Calcitonin Gene-related Peptide In Patients Research Articles

Expression and Role of Calcitonin Gene-Related Peptide in Patients With Chronic Rhinosinusitis With Nasal Polyposis

Expression and Role of Calcitonin Gene-Related Peptide in Patients With Chronic Rhinosinusitis With Nasal Polyposis

Serum calcitonin gene-related peptide in patients with persistent post-concussion symptoms, including headache: a cohort study.

Calcitonin gene-related peptide (CGRP) plays an important role in migraine pathophysiology, and post-traumatic headache (PTH) frequently presents with migraine-like features. Despite several clinical similarities, few studies have explored CGRP in PTH and concussion. This study investigates serum CGRP levels in patients with persistent post-concussion symptoms (PPCS), including PTH. This cohort study was based on serum samples from individuals aged 18-30years with PPCS who participated in a previously published randomized controlled trial of a non-pharmacological intervention. The primary outcome was serum CGRP concentrations, determined at baseline before randomization and at follow-up 7months later, using an enzyme-linked immunosorbent assay (ELISA). CGRP levels at baseline were compared with healthy anonymous blood donors in the same age group. Baseline serum samples were collected from 86 participants with PPCS. The participants were most often female (78%) and migraine-like headache was the most frequent headache phenotype (74%). Serum CGRP levels were higher in participants with PPCS than in 120 healthy individuals (median: 158.5pg/mL vs. 76.3pg/mL, p = 0.050). A stratified analysis revealed that females with PPCS had a fivefold higher median than healthy females (166.3pg/mL vs. 32.1pg/mL, p = 0.0006), while no differences were observed in males (p = 0.83). At follow-up, CGRP levels decreased with a median change of - 1.3pg/mL (95% confidence interval: - 17.6-0, p = 0.024). Elevated serum levels of CGRP in patients with PPCS and a decrease over time suggest an involvement of CGRP in PTH/PPCS. If confirmed in other studies, it could pave the way for CGRP-targeted therapies, which could have clinical significance.

Expression and Role of Calcitonin Gene-Related Peptide in Patients With Chronic Rhinosinusitis With Nasal Polyposis

This corrects the article "Expression and Role of Calcitonin Gene-Related Peptide in Patients With Chronic Rhinosinusitis With Nasal Polyposis" in volume 65 on page 208.

Expression and Role of Calcitonin Gene-Related Peptide in Patients With Chronic Rhinosinusitis With Nasal Polyposis

Background and Objectives A recent study revealed that calcitonin gene-related protein (CGRP) plays an important role in inflammatory airway diseases. However, the influence of CGRP on chronic rhinosinusitis (CRS) has not been studied. This study investigated the expression, activity, and potential pathogenic role of CGRP in patients with CRS with nasal polyposis (CRSwNP).Subjects and Method Patients with CRSwNP and control subjects were enrolled. The CRSwNP group was divided according to the presence of eosinophilic polyps and non-eosinophilic polyps. Nasal polyps (NPs) and uncinate tissues (UTs) from patients with CRSwNP and UTs from control subjects were obtained to investigate the expression of α-/β-CGRP and chromogranin A. In addition, the expression patterns of cytokines following exposure to exogenous CGRP were analyzed in dispersed nasal polyp cells (DNPCs) from patients with eosinophilic or non-eosinophilic CRSwNP. The effects of CGRP on lipopolysaccharide (LPS)-induced nuclear factor-kappa light chain enhancer of activated B cells (NF-κB) signaling change were evaluated in THP-1 cells.Results The expression of α-/β-CGRP and number of CGRP-producing cells were significantly higher in NPs from patients with CRSwNP than in UTs from controls. Exogenous CGRP decreased the expression of inflammatory cytokines and increased that of the anti-inflammatory cytokines in DNPCs from patients with eosinophilic nasal polyps (EPs) and also increased the expression of tissue remodeling-related and anti-inflammatory cytokines in DNPCs from patients with non-eosinophilic nasal polyps (N-EPs). CGRP inhibited the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor (IκB) phosphorylation and NF-κB translocation in LPS-stimulated M1 macrophages.Conclusion CGRP expression in NPs may play a significant role in nasal polypogenesis through inflammatory modulation, and it could be a future target to modulate certain aspects of CRSwNP.

