CROMOGRANIN A AND ITS CLINICAL USE

  • Rudi Pavlin Inštitut za patološko fiziologijo Medicinska fakulteta Zaloška 4 1105 Ljubljana
Keywords: chromogranin A, diagnostic values, neuroendocrine tumors, gastric enterochromaffine cells

Abstract

Background. An old widely recepted opinion was that the medullary part of the suprarenal gland was primarily responsible for a adequate response to stress. Recently a broader significance of the gland has been recognised. The chromogranin A which is produced and secreted by its enterochromaffine cells is extensively involved in several physiological and pathological processes in the body. Determination of the serum concentration of chromogranin A is nowadays extremely useful for diagnosis of the neuroendocrine tumors of the gastrointestinal tract.

Conclusions. In the present article its localisation in the body and its biochemistry are described, as well as normal serum concentration values and their changes in various pathological states.

Downloads

Download data is not yet available.

References

Blaschko H, Comline RS, Schneider PH, Silver M, Smith AD. Secretion of a chromaffin granule protein, chromogranin, from the adrenal gland after splanchnic stimulation. Nature 1967; 215: 58–9.

Schneider FH, Smith AD, Winkler H. Secretion from the adrenal medulla: biochemical evidence for exocytosis. Br J Pharmac Chemother 1967; 31: 94–104.

Winkler H, Fischer-Colbrie R. The chromogranins A and B the first 25 years and future perspectives. Neuroscience 1992; 49: 497–528.

Rosa P, Zanini A. Purification of a sulfated secretory protein from the adenohypophysis. Immunochemical evidence that similar macromolecules are present in other glands. Eur J Cell Biol 1983; 31: 94–8.

Laslop A, Mahata SK. Neuropeptides and chromogranins. Ann NY Acad Sci 2002; 971: 294–9.

Ferrari L, Seregni E, Bajetta E, Martinetti A, Bombardieri E. The biological characteristics of chromogranin A and its role as a circulating marker in neuroendocrine tumours. Anticancer Res 1999; 19: 3415–28.

Hendy GN, Bevan S, Mattei MG, Mouland AJ. Chromogranin A. Clin Invest Med 1995; 18: 47–65.

Buffa R, Mare P, Gini A, Salvadore M. Chromogranins A and B and secretogranin II in hormonally identified endocrine cells of the gut and the pancreas. Basic Appl Histochem 1988; 32: 471–84.

Trifaro JM. Molecular biology of the chromatin cell. Ann NY Acad Sci 2002; 971: 11–8.

Bulenda D, Gratzl M. Matrix freee Ca2+ in isolated chromaffin vesicles. Biochemistry 1985; 24: 7760–5.

Benedum UM, Bauerle PA, Konecki DS, Frank E, Powell J, Mallet J. The primary structure of bovine chromogranin A: a representative of a class of acidic secretory proteins common to a variety of peptidergic cells. EMBO J 1986; 5: 1495–502.

Eriksson B, Öberg K, Strindsberg M. Tumor markers in neuroendocrine tumours. Digestion 2000; 62: Suppl 1: 33–8.

Maget-Dana R, Metz-Boutique MH, Helle KB. The N-terminal domain of chromogranin A (CgAl-40) interacts with monolayers of membrane lipids of fungal and mammalian compositions. Ann NY Acad Sci 2002; 971: 362–5.

Parmer RJ, Zinder O. Catecholaminergic pathways, chromaffin cells, and human disease. Ann NY Acad Sci 2002; 971: 497–505.

Galindo E, Mendez M, Calvo S et al. Chromostatin receptors control calcium channel activity in adrenal chromaffin cells. J Biol Chem 1992; 267; 407–12.

Galindo E, Rill A, Bader MF, Aunis D. Chromostatin, a 20-amino acid peptide derived from chromogranin A, inhibits chromaffin cell secretion. Proc Natn Acad Sci U. S. A. 1991; 88: 1426–30.

Cavadas C, Ribeiro AF, Cotrim MD, Mosimann F, Brunner HR, Grouzmann E. Catecholamine and neuropeptide Y secretion from human adrenal chromaffin cells. Ann NY Acad Sci 2002; 971: 332–4.

Takiyyuddin MA, Cervenka JH, Hsiao RJ, Barbosa JA, Parmer RJ, O’Connor DT. Chromogranin A. Hypertension 1990; 15: 237–46.

Granberg D, Stridsberg M, Seensalu R et al. Plasma chromogranin A in patients with multiple endocrine neoplasia type 1. J Clin Endocrin Metabol 1999; 84: 2712–7.

