Calcitonin gene-related peptide in hamster lung and its coexistence with serotonin: a chemical and immunocytochemical study

The diffuse endocrine system: from embryogenesis to carcinogenesis

In the present review we will summarise the current knowledge about the cells comprising the Diffuse Endocrine System (DES) in mammalian organs. We will describe the morphological, histochemical and functional traits of these cells in three major systems gastrointestinal, respiratory and prostatic. We will also focus on some aspects of their ontogeny and differentiation, as well as to their relevance in carcinogenesis, especially in neuroendocrine tumors. The first chapter describes the characteristics of DES cells and some of their specific biological and biochemical traits. The second chapter deals with DES in the gastrointestinal organs, with special reference to the new data on the differentiation mechanisms that leads to the appearance of endocrine cells from an undifferentiated stem cell. The third chapter is devoted to DES of the respiratory system and some aspects of its biological role, both, during development and adulthood. Neuroendocrine hyperplasia and neuroendocrine lung tumors are also addressed. Finally, the last chapter deals with the prostatic DES, discussing its probable functional role and its relevance in hormone-resistant prostatic carcinomas.

Targeted blocking of gene expression for CGRP receptors elevates pulmonary artery pressure in hypoxic rats

We previously described the protection by calcitonin gene-related peptide (CGRP) against hypoxic pulmonary hypertension. Here, we examine the roles of its putative receptor RDC-1 and receptor activity-modifying protein (RAMP) 1 in mediating this protection by selectively inhibiting their synthesis. RAMP1 is an accessory protein for another putative CGRP receptor, calcitonin receptor-like receptor. Antisense oligodeoxyribonucleotides (ASODNs, 5 mg.kg-1.day-1 or 5 and 10 mg.kg-1.day-1 for RDC-1) targeting RAMP1 and RDC-1 mRNAs were chronically infused to the pulmonary circulation of male Sprague-Dawley rats during 7 days of normoxia or hypobaric hypoxia (380 mmHg), and alpha-CGRP ASODN was used as a technical control. CGRP, RAMP1, and RDC-1 ASODNs significantly elevated pulmonary artery pressure (PPA) in chronic hypoxic rats compared with hypoxic mismatched ASODN (MMODN) and saline vehicle controls. CGRP and RAMP1 ASODNs raised PPA in normoxic rats briefly exposed to 10% O2 above MMODN and saline controls. Moreover, normoxic rats treated with CGRP ASODN had higher basal pulmonary vascular tone compared with controls. These data confirm the protective role of CGRP in the pulmonary circulation and suggest that endogenous RAMP1 and RDC-1 are essential in regulation of PPA in hypoxia. This is the first in vivo evidence supporting RDC-1 and RAMP1 as functional CGRP receptor and receptor component.

Immunocytochemical localization of prohormone convertases PC1 and PC2 in the mouse thyroid gland and respiratory tract

We examined immunocytochemical localization of the prohormone convertases, PC1 and PC2, in the thyroid gland and respiratory tract of the adult mouse using the indirect enzyme- and immunogold-labeled antibody methods for light and electron microscopy, respectively. In the thyroid gland, PC1- and/or PC2-immunoreactive cells were cuboidal, scattered in the follicular epithelium and in the interfollicular spaces. When serial sections were immunostained with anti-calcitonin, anti-PC1, anti-calcitonin-gene-related-peptide (CGRP), and anti-PC2 sera, respectively, localization of both PC1 and PC2 was restricted to the calcitonin/CGRP-producing parafollicular cells. In the respiratory tract, only PC1 immunoreactivity was observed in the basal granulated neuroendocrine cells, which were scattered in the tracheal epithelium. Consecutive sections immunostained with anti-PC1 and anti-CGRP sera showed that a subpopulation of these PC1-immunoreactive cells contained CGRP. Double immunogold electron microscopy of the thyroid parafollicular cells revealed that calcitonin- and/or CGRP-immunopositive secretory granules were also labeled with both PC1 and PC2. These findings suggest that procalcitonin is proteolytically cleaved by PC2 alone or by PC2 together with PC1, and that the proCGRP is cleaved by PC1.

mRNA expression of novel CGRP1 receptors and their activity-modifying proteins in hypoxic rat lung