Galcanezumab CONQUERs migraine prevention

The introduction of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) or its receptor for migraine prevention has been a great success. In The Lancet Neurology, Wim M Mulleners and colleagues report data that complete findings from a series of randomised, controlled trials targeting CGRP in patients with migraine in whom previous prophylactic treatment attempts had been unsuccessful.1 These trials have shown that erenumab,2 fremanezumab,3 and, as reported now in this Article, galcanezumab1 can provide beneficial effects for these patients.

Effect of Helicobacter pylori Infection on Autonomic Nervous Function and Calcitonin Gene-related Peptide in Patients with Functional Dyspepsia

Objective To investigate the effects of Helicobacter pylori(H.pylori)infection on autonomic nervous function and calcitonin gene-related peptide in patients with functional dyspepsia(FD). Methods Thirty-one patients with FD matching Rome Ⅳ criteria were included and divided into H.pylori-positive group and H.pylori-negative group.All patients were evaluated by Symptom Index of Dyspepsia(SID),Nepean Dyspepsia Index(NDI),and Hospital Anxiety and Depression Scale(HADS).Their heart rate variability(HRV)and calcitonin gene-related peptide(CGRP)level were also measured. Results There were no significant differences in SID(Z=-0.858, P=0.858),NDI(Z=-1.464, P=0.143),and Hospital Depression Scale score(Z=0.699, P=0.485).However,the Hospital Anxiety Scale score was significantly higher in H.pylori-positive group than the H.pylori-negative group(Z=-2.470, P=0.014).The level of CGRP in H.pylori-positive group[(0.999±0.274)ng/ml]was significantly higher than that in the H.pylori-negative group[(0.812±0.172)ng/ml;t=2.238, P=0.033].HRV data showed no significant difference between these two groups at very low frequency(t=-1.210, P=0.236),low frequency(LF)(t=0.419, P=0.678),high frequency(HF)(t=0.612, P=0.546),LF/HF(t=-0.882, P=0.399),and total power(t=-0.963, P=0.344). Conclusion In FD patients,patients with H.pylori-positive FD patients have higher depression and CGRP levels than those without H.pylori infection,although their dyspepsia symptoms and HRV show no notable changes.

Radix Puerariae rebalances vasomotor factors and improves left ventricular diastolic dysfunction in patients with essential hypertension.

The aim of the present study was to validate the beneficial role of Radix Puerariae in rebalancing the plasma levels of endothelin, angiotensin II (AngII) and calcitonin gene-related peptide (CGRP) in patients with essential hypertension (EHT). A total of 150 patients with EHT were enrolled consecutively and randomized to receive antihypertensive drugs according to guideline-directed medical therapy (GDMT group) and GDMT plus Radix Puerariae (GDMT + RP group). The blood pressure was recorded biweekly. At baseline and at the end of the follow-up (12 weeks), the plasma levels of endothelin, AngII and CGRP were detected, whilst the left ventricular (LV) diastolic function was evaluated by echocardiography. At baseline, the two groups did not differ in terms of demographic characteristics and LV diastolic dysfunction. At the end of the follow-up, lower blood pressure was observed in the GDMT + RP compared with that in the GDMT group. The plasma levels of AngII and endothelin were also significantly lower in the GDMT + RP group. The plasma levels of CGRP increased significantly in the GDMT + RP compared with those in the GDMT group. The addition of Radix Puerariae improved LV diastolic function, with the percentage of dysfunction decreasing to only 9%, while this percentage remained significantly elevated (21%) in the GDMT group. The results of the present study demonstrated that Radix Puerariae is able to regulate blood pressure and the plasma levels of endothelin, AngII and CGRP in patients with EHT. LV diastolic dysfunction was also improved, as detected by echocardiography.

Periodontal inflammation is related to increased serum calcitonin gene-related peptide levels in patients with chronic migraine.