Takiyyuddin MA, Neumann HP, Cervenka JH et al. Ultradian variations of chromogranin A in humans. Amer J Physiol 1991; 261: R939–44.

Takiyyuddin MA, Brown MR, Dinh TQ, Cervenka JH, Braun SD, Parmer RJ. Sympatho-adrenal secretion in humans: factors governing catecholamine and storage vesicle peptide co-release. J Auton Pharmacol 1994; 14: 177–90.

Koeslag JH, Saunders PT, Wessels JA. The chromogranins and the counterregulatory hormones: do they make homeostatic sense? J Physiol 1999; 517 (3): 643–9.

O’Connor DT, Frigon RP. Chromogranin A, the major catecholamine storage vesicle soluble protein. J Biol Chem 1984; 259: 3237–47.

Gorr SU, Hamilton JW, Cohn DV. Sulfated secreted forms of bovine and porcine parathyroid chromogranin A (secretory protein-I). J Biol Chem 1991; 266: 5780–4.

Gorr SU, Kumarasamy R, Dean WL, Cohn DV. New suggestions for the physiological role of secretory protein-I. None Min 1987; 2: 251–5.

Sietzen M, Schober M, Fischer-Colbrie R, Schermann D, Sperk G, Winkler H. Rat adrenal medulla: levels of chromogranins, enkephalins, dopamine beta-hydroxylase and of the amine transporter are changed by nervous activity and hypophysectomy. Neuroscience 1987; 22: 131–9.

Rausch DM, Iacangelo A, Eiden LE. Glucocorticoid- and nerve growth factorinduced changes in chromogranin A expression define two different neuronal phenotypes in PC12 cells. Molec Endocr 1988; 2: 921–7.

Anouar Y, Benie T, Demonti M, Counis R, Duval J. Estradiol negatively regulates secretogranin II and chromogranin A messenger ribonucleic acid levels in the female rat pituitary but not in the adrenal. Endocrinology 1991; 129: 2393–9.

Fischer-Colbrie R, Schmid KW, Mahata SK, Mahata M, Laslop A, Bauer JW. Sex-related differences in chromogranin A, chromogranin B and secretogranin II gene expression in rat pituitary. J Neuroendocr 1992; 4: 125–30.

Takiyyuddin MA, Cervenka JH, Pandian MR, Stuenkel CA, Neumann HP, O’Connor DT. Neuroendocrine sources of chromogranin-A in normal man: clues from selective stimulation of endocrine glands. J Clin Endocrin Metabol 1990; 71: 360–9.

Banks P, Helle K. The release of protein from the stimulated adrenal medulla. Biochem J 1965; 97: 40c–1c.

Winkler H. Occurrence and mechanism of exocytosis in the adrenal medulla and sympathetic nerve. In: Trendelenburg U, Weiner N eds. Handbook of experimental pharmacology 90/1. New York: Springer, 1988: 43–118.

O’Connor DT, Deftos LJ. Secretion of chromogranin A by peptide producing endocrine neoplasms. New Engl J Med 1986; 314: 1145–51.

O’Connor DT, Pandian MR, Carlton E, Cervenka JH, Hsiao RJ. Rapid radioimmunoassay of circulating chromogranin A: in vitro stability, exploration of the neuroendocrine character of neoplasia, and assessment of the effects of organ failure. Clin Chem 1989; 35: 1631–7.

Takiyyuddin MA, Baron AD, Cervenka JH et al. Suppression of chromogranin-A release from neuroendocrine sources in man: pharmacological studies. J Clin Endocrinol Metab 1991; 72: 616–22.

O’Connor DT, Bernstein KN. Radioimmunoassay of chromatogranin A in plasma as a measure of exocytotic sympathoadrenal activity in normal subjects and patients with pheochromocytoma. New Engl J Med 1984; 311: 764–70.

Schults CW, O’Connor DT, Baird A et al. Clinical improvement in parkinsonian patients undergoing adrenal to caudate transplantation is not reflected by chromogranin A or basic fibroblast growth factor in ventricular fluid. Expl Neurol 1991; 111: 276–81.

O’Connor DT, Cervenka JH, Stone RA, Parmer RJ, Franco-Bourland RE, Madrazo I. Chromogranin A immunoreactivity in human cerebrospinal fluid: properties, relationship to noradrenergic neuronal activity, and variation in neurologic disease. Neuroscience 1993; 56: 999–1007.