Calcitonin gene-related peptide (CGRP) is a potent vasodilator. Our group has reported that exogenous CGRP may prevent or reverse hypoxic pulmonary hypertension in rats. The vasodilatory action of CGRP is mediated primarily by CGRP1 receptors. The calcitonin receptor-like receptor (CRLR) and the orphan receptor RDC-1 have been proposed as CGRP1 receptors, and recent evidence suggests that CRLR can function as either a CGRP1 receptor or an adrenomedullin (ADM) receptor. Receptor activity-modifying proteins (RAMPs) determine the ligand specificity of CRLR: coexpression of CRLR and RAMP1 results in a CGRP1 receptor, whereas coexpression of CRLR and RAMP2 or -3 results in an ADM receptor. We used qualitative, semiquantitative, and real-time quantitative RT-PCR to detect and quantitate the relative expression of these agents in the lungs of rats exposed to normoxia (n = 3) and 1 and 2 wk of chronic hypobaric hypoxia (barometric pressure 380 mmHg, equivalent to an inspired O(2) level of 10%; n = 3/time period). Our results show upregulation of RDC-1, RAMP1, and RAMP3 mRNAs in hypoxic rat lung and no change in CRLR and RAMP2 mRNAs. These findings support a functional role for CGRP and ADM receptors in regulating the adult pulmonary circulation.

Sensory CGRP depletion by capsaicin exacerbates hypoxia-induced pulmonary hypertension in rats

Pulmonary hypertension is a debilitating disease that occurs among infants and adults. One of many etiologies is airway hypoxia. We previously demonstrated a role of endogenous calcitonin gene-related peptide (CGRP), a potent vasodilator, in ameliorating the pulmonary vascular pressor response to chronic hypoxia and related changes in the lungs and heart. This study evaluates the role of endogenous sensory CGRP in hypoxic pulmonary hypertension and examines the intrinsic neural microcircuitry. Rats were pretreated with capsaicin i.p. to deplete pulmonary sensory C-fiber stores of CGRP and substance P and placed in hypobaric hypoxia (10% O2, 16 days) or normoxia together with sham controls. Hypoxia increased pulmonary artery pressure, right-ventricular weight, arterial medial thickness, elasticized capillaries, endothelial cell density, lung water and hematocrit in control rats. Capsaicin augmented pulmonary artery pressure and right-ventricular hypertrophy in hypoxia, and medial thickness and endothelial cell density both in normoxia and hypoxia. Because of the limited effects on these parameters by substance P and other capsaicin-sensitive lung agents, our results suggest that sensory CGRP deficit severely exacerbates pathological signs of hypoxic pulmonary hypertension. A neural microcircuitry consistent with an axon reflex pathway is outlined histochemically. We conclude that endogenous CGRP modulates pulmonary vascular tone in hypoxic pulmonary hypertension which requires intact primary sensory fibers.

Colocalization of immunoreactivities to serotonin, calcitonin and CGRP in endocrine pulmonary cells of the iberian lizard Podarcis hispanica (Reptilia)

The coexistence of immunoreactivities to serotonin (5HT), calcitonin (CT) and calcitonin gene-related peptide (CGRP) was studied in pulmonary endocrine cells of the Iberian lizard by immunocytochemistry and in semithin/thin sections under light and electron microscope. Immunostaining of serial sections revealed coexistence of 5HT/CT/CGRP immunoreactivities in some cells, while in others only 5HT/CT or CGRP immunoreactivities were found. Appropriate absorption controls excluded crossreactivity between the antisera used. Ultrastructurally, cells immunoreactive to 5HT/CT and CGRP share similar features, with round or slightly ovoid secretory granules of mean diameter from 165 to 180 nm. The possible functional significance of the copresence of 5HT, CT and CGRP is discussed.

Calcitonin, CGRP and helodermin in endocrine cells of the developing rat lung

Calcitonin gene-related peptide (CGRP), calcitonin and immunoreactive helodermin occur in endocrine cells in the murine airways. In the lungs these cells form clusters, while they occur scattered in the larynx and trachea. In the present study of the developing rat CGRP-immunoreactive cells were more numerous at all stages than the calcitonin- and helodermin-containing ones. A subpopulation of the CGRP-containing cells contained either calcitonin or helodermin. Immunocytochemistry revealed a higher density of CGRP-containing endocrine cells in the lungs of fetal and newborn rats than in the lungs of older rats, while the density of calcitonin-containing cells was largely unchanged. The helodermin-containing cells were few at all developmental stages examined. The concentration and content of CGRP were highest in newborn rats; the levels decreased postnatally. The calcitonin concentration did not change during development while the content increased with age. The concentration and content of helodermin increased with age.