Recently, a relationship was found between periodontitis and chronic migraine. Calcitonin gene-related peptide (CGRP) is a key element in migraine pathophysiology. However, no information exists of the potential association between periodontal inflammation and CGRP in chronic migraine. The aim of the study was, therefore, to investigate whether there is a link between periodontitis and peripheral levels of CGRP in a cohort of patients with chronic migraine. We included 102 chronic migraineurs and 77 age- and sex-matched individuals free of headache/migraine. Full-mouth periodontal parameters were recorded and the periodontal inflamed surface area (PISA) was calculated to quantify the periodontal inflammatory status for each participant. Sociodemographic data and comorbidities were assessed by means of a standard questionnaire. We collected blood samples and serum concentrations were done for CGRP, interleukin (IL)-6 and IL-10. In the chronic migraine group, patients with periodontitis had greater levels of serum CGRP (19.7 ± 6.5versus 15.3 ± 6.2 pg/mL, P < 0.0001) and IL-6 (15.1± 9.2versus 9.6 ± 6.3 pg/mL, P<0.0001) while non-significant differences were observed with IL-10 (2.0 ± 1.0versus 2.8 ± 1.5 pg/mL, P=0.675) concentrations than those without periodontitis. PISA was independently associated with CGRP in patients with chronic migraine (β=0.003; 95% confidence interval: 0.001 to 0.006, P=0.031). PISA correlated positively with CGRP (r=0.236; P=0.017) and IL-6 (r=0.262; P=0.008) in chronic migraine. Periodontal inflammation is associated with increased circulating levels of CGRP in chronic migraineurs. Elucidating the exact mechanisms through which periodontitis and CGRP are linked in these patients deserves further investigation.

Migraine induction with calcitonin gene-related peptide in patients from erenumab trials

BackgroundMigraine prevention with erenumab and migraine induction by calcitonin gene-related peptide (CGRP) both carry notable individual variance. We wanted to explore a possible association between individual efficacy of anti-CGRP treatment and susceptibility to migraine induction by CGRP.MethodsThirteen migraine patients, previously enrolled in erenumab anti-CGRP receptor monoclonal antibody trials, received CGRP in a double-blind, placebo-controlled, randomized cross-over design to investigate their susceptibility to migraine induction. A standardized questionnaire was used to assess the efficacy of previous antibody treatment. The patients were stratified into groups of high responders and poor responders. Primary outcomes were incidence of migraine-like attacks and area under the curve of headache intensity after infusion of CGRP and placebo. All interviews and experiments were performed in laboratories at the Danish Headache Center, Copenhagen, Denmark.ResultsTen high responders and three poor responders were included. CGRP induced migraine-like attacks in ten (77%) patients, whereof two were poor responders, compared to none after placebo (p = 0.002). The area under the curve for headache intensity was greater after CGRP, compared to placebo, at 0–90 min (p = 0.009), and 2–12 h (p = 0.014). The median peak headache intensity score was 5 (5–9) after CGRP, compared to 2 (0–4) after placebo (p = 0.004).ConclusionsPatients with an excellent effect of erenumab are highly susceptible to CGRP provocation. If an association is evident, CGRP provocation could prove a biomarker for predicting antibody treatment efficacy.Trial registrationRetrospectively registered at clinicaltrials.gov with identifier: NCT03481400.

Alterations in enteric calcitonin gene-related peptide in patients with colonic diverticular disease: CGRP in diverticular disease.

Diverticular disease (DD) is one of the most prevalent diseases of the large bowel. Lately, imbalance of neuro-muscular transmission has been recognized as a major etiological factor for DD. Neuronal calcitonin gene-related peptide (CGRP) is a potent gastrointestinal smooth muscle relaxant shown to have a widespread effect within the alimentary tract. Nevertheless, CGRPergic innervation of the enteric ganglia has never been considered in the context of motility impairment observed in DD patients. Changes in CGRP and calcitonin receptor-like receptor (CRLR) abundance within enteric ganglia were investigated in sigmoid samples from symptomatic and asymptomatic DD patients using quantitative fluorescence microscopy. CGRP effect on gastrointestinal smooth muscle was investigated using organ bath technique. We found CGRP levels within the enteric ganglia to be declined by up to 52% in symptomatic DD patients. Conversely, CRLR within the enteric ganglia was upregulated by 41% in symptomatic DD. Longitudinal smooth muscle displayed an elevated (+10.5%) relaxant effect to the exogenous application of CGRP in colonic strips from symptomatic DD patients. Samples from asymptomatic DD patients consistently showed intermediate values across different experiments. In conclusion, the present study demonstrates that CGRPergic signaling is subject to alteration in DD. Our results suggest that a hypersensitization mechanism to gradually decreasing levels of CGRP-IR nerve fibers takes place during DD progression. Alterations to CGRPergic signaling in DD disease may have implications for physiological abnormalities associated with colonic DD.

