高血圧疾患における血漿calcitonin gene-related peptide(CGRP)の臨床的検討
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概要
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Calcitonin gene-related peptide (CGRP) is a potent endogenous vasodilator in humans, and has been reported to be localized in peripheral nerve fibers distributed in the cardiovas-cular system. Thus, CGRP is considered as a modulator of peripheral vascular tone. In this study, in order to investigate the pathophysiological role of CGRP in hypertensive dis-eases, plasma CGRP levels (pCGRP) were evaluated in patients with essential hypertension (EHT, n=31 ; WHO I-II), primary aldosteronism (PA, n=13), pheochromocytoma (Pheo, n=4) and nor-motensive subjects (Control, n=25), using a sensitive radioimmunoassay previously established in our laboratory. The effects of chronic treatment with Ca?? antagonist (manidipine 20mg/day) or α?-blocker (bunazosin 3mg/day) on pCGRP were studied in 11 cases of EHT. pCGRP were also measured after adrenalectomy in 5 cases of PA. EHT showed significantly higher pCGRP compared with Control. Significant positive correla-tions were observed between both systolic and diastolic blood pressures and pCGRP in the combined group of EHT and Control. In 6 EHT, pCGRP decreased significantly after 2 weeks administration of manidipine simultaneously with a marked blood pressure fall. A significant decrease of pCGRP was also observed after 2 weeks treatment with bunazosin in 5 EHT. In secondary hypertension, in spite of their clear differences in humoral factors such as plasma renin activity, plasma cate-cholamine level or plasma aldosterone concentration, both PA and Pheo showed significantly higher pCGRP compared with Control. No significant difference in pCGRP was observed among EHT, PA and Pheo. pCGRP markedly decreased after adrenalectomy accompanied with a significant fall hi blood pressure in PA. Thus, it was suggested in this study that the increased pCGRP observed in EHT, PA and Pheo are a secondary, compensatory reaction to elevated blood pressure.
- 札幌医科大学の論文
- 1994-04-01
札幌医科大学 | 論文
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