Ontogeny of endocrine cells in the respiratory system of Syrian golden hamsters. I. Larynx and trachea

The ontogeny of protein gene product 9.5 (PGP 9.5), serotonin (5-HT), calcitonin gene-related peptide (CGRP), and calcitonin (CT) immunoreactivity was evaluated in small-granule endocrine cells of hamster laryngotracheal epithelium from fetal day 11 to adulthood. Two centrifugal (proximal-to-distal) patterns of differentiation occur. The first pattern begins during fetal life. Endocrine cells, single and clustered in groups (presumptive- or protoneuroepithelial bodies, pNEBs), initially colocalize immunostaining for PGP 9.5, 5-HT, and CGRP in the larynx and proximal 2/3 of the trachea on day 12 and spread to the caudal trachea on day 13. 5-HT disappears fleetingly during the 24 h preceding birth; otherwise immunoreactivity for all three substances persists into adulthood. The clusters of endocrine cells survive beyond birth but are so diluted by expansion of the nonendocrine epithelium as to become inconspicuous. Since innervation was not actually observed, these clusters may persist as pNEBs, without developing connections to afferent or efferent nerve fibers. The second pattern concerns single small-granule cells stainable for CGRP but not for 5-HT. These cells first appear in the larynx and cartilaginous part of the cranial trachea on postnatal day 3, and in the middle and caudal trachea, on day 5. The cells increase in number on day 7. In adults, they predominate among endocrine cells of the cartilaginous region. A subset of these cells begins to co-express CT proximally on postnatal day 10, reaching the caudal end of the trachea by 3 weeks. A few elements of the older 5-HT-positive population may also become immunoreactive for CT in juvenile hamsters.

Ontogeny of endocrine cells in the respiratory system of Syrian golden hamsters. II. Intrapulmonary airways and alveoli

Results of this and the preceding study reveal 3 patterns of endocrine cell development in hamster airway. The first, a prenatal wave, begins in the larynx and sweeps down the extra- and intrapulmonary conducting airway to the bronchioloalveolar portals. Cells differentiate singly and in groups (presumptive neuroepithelial bodies, pNEBs), colocalize immunoreactivity for serotonin (5-HT) and calcitonin gene-related peptide (CGRP), and persist throughout adulthood. Postnatally a few cells also express calcitonin (CT). Appearance of 5-HT and CGRP staining correlates with the onset of local, NEB-associated mitogenesis in fetal hamster airway epithelium. The second pattern begins after birth and is unique to the larynx and cartilaginous trachea. It involves differentiation of single cells which stain for CGRP but not 5-HT. Later, a proportion also stain for CT. This pattern seemingly accounts for the predominance of single cells in laryngotracheal epithelium of adult animals. In the third pattern, cells immunoreactive for peptide YY (PYY) differentiate, singly at first and later among cells of tiny pNEBs. This begins postnatally in alveoli, spreading centripetally with retrograde differentiation of alveolar epithelium back into the bronchiolar terminations. Restricted distribution and lack of immunoreactivity for 5-HT, CGRP, or CT suggest that the PYY-positive endocrine cells form a regional subset performing special roles in pulmonary homeostasis.

Ultrastructure and innervation of neuroepithelial bodies in the lungs of newborn cats

Neuroepithelial bodies (NEB) occur throughout the airway mucosa and alveolar parenchyma of kitten lungs. In the bronchi, they are often situated on top of a cartilage plate. They form compact corpuscles containing 10-20 corpuscular cells and appear covered with a layer of flattened Clara cells. Kitten NEB are occasionally observed to display mitosis of the corpuscular epithelial cells. A prominent blood capillary lies at their basal pole. The corpuscular cells contain numerous dense core vesicles (DCV), whose number and diameter remain unchanged with age. Kitten NEB are innervated by nerve fibres that "loop" through the corpuscle and form morphologically afferent as well as efferent nerve endings. The nerve endings display afferent synaptic junctions with the corpuscular cells and sometimes run in clusters, so that they contact each other. Many nerve endings undergo spontaneous degeneration. We conclude that kitten NEB are well adapted to function as chemoreceptors and as endocrine or paracrine organs. Their chemoreceptor activity could be modulated by axon reflexes since their afferent nerve endings are often continuous with the efferent ones, as well as by interneural modulation since nerve endings often form clusters. In addition, kitten NEB innervation appears to involute rapidly soon after birth. This may indicate that their chemoreceptor function is only of primary importance during gestation and at birth. However, the secretory function of kitten NEB, as evidenced by the unchanged numbers and dimensions of their DCV, seems to remain steady throughout life.