The Relationship between Trypsin/Calcitonin Gene Related Peptide (CGRP) in Serum and Acute Pancreatitis (AP).

Activation of trypsin from proteolytic cleavage of trypsinogen in the pancreas can lead to acute pancreatitis. Calcitonin gene related peptide (CGRP) from both peripheral and central neurons is involved in a variety of physiological/pathophysiological processes, especially sensory (nociceptive) and efferent (effector) functions. To better understand the change of trypsin/CGRP in acute pancreatitis, the study investigated the serum level of trypsin/CGRP in patients with acute pancreatitis. The study investigated 140 patients with acute pancreatitis, including 72 cases of biliary acute pancreatitis, 60 cases of hyperlipidemic acute pancreatitis, and 8 cases of idiopathic acute pancreatitis. Sixty volunteers acted as the normal control group. The levels of trypsin and CGRP in serum were analyzed. The serum levels of trypsin and CGRP in males with acute pancreatitis were higher than in females, but there was no statistical difference (p > 0.05). However, the serum levels of trypsin and CGRP in different types of acute pancreatitis were significantly higher than controls (p < 0.001), and the level of trypsin and CGRP in serum of patients with inflammation effusion was significantly higher than patients without inflammation effusion (p < 0.001). In addition, the serum levels of trypsin and CGRP in patients with I-II, III, IVA and IVB acute pancreatitis were higher than controls (p < 0.001). According to the results, we concluded that the trypsin and CGRP in serum can act as a new detection index of acute pancreatitis occurring. The serum levels of trypsin and CGRP in patients with acute pancreatitis is able to determine whether inflammation effusion happens.

Venopunction of the cubital vein as an alternative approach for CGRP plasma level evaluation in tmd patients

Calcitonin gene-related peptide is an important vasodilator. It plays an important role in the metabolism of chewing muscles. The aim of the study was to evaluate the plasma level of CGRP in patients with myofascial pain (RDC/TMD Ia) and myofascial pain with limited opening (RDC/TMD Ib) before and after occlusal splint therapy (Michigan splint). A randomised trial was performed including 39 patients (males = 3, females = 36). Blood samples were taken from the external jugular vein (JUG) and cubital vein (CUB) before and after 30 days of occlusal splint therapy. Plasma levels of CGRP were measured with ELISA KIT for Human Calcitonin Gene Related Peptide (CGRP) 96T (USCNK Business Co. Ltd.). The results of the study show that the plasma CGRP level was higher in the external jugular vein (JUG1 = 5.07pg/mL [SD = 1.99]) than in cubital vein (CUB1 = 4.3 pg/mL [SD = 1.6]). After 30 days of the occlusal splint therapy the levels in both veins increased: JUG2 = 6.07 pg/mL (SD = 2.19), and CUB2 = 4.9 pg/mL (SD = 1.4). The CGRP plasma level increase was statistically significant only in the external jugular vein (JUG) (p < 0.05). Statistically significant pain intensity reduction was observed: VAS1 = 5.4 (SD = 2.08) decreased to VAS2 = 1.7 (SD = 2.07) after splint therapy (p < 0.05). Venepuncture of an external jugular vein is more precise, than venepuncture of a cubital vein in evaluating CGRP plasma level changes in patients with TMD.

