Effects of endurance exercise on serum concentration of calcitonin gene-related peptide (CGRP): a potential link between exercise intensity and headache

Cantor Tarperi; Fabian Sanchis-Gomar; Martina Montagnana; Elisa Danese; Gian Luca Salvagno; Matteo Gelati; Kristina Skroce; Federico Schena; Giuseppe Lippi

doi:10.1515/cclm-2019-1337

Article

Effects of endurance exercise on serum concentration of calcitonin gene-related peptide (CGRP): a potential link between exercise intensity and headache

Cantor Tarperi , Fabian Sanchis-Gomar , Martina Montagnana , Elisa Danese , Gian Luca Salvagno , Matteo Gelati , Kristina Skroce , Federico Schena and Giuseppe Lippi

Published/Copyright: April 10, 2020

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 58 Issue 10

Abstract

Background

Calcitonin gene-related peptide (CGRP) is a powerful neuropeptide that is strongly involved in headache pain pathogenesis by triggering vasodilation, mast cell degranulation and neurogenic inflammation. This evidence has prompted us to investigate the acute influence of endurance exercise on CGRP concentration in blood.

Methods

The study population consisted of 48 male amateur runners, who ran a half-marathon distance at 75%–85% of maximal oxygen uptake. Blood was drawn before the run (pre-run) and immediately after each runner ended his trial (post-run). The serum concentration of CGRP was measured with a commercial enzyme-linked immunosorbent assay (ELISA) technique.

Results

Overall, 22/48 subjects (45.8%) reported suffering from headache, three of whom (6.2%) had an exertional headache, whilst 26/48 (54.2%) subjects did not report at least one headache episode during the previous 6 months (i.e. headache-free). All 48 athletes successfully covered the 21.1 km distance. Serum concentration of CGRP significantly increased by 1.5-fold in the entire group, as well as in the headache-positive and headache-free cohorts. Univariate Spearman’s correlation revealed that post-run variation of serum CGRP was significantly and inversely associated with running time (r = −0.30; p = 0.036).

Conclusions

The serum concentration of CGRP is significantly enhanced by medium-distance endurance exercise and the post-exercise increase is dependent on running intensity. Accordingly, high-exercise intensity might be directly related to triggering both exertional headache and/or migraine episodes.

Keywords: anti-calcitonin gene-related peptide agents; headache; migraine; neuropeptide; physical activity; running

aFederico Schena and Giuseppe Lippi share senior authorship on this work.

Corresponding author: Fabian Sanchis-Gomar, MD, PhD, Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Av. Blasco Ibañez, 15, 46010 Valencia, Spain

Acknowledgments

Fabian Sanchis-Gomar is supported by a postdoctoral contract granted by “Subprograma Atracció de Talent – Contractes Postdoctorals de la Universitat de València”.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2019-12-30

Accepted: 2020-03-09

Published Online: 2020-04-10

Published in Print: 2020-09-25

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Articles in the same Issue

https://doi.org/10.1515/cclm-2019-1337

Keywords for this article

anti-calcitonin gene-related peptide agents; headache; migraine; neuropeptide; physical activity; running