The Calcitonin Gene-Related Peptide (CGRP), associated with chronic pain, could be generated by skin cells themselves.
Skin cells could be behind certain types of chronic pain, scientists have found. The Calcitonin Gene-Related Peptide (CGRP), associated with chronic pain, could be generated by skin cells themselves.
Previously the source of the increased CGRP was thought to be certain types of sensory nerve fibers in the skin that normally make and release a type or “isoform” called CGRP-alpha. Curiously, however, the authors of the current study found that nerve fibers containing CGRP-alpha are actually reduced under painful conditions – leading them to investigate where the increased CGRP in the skin came from.They found the skin cells themselves generate increased amounts of a lesser-known “beta” isoform of CGRP. This skin cell-derived CGRP-beta is increased in painful conditions and may be sending pain signals to remaining sensory nerve fibers in the skin. The discovery of CGRP-beta as a therapeutic target presents a potentially important new treatment approach.
“Since CGRP-alpha normally plays an important role in both the regulation of blood flow and normal inflammatory responses, targeting this molecule as atreatment for chronic pain could cause undesired side-effects on circulation,” said the paper’s corresponding author, Phillip J. Albrecht, Ph.D., Assistant Professor of Neuroscience at Albany Medical College and Vice President at Integrated Tissue Dynamics, LLC, whose team conducted the research. “However, since we know that these two forms of CGRP are derived from separate genes, we may be able to selectively manipulate the beta isoform without affecting the alpha, and dramatically reduce unwanted toxicities — a common problem limiting the successful development of novel pain therapeutics. This is really a two-for-one discovery: a novel mechanism we can specifically target in a novel skin location.”
The discovery that CGRP-beta from keratinocyte cells of skin may be causing pain has profound implications for the treatment and study of a host of chronic neuropathic pain conditions such as shingles, diabetic neuropathy, and physical injury, which altogether affect approximately 30 million people in the U.S. who collectively spend more than $4.5 billion each year to treat chronic nerve pain.
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To observe differences between CGRP in healthy and inflamed or painful skin, the researchers used an imaging methodology called chemomorphometric analysis (CMA), a technique they use to observe, quantify, and characterize molecules like CGRP in the microscopic structure of skin samples half the size of a pencil eraser. A commercially expanded version of the technique, pioneered by Integrated Tissue Dynamics, LLC, interpreted those results and integrated them with assessments of the genetic activity for each CGRP isoform, which led to the discovery that the beta molecule, not the alpha, predominated in keratinocytes.
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