Calcitonin Gene-Related Peptide as a Biomarker in Migraine

Background: Migraine is a prevalent disease with much economic burden and relatively inadequate available treatment. Calcitonin gene-related peptide (CGRP) is the most abundant neuropeptide in the trigeminal nerve and it may be involved in the pathogenesis of migraine. The aim of the study was to determine the plasma level of CGRP in patients with primary headache, and if it could be a potential biomarker for migraine. Methods: The study involved four groups with 20 patients in each one: chronic migraine, episodic migraine, cluster headache and tension type headache subjects, as well as healthy volunteers of matched age and sex as controls. Their venous blood was drawn, plasma was separated, and CGRP was analyzed with commercially available ELISA kit. Results: Plasma CGRP levels were significantly increased in chronic migraine (165.0 ± 17.9 ng/L, range 131.8 - 194.6) as compared with control group (70.5 ± 8.36 ng/L, range 51.7 - 83.65), patients with episodic migraine (94.1 ± 17.83 ng/L, range 69.6 - 121.9), and patients with cluster headache and tension type headache (87.2 ± 13.8 ng/L, range 62.8 - 110.8). Plasma CGRP levels in chronic migraine were significantly higher in patients with aura (191.32 ± 5.09, range 185.45 - 194.60) than without aura (160.30 ± 14.93, range 131.80 - 186.0), and in episodic migraine were significantly higher in patients with aura (109.88 ± 7.54, range 100.70 - 116.30) than without aura (90.16 ± 17.56, range 69.60 - 121.90). Conclusion: The plasma CGRP levels were elevated in patients with chronic migraine and may be considered a potential biomarker for it. This opens the door for a therapeutic role of it for migraine. J Neurol Res. 2017;7(6):103-107 doi: https://doi.org/10.14740/jnr460w

Effect of Chinese herbal fumigation combined with tuina on vertigo and concentrations of endothelin and calcitonin gene-related peptide in patients with vertebral artery cervical spondylosis

Objective To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS).

Ultrasonic diagnosis and vasoactive substances examination in patients with cirrhosis

ObjectiveTo investigate hemodynamic change of patients with cirrhosis by using Color Doppler ultrasound technique and to explore the significance of change in the content of vasoactive substances-plasma endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP). MethodsA total of 178 cases with cirrhosis were regarded as study groups, and were divided into three degrees: A, B and C according to child-pugh and meanwhile 60 cases were regarded as normal control group. Portal vein and splenic vein of patients were explored by adopting Color Doppler ultrasound technique, related indexes were recorded and the blood flow as well as their ration in the two groups was calculated. Radio immunoassay was adopted to detect the content of plasma ET-1 and CGRP in both study group and contrast group. ResultsCompared with the healthy cases in the contrast group, there was abnormal hemodynamics in the system of portal vein of patients with cirrhosis and the content of plasma ET-1 and CGRP was increased obviously. In the Child-Pugh liver function grades, the content of ET-1 and CGRP was increased as the degree of cirrhosis became more and more serious. There was no significant difference in the comparison between those without ascites and those in contrast group (P>0.05), the content of plasma ET-1 and CGRP in patients without ascites was increased remarkably. Besides, there was positive correlation between the content of plasma ET-1 and CGRP and Dpv, Dsv and Qsv. ConclusionDetection of abnormal hemodynamics of portal vein and splenic vein by Color Doppler ultrasound technique can be one of the means for diagnosis of hypertension. Plasma ET-1 and CGRP of patients with cirrhosis reflect the serious degree of the damage in live function and play an important role in the formation and development of portal hypertension.

Calcitonin-gene related peptide and cerebral vasospasm

The pathophysiology of arterial vasospasm following subarachnoid hemorrhage (SAH) is poorly understood and the contribution of endogenous neuropeptides has not been sufficiently elucidated. Recently, we detected an excessive release of vasoconstrictive neuropeptide Y (NPY) in SAH patients and identified a significant correlation of NPY cerebrospinal fluid (CSF) levels with vasospasm-related ischemia. Here, we present the results of an experimental study on the possible role of the potent endogenous vasodilator calcitonin-gene related peptide (CGRP) in the acute stage of SAH. Twelve consecutive patients with SAH were included. Seven patients had severe arterial vasospasm, confirmed by transcranial doppler-sonography (TCD). Prospectively, CSF was collected from day 1 to day 10 after onset of the SAH. The levels of CGRP were determined in a competitive enzyme immunoassay and were correlated with the clinical course and hemodynamic changes. A cohort of 29 patients without CNS disease served as a control. CGRP was significantly higher in SAH patients compared with the control group (p<0.05). From day 1 to day 4, the CGRP levels in patients without vasospasm were significantly higher than the levels of CGRP in patients with vasospasm (p<0.05). These patients did not develop cerebral ischemia. The significantly increased levels of the CGRP during the first days after onset of the SAH in the non-vasospasm group indicate a potential protective role of CGRP. CGRP may alleviate arterial vasoconstriction and thus protect the brain from vasospasm and subsequent ischemia.

