title: The association between calcitonin gene-related peptide (CGRP), substance P and headache in pituitary tumours.
abstract: OBJECTIVE
  To determine if the differential expression of calcitonin gene-related peptide (CGRP) or substance P (SP) in a range of pituitary tumours was related to the presence or absence of headache.
  
  
  METHODS
  Using recognised immunohistochemical techniques we examined twenty-six consecutive pituitary adenoma specimens for the presence of CGRP and SP. We included one normal post mortem pituitary specimen for comparison. A separate observer divided the patients into two groups: headache and non-headache. The association between the presence of CGRP, SP and headache was observed.
  
  
  RESULTS
  We observed CGRP in seven specimens (27%) and SP in six tumour specimens (23%), with cytoplasmic staining being the predominant morphological picture. CGRP and SP were co-expressed in the same tumour specimen in five cases. There was no significant association between the presence of CGRP and headache (chi(2) 0.86; P = 0.35). We did not observe CGRP or SP in the control specimen. There was no correlation between tumour subtype and the presence of CGRP or SP.
  
  
  CONCLUSIONS
  The mechanism of pituitary tumour-associated headache remains undetermined. The significance of the presence of CGRP and SP in pituitary tumours is unknown but does not appear to be related to headache or endocrine activity of the tumour.
authors.affiliation: Headache Group, Institute of Neurology, Queen Square, London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Levy
authors.forename: J D
authors.initials: JD
authors.lastname: Classey
authors.forename: S
authors.initials: S
authors.lastname: Maneesri
authors.forename: K
authors.initials: K
authors.lastname: Meeran
authors.forename: M
authors.initials: M
authors.lastname: Powell
authors.forename: P J
authors.initials: PJ
authors.lastname: Goadsby
mesh_terms: D000172:Acromegaly / Q000378:metabolism / Q000473:pathology; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism*; D006261:Headache / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D047748:Pituitary ACTH Hypersecretion / Q000378:metabolism / Q000473:pathology; D010911:Pituitary Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D015995:Prevalence; D015175:Prolactinoma / Q000378:metabolism / Q000473:pathology; D013373:Substance P / Q000378:metabolism*
chemical_list: D013373:Substance P; D015740:Calcitonin Gene-Related Peptide