Evidence for the coexistence of serotonin and calcitonin gene-related peptide at the subcellular level in neuroepithelial bodies in the lung of a marsupial, Isoodon macrourus

The coexistence of serotonin and calcitonin gene-related peptide (CGRP) in neuroepithelial bodies of the bandicoot, Isoodon macrourus, has been examined using immunocytochemistry at the light- and electron-microscope levels. The avidin-biotin technique of antigen localisation was used initially to identify serotonin-like and CGRP-like immunoreactivity (-LI). Serotonin-LI and CGRP-LI were found in neuroepithelial cells in the lungs of 30-day-old bandicoots. CGRP-LI could also be demonstrated in nerve fibres associated with some neuroepithelial bodies. The protein A-gold technique of antigen localisation was used to label neuroepithelial cells and nerve fibres at the subcellular level. Serotonin-LI and CGRP-LI were observed in the same dense-cored vesicles of most neuroepithelial cells; however, some neuroepithelial cells were shown to possess serotonin-LI without CGRP-LI. Nerve fibres immediately adjacent to neuroepithelial bodies exhibited mainly CGRP-LI. These results show that serotonin-LI and CGRP-LI are present in neuroepithelial cells of the bandicoot in the same secretory vesicles. This pattern of co-localisation may reflect co-ordinated or synergistic actions of these two neuroactive substances.

Immunocytochemical study of the diffuse neuroendocrine system cells in equine lungs

This study was undertaken to investigate the presence of neuroendocrine cells (N.E.C.) by immunocytochemical means in equine lungs during three distinct evolutionary periods: fetal, neonatal and adult. The authors identified bombesin, somatostatin and calcitonin secretory cells. In the fetal lungs the N.E.C. were located in the interstitial tissue and exhibited greater immunoreactivity to bombesin than to the other two neuropeptides studied. A large number of calcitonin-producing cells and a smaller number of bombesin-positive cells were seen in the bronchial and bronchiolar epithelium of newborn Equidae. In the adult equine lungs far fewer N.E.C. were observed than in the earlier stages. Somatostatin-producing cells were not seen in neonatal or adult lung tissue.

Dynamic aspects of regulatory lung peptides in chronic hypoxic pulmonary hypertension

Male Sprague-Dawley rats were placed in hypobaric hypoxia for 17-21 d (FIO2 10%) to establish pulmonary hypertension (PH) and control rats were kept in normobaric room air. Right mean atrial and ventricular pressures (PRA, PRV) were recorded, left ventricular (LV) blood was collected, and lungs were perfused with heparinized saline. Hearts were removed to evaluate right ventricular (RV) hypertrophy (RV/(LV+septum)%). Peptides were quantitated with radioimmunoassay in lung tissue extracts and plasma. Wet lung weight, PRA, PRV, and RV/(LV+S)% were higher and body weight was lower in hypoxia rats, and lung morphometry revealed increased arterial medial thickness (MT/OD%) and elastification of arterioles and capillaries. Lung tissue CGRP, PYY, gamma 2-MSH, and SOM were higher in PH rats and ANP was unchanged. Blood AVP, CGRP, PYY, VIP, and SOM were reduced in PH rats and ANP was unchanged. Lung levels of PYY and SOM correlated significantly with the time in hypoxia and with all parameters examined and CGRP and gamma 2-MSH correlated with all but medial thickness. PYY had the highest correlation of the peptides with body weight, PRV, and RV/(LV+S)%, and SOM the highest with time in hypoxia, wet lung weight, PRA, MT/OD%, and elastification of arterioles and capillaries. Blood peptides correlated inversely with these parameters. ANP had the overall weakest correlations and CGRP, PYY, and SOM had the highest. SOM correlated the highest with arterial medial hypertrophy, PRV, RV hypertrophy, and elastification of peripheral capillaries. VIP correlated the highest of the blood peptides with body weight and wet lung weight. Statistically significant correlations do not necessarily imply causal relationships. The putative roles of these peptides in pulmonary function are discussed.