Plasma level of calcitonin gene-related peptide in patients with polycystic ovary syndrome and its relationship to hormonal and metabolic parameters

The aim of the study was to evaluate the plasma level of calcitonin gene-related peptide (CGRP) in patients with polycystic ovary syndrome (PCOS) and its relationship to hormonal and metabolic parameters. We also observed the effect of CGRP on testosterone (T) and estradiol (E2) release in cultured human granulosa cells. PCOS subjects (n=215) and matched healthy control women (n=103) at age of 22–38 years were enrolled in this study. We analyzed plasma CGRP concentrations, relationship of plasma CGRP with insulin resistance (IR), body mass index (BMI), luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio and T. The T and E2 release levels of cultured human granulosa cells treated by CGRP were also measured. The results showed that plasma CGRP concentrations were significantly higher in women with PCOS than those of control subjects. In women with PCOS, there was a strong positive correlation between the plasma CGRP level with HOMA-IR, AUC-insulin, AUC-glucose, the ratio of LH/FSH and plasma T concentration. Human granulosa cells expressed CGRP receptor. Exogenous CGRP caused an elevation of T and E2 released from the human granulosa cells. These findings suggest that CGRP may participate in the pathophysiological process of PCOS.

Exercise-induced increase in plasma concentrations of calcitonin gene-related peptide in patients with coronary heart disease and healthy controls

Calcitonin gene-related peptide is a potent regulator of vascular tone. In the present study the authors investigated plasma levels of calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) during maximum bicycle exercise in 8 patients with coronary heart disease (CHD) and in a control group of 11 healthy volunteers. There was no significant difference in CGRP-LI baseline concentrations between patients with CHD and controls. During exercise a significant increase in CGRP-LI was observed in both groups, as compared with baseline values. Although maximum CGRP-LI values did not differ significantly between the two groups, the increase in CGRP-LI was found at a much-lower work load (p=0.0006) in patients with CHD.

Plasma Changes of Calcitonin Gene-Related Peptide and Substance P in Patients with Dialysis Headache

Little is known of mechanism of dialysis headache (DH). As suggested for migraine, a role for neuropeptides has been investigated. Twenty-four patients under haemodialysis were studied. Twelve of them suffered from DH. The remaining patients were headache free. Blood samples for radioimmunoassay of calcitonin gene-related peptide (CGRP) and substance P (SP) were collected from the arteriovenous fistula before and after dialysis treatment. Basal plasma concentrations of CGRP were found to be higher in headache patients. Dialysis significantly decreased CGRP concentrations in both groups. No difference in basal plasma concentrations of SP was observed between groups. At the end of the treatment plasma SP concentrations were reduced in headache-free patients but increased in headache patients. Elevated plasma concentrations of CGRP in patients with DH could represent a biochemical factor contributing to susceptibility to headache. Because of the disputable role of SP in migraine, the significance of the increase of the peptide in plasma during DH remains to be elucidated.

Clinical study on influence of Buyang Huanwu Decoction on the metabolic imbalance of endothelin and calcitonin gene related peptide in patients with early cerebral infarctionon the metabolic imbalance of endothelin and calcitonin gene related peptide in patients with early cerebral infarction

Objective: To explore the mechanism of Buyang Huanwu Decoction (BHD) in treating early cerebral infarction.Methods: Seventy cases with early cerebral infarction were randomly divided into two groups. Chinese medicine group (CMG, n = 35) was treated with BHD; western medicine group (WMG, n = 35) was treated with hydroxyethyl starch injection and enteric coated aspirin tablets. The levels of endothelin (ET) and calcitonin gene related peptide (CGRP) in plasma before and after treatment and the results of clinical treatment were observed. Also healthy subjects were used as the normal control.Results: The levels of ET before treatment in the two treated groups were significantly higher than that of the healthy subjects (P<0. 001), and the levels of CGRP were significantly lower (P < 0.001). After treatment the metabolic imbalance of ET and CGRP improved significantly in the two treated groups (P<0. 001), but the ET and CGRP in CMG improved more obviously than those in WMG (P<0.01, P<0.05). The markedly effective and curative rate of CMG was higher than that of WMG (68. 6 % vs 31.4 %; ϰ2 = 9. 65, P < 0. 01).Conclusion: BHD could improve the metabolic imbalance of ET and CGRP in patients with early cerebral infarction and on the virtue of this mechanism it could be used to treat cerebral infarction.