Hsiao RJ, Mezger MS, O’Connor DT. Chromogranin A in uremia: progressive retention of immunoreactive fragments. Kidney Int 1990; 37: 955–64.

Udenfriend S, Cooper JR, Clark CT, Baer JE. Rate of turnover of epinephrine in the adrenal medulla. Science 1953; 117: 663–5.

Watkinson A, Robinson I. Reserpine-induced processing of chromogranin A in cultured bovine adrenal chromaffin cells. J Neurochem 1992; 58: 877–83.

Small DH, Ismael Z, Chubb IW. Acetylcholinesterase hydrolyses chromogranin A to yield low molecular weight peptides. Neuroscience 1986; 19: 289–95.

Small DH. Non-cholinergic actions of acetylcholinesterases: proteases regulating cell growth and development? Trends Biochem Sci 1990; 15: 213–6.

Palatini P. Heart rate as a risk factor for atherosclerosis and cardiovascular mortality. Drugs 1999; 57: 713–24.

Kim T, Tao-Cheng J, Eiden LE, Loh YP. Chromogranin A, an »on/off« switch controlling dense-core secretory granule biogenesis. Cell 2001; 106: 499–509.

Videen JS, Mezger MS, Chag YM, O’Connor DT. Calcium and catecholamine interaction with adrenal chromogranins. J Biol Chem 1992; 267: 3066–73.

Westermann R, Stögbauer F, Unsicker K, Lietzke R. Calcium-dependence of chromogranin A-catecholamine interaction. Fedn Eur Biochem Socs Lett 1988; 239: 203–6.

Nobels FR, Kwekkeboom DJ, Bouillon R, Lamberts SW. Chromogranin A: its clinical value as marker of neuroendocrine tumours. Europ J Clin Invest 1998; 28: 431–40.

Bajetta E, Ferrari L, Martinetti A et al. Chromogranin A, neuron specific enolase, carcinoembrionic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors. Cancer 1999; 86: 858–65.

Schurmann G, Raeth U, Wiedenmann B, Buhr H, Herfarth C. Serum chromogranin A in the diagnosis and follow-up of neuroendocrine tumors of the gastroenteropancreatic tract. 1992; 16: 697–701.

Granberg D, Stridsberg M, Seensalu R et al. Plasma chromogranin A in patients with multiple endocrine neoplasia type 1. J Clin Endocr Met 1999; 84: 2712–7.

Colombo B, Curnis F, Foglieni C, Monno A, Arrigoni G, Corti A. Chromogranin A expression in neoplastic cells affects tumor growth and morphogenesis in mouse models. Cancer Res 2002; 62: 941–6.

Kimura N, Miura W, Noshiro T et al. Plasma chromogranin A in pheochromocytoma, primary hyperparathyroidism and pituitary adenoma in comparison with catecholamine, paratyroid hormone and pituitary hormones. Endocr J 1997; 44: 319–27.

Boomsma F, Bhaggoe UM, Man in’t Veld AJ, Schalekamp MADH. Sensitivity and specificity of a new ELISA method for determination of chromogranin A in the diagnosis of pheochromocytoma and neuroblastoma. Clin Chim Acta 1995; 239: 57–63.

Stridsberg M, Husebye ES. Chromogranin A and chromogranin B are sensitive circulating markers for pheochromocytoma. Eur J Endocrinol 1997; 136: 67–73.

Canale MP, Bravo EL. Diagnostic specificity of serum chromogranin-A for pheochromocytoma in patients with renal dysfunction. J Clin Endocr Met 1994; 78: 1139–44.

Aardal S, Aardal NP, Larsen TH et al. Human pheochromocytoma: different patterns of catecholamines and chromogranins in the intact tumour, urine and serum in clinically unsuspected cases. Scand J Clin Lab Invest 1996; 56: 511–23.

Rao F, Keiser HR, O’Connor DT. Malignant and benign pheochromocytoma. Ann NY Acad Sci 2002; 971: 530–2.

Hsiao RJ, Neumann HP, Parmer RJ, Barbosa JA, O’Connor DT. Chromogranin A in familial pheochromocytoma: diagnostic screening value, prediction of tumor mass, and post-resection kinetics indicating two-compartment distribution. Am J Med 1990; 80: 607–13.

Seregni E, Ferrari L, Bajetta E, Martinetti A, Bombardieri E. Clinical significance of blood chromogranin A measurement in neuroendocrine tumours. Ann Oncol 2001; 12: Suppl 2: S69–S72.

Tiensuu Janson EM, Öberg KE. Carcinoid tumours. Bailleres Clin Gastroenterol 1996; 10: 589–601.