Chemical coding of endocrine cells of the airways: presence of helodermin-like peptides

The epithelium of the airways is rich in endocrine cells containing serotonin and/or a wide variety of regulatory peptides. These cells usually occur in clusters in the lungs but are also found scattered in the larynx and trachea. In the present study, endocrine cells in the airways of mouse, rat, hamster, guinea pig, pig, sheep and squirrel monkey were examined for the presence of serotonin, helodermin-like peptides and other regulatory peptides using immunocytochemistry and radioimmunoassay. In addition, we looked for the protein gene product 9.5 (PGP), which occurs in many peptide hormone-producing endocrine cells in the body. Both clustered and scattered endocrine cells in the airways were found to display coexistence of serotonin and peptides, such as a helodermin-like peptide, calcitonin and calcitonin gene-related peptide (CGRP). The PGP-immunoreactive cells were numerous and included elements containing serotonin and/or regulatory peptides. An additional PGP-immunoreactive endocrine cell population lacked serotonin and regulatory peptides. Helodermin-immunoreactive material was demonstrated in endocrine cells of the airways in the mouse and hamster but not in any of the other species studied. Serotonin was an endocrine cell constituent in all the species studied. Calcitonin and CGRP could be demonstrated by immunocytochemistry in the mouse, rat, and hamster, but not in the guinea pig, sheep, pig and monkey.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitonin gene-related peptide and its mRNA in pulmonary neuroendocrine cells and ganglia

The occurrence of calcitonin gene-related peptide (CGRP) and it's mRNA was studied in lungs of rats and piglets using in situ hybridization with two synthetic oligonucleotide probes followed by immunocytochemistry (ICC). CGRP mRNA was present in pulmonary neuroendocrine cells (PNEC) of both the solitary type and cluster type (neuroepithelial body; NEB) at all levels of the airway epithelium from bronchi to alveoli. The distribution of labelled cells was similar to that previously described with ICC. The 44-mer probe provided stronger hybridization signal than the 34-mer and the two combined increased labelling slightly. Formalin fixation reduced labelling and tended to increase background. Labelling for CGRP mRNA was evenly distributed over the cytoplasm, whereas CGRP-like immunoreactivity (LI) usually was of highest intensity toward the base of the PNEC, suggesting basal accumulation of synthesized peptide. CGRP-LI was also observed in occasional rat ganglia and in some, but not all, piglet ganglia. These local neurons may contribute to the CGRP fibers of airways and vasculature, and could theoretically bridge their dendrites and axons between NEB and the effector organ (e.g. artery or arteriole) thus accomplishing a function similar to the postulated axon reflex.

Co-occurrence of immunoreactive calcitonin and calcitonin gene-related peptide in neuroendocrine cells of rat lungs

Neuroendocrine cells of the lung, occurring singly or in clusters known as neuroepithelial bodies, contain a variety of biologically active compounds, including several neuropeptides. We have investigated the localization of calcitonin and calcitonin gene-related peptide (CGRP) within single and grouped neuroendocrine cells in the respiratory epithelium of rats by an immunohistochemical double-staining technique which uses specific antisera raised in heterogeneous animal species. Calcitonin- and CGRP-immunoreactivities were nearly totally co-localized in both single neuroendocrine cells and neuroepithelial bodies. CGRP-immunoreactivity was also present in neurons in the jugular, nodose and dorsal root ganglia. The calcitonin-immunoreactivity in neuroendocrine cells, as in thyroid parafollicular (C) cells, was abolished by preincubation of the anti-calcitonin serum with synthetic calcitonin. The CGRP-immunoreactivity in neuroendocrine cells and in the neuronal cells was abolished by preincubation of anti-CGRP serum with synthetic CGRP. Thus, while the calcitonin gene is expressed exclusively or predominantly as either calcitonin or CGRP in all other tissues except thyroid C-cells, our results strongly suggest that both peptides are expressed in the rat bronchopulmonary neuroendocrine cells.

