft tissue injury. Neur opeptides were measure by enzyme immunoassay technique. Median:(lowerquarti le-upperquartile) in pmol/L CGRP level was elevated in patients [50.37 : (1 2.4-110.9)] compared to controls [13.9 : (10.9-36.96)] p<0.05; Endothelin a nd NPY did not vary much between groups p=NS; ET: patients [8.7 : (1.7-87.1 ), controls 8.8 : (1.7-32.9)]; NPY: Patients [11.7 : (10.5-14.99), controls 11 : (10.3-12.8)]. SP was increase in patients [302.3 : (79.9-707.3)], tha n controls [5.6 : (3.2-36.6)] p<0.05. Furthermore, Elastase (a decisive mar ker for inflammation and infectious complications), was measure (ng/L), and found to be slightly higher in patients (102:25.5-223), than controls (91. 8:45.9-127). In summary, plasma levels of sensory peptides increased signif icantly, in patients with soft tissue injury, in contrast to vasocostrictor peptides that remained unchanged. These sensory peptides may yet be anothe r group of neuromodulators playing a significant role in immune, pain, infl ammatory and wound healing in soft tissue injury patients.