Eriksson B, Arnberg H, Lindgren PG et al. Neuroendocrine pancreatic tumours: clinical presentation, biochemical and histopathological findings in 84 patients. J Intern Med 1990; 228: 103–13.

Janson ET, Holmberg L, Stridsberg M et al. Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann Oncol 1997; 8: 685–90.

Pirker RA, Pont J, Pöhnl R, Schütz W, Griesmacher A, Müller MM. Usefulness of chromogranin A as a marker for detection of relapses of carcinoid tumours. Clin Chem Lab Met 1998; 36: 837–40.

Öberg K. Neuroendocrine gastrointestinal tumors – a condensed overview of diagnosis and treatment. Ann Oncol 1999; 10: Suppl 2: S3–8.

Boehme MW, Schmidt-Gayk H, Bihl H, Eisenhut M, Herfahrt CH, Kommerere B, Raeth U. Efficient symptomatic control of carcinoid tumors with somatostatin in patients with disease progression under alpha-interferon therapy. Hepato-Gastroent 1995; 42: 1053–61.

Eriksson B, Janson ET, Bax ND et al. The use of new somatostatin analogues, lanreotide and octastatin, in neuroendocrine gastrointestinal tumours. Digestion 1996; 57: Suppl 1: 77–80.

Granberg D, Wilander E, Stridsberg M, Granerus G, Skogseid B, Öberg K. Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids. Gut 1998; 43: 223–8.

Iwao M, Nakamuta M, Enjoji M et al. Primary hepatic carcinoid tumor: case report and review of 53 cases. Med Sci Mon 2001; 7: 746–50.

Zanner R, Gratzl M, Prinz C. Circle of life of secretory vesicles in gastric enterochromaffin-like cells. Ann NY Acad Sci 2002; 971: 389–96.

Sanduleanu S, De Brine A, Stridsberg M et al. Serum chromogranin A as a screening test for gastric enterochromaffine-like cell hyperplasia during acid-suppressive therapy. Europ J Clin Invest 2001; 31: 802–11.

Nobels FR, Kwekkeboom DJ, Coopmans W et al. Chromogranin A as a serum marker for neuroendocrine neoplasia: comparison with neuronspecific enolase and the alpha-subunit of glycoprotein hormones. J Clin Endocr Met 1997; 82: 2622–8.

Borch K, Stridsberg M, Burman P, Rehfeld JF. Basal chromogranin A and gastrin concentrations in circulation correlate to endocrine cell proliferation in type-A gastritis. Scand J Gastroenterol 1997; 32: 198–202.

Sagar M, Bertilsson L, Stridsberg M, Kjellin A, Mardh S, Seensalu R. Omeprazole and CYP2C19 polymorphism: effects of long-term treatment on gastrin, pepsinogen I and chromogranin A in patients with acid related disorders. Aliment Pharm Ther 2000; 14: 1495–502.

Kleveland O, Syversen U, Slordahl K, Waldum HL. Hypergastrinemia as a cause of chromogranin A increase in blood in patients suspected to have neuroendocrine tumor. Digestion 2001; 64: 71–4.

Waldum HL, Brenna E. Personal view: is profound acid inhibition safe? Aliment Pharm Ther 2000; 14: 15–22.

Kadmon D, Thompson TC, Lynch GR, Scardino PT. Elevated plasma chromogranin-A concentrations in prostatic carcinoma. J Urology 1991; 146: 358–61.

Angelsen A, Syversen U, Haugen OA, Stridsberg M, Mjolnerod OK, Waldum HL. Neuroendocrine differentiation in carcinomas of the prostate: do neuroendocrine serum markers reflect immunohistochemical findings? Prostate 1997; 30: 1–6.

Deftos LJ, Abrahamsson PA. Granins and prostate cancer. Urology 1998; 51: Suppl 5A: 141–5.

Kimura N, Hoshi S, Takahashi M, Takeha S, Shizawa S, Nagura H. Plasma chromogranin A in prostatic carcinoma and neuroendocrine tumors. J Urol 1997; 157: 565–8.

Wu JT, Erickson AJ, Tsao KC, Wu TL, Sun CF. Elevated serum chromogranin A is detectable in patients with carcinoma in advanced disease stages. Ann Clin Lab Sci 2000; 30: 175–8.

Berutti A, Dogliotti L, Mosca A et al. Circulating neuroendocrine markers in patients with prostate carcinoma. Cancer 2000; 88: 2590–7.

Berutti A, Dogliotti L, