Role of extracellular calcitonin gene-related peptide in spinal cord mechanisms of cancer-induced bone pain

Rikke R. Hansen*, Valentina Vacca, Thomas Pitcher, Anna K. Clark, Marzia Malcangio

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
334 Downloads (Pure)


Severe pain is a common and debilitating complication of metastatic bone cancer. Current analgesics provide insufficient pain relief and often lead to significant adverse effects. In models of cancer-induced bone pain, pathological sprouting of sensory fibers at the tumor-bone interface occurs concomitantly with reactive astrocytosis in the dorsal horn of the spinal cord. We observed that calcitonin gene-related peptide (CGRP)-fiber sprouting in the bone was associated with an increase in CGRP content in sensory neuron cell bodies in the dorsal root ganglia (DRG) and increased basal and activity-evoked release of CGRP from their central terminals in the dorsal horn. Intrathecal administration of a peptide antagonist (α-CGRP8-37) attenuated referred allodynia in the hind paw ipsilateral to bone cancer. CGRP receptor components (CLR and RAMP1) were up-regulated in dorsal horn neurons and expressed by reactive astrocytes. In primary cultures of astrocytes, CGRP incubation led to a concentration-dependent increase of forskolin-induced cAMP production, which was attenuated by pretreatment with CGRP8-37. Furthermore, CGRP induced ATP release in astrocytes, which was inhibited by CGRP8-37. We suggest that the peripheral increase in CGRP content observed in cancer-induced bone pain is mirrored by a central increase in the extracellular levels of CGRP. This increase in CGRP not only may facilitate glutamate-driven neuronal nociceptive signaling but also act on astrocytic CGRP receptors and lead to release of ATP.

Original languageEnglish
Pages (from-to)666-676
Number of pages11
Issue number3
Early online date13 Nov 2015
Publication statusPublished - 1 Mar 2016


  • Astrocyte
  • Calcitonin gene-related peptide
  • Cancer-induced bone pain


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