Calcitonin gene-related peptide, enkephalin and serotonin coexist in neuroepithelial bodies of the respiratory tract of the red-eared turtle, Pseudemys scripta elegans. An immunocytochemical study

The lungs of the red-eared turtle, Pseudemys scripta elegans, have been investigated by light-microscopical immunocytochemistry for serotonin (5-HT) and the neuropeptides calcitonin gene-related peptide (CGRP), enkephalin (ENK), bombesin, somatostatin, calcitonin and cholecystokinin. CGRP- or 5-HT-like immunoreactivity (LI) was demonstrated in neuroepithelial bodies (NEBs) and solitary neuroepithelial endocrine cells lying between the ciliated epithelial cells of the intrapulmonary bronchi, and of the primary, secondary and tertiary trabeculae. Furthermore, ENK-LI NEBs were found between the trabecular ciliated epithelial cells. No reaction was observed with antisera against bombesin, somatostatin, calcitonin, and cholecystokinin. Using consecutive sections, CGRP-LI appears to be colocalized with 5-HT-LI in NEB cells. In addition, it was demonstrated that all the ENK-LI NEBs also contain CGRP-LI, whereas only a part of the CGRP-LI NEBs reveal ENK-LI. To our knowledge this is the first demonstration of CGRP- and/or ENK-LI in pulmonary NEBs of a lower vertebrate.

PYY-like material and its spatial relationship with NPY, CGRP and 5-HT in the lung of the Syrian golden hamster

We investigated the presence of peptide YY, neuropeptide Y, calcitonin gene-related peptide and serotonin in the hamster lung by radioimmunoassay, high performance liquid chromatography and immunocytochemistry. Lung-tissue concentrations of peptide YY and neuropeptide Y were 1.3 +/- 0.2 and 2.5 +/- 0.2 pmol/g wet weight, respectively. These two closely related pancreatic peptides were demonstrated in separate peaks with high performance liquid chromatography. The peptide YY appeared fragmented as immunoreactive peptide YY eluted primarily late in the gradient but showed additional peaks early in the gradient. Peptide YY-like immunoreactivity (PYY-LI) was predominantly observed in one or more cells of neuroepithelial bodies in all airways peripheral to bronchioles, and in solitary neuroendocrine cells primarily located in the same peripheral areas. Neuropeptide Y-LI was seen in individual, thin nerve fibers around arteries and veins, in the airway lamina propria, and in the airway epithelium; in the latter also immunopositive nerve terminals were located. This pattern did not appear to coincide with that of calcitonin gene-related peptide-LI in epithelial nerve fibers and terminals. Peptide YY-LI, calcitonin gene-related-LI and serotonin-LI were present in cells of one and the same neuroepithelial body. However, peptide YY-LI was never found to be co-localized with calcitonin gene-related-LI or serotonin-LI, but the latter two were co-localized as previously reported.

Elevated serum levels of calcitonin gene-related peptide (CGRP) but no evidence for CGRP gene expression in non-small cell lung carcinomas

Calcitonin gene-related peptide (CGRP) is a hormone formed by alternative post-transcriptional processing of the calcitonin gene. It is a neuropeptide localized to discrete regions of the central nervous system (CNS) and in nerve fibres associated with blood vessels. It is also expressed in medullary carcinomas of the thyroid and lung carcinoma cell lines. The latter finding suggests a possible value for CGRP as tumour marker in lung carcinomas. In this investigation of 22 patients undergoing operation for lung tumours, pre and post-operative levels of serum CGRP were measured. Preoperative as well as postoperative serum CGRP levels were significantly elevated when compared to age-matched normals. However, no evidence could be found for CGRP gene expression in tumour tissue from the same patients as judged by immunocytochemistry or in-situ hybridization using CGRP cRNA probes. CGRP has been localized to nerve fibres in relation to pulmonary blood vessels and has been shown to be a potent vasodilator. These findings, and the absence of evidence for synthesis in tumours, as opposed to cell lines derived from lung carcinomas, suggests that the lack of post-operative normalization of serum CGRP concentrations may be related to physiological changes in cardiovascular haemodynamics following surgery. Elevated pre-operative serum CGRP levels may also reflect a consequence of the lung carcinoma leading to increased release of CGRP from sites in the vasculature yet to be determined, but does not indicate synthesis de novo and secretion of CGRP by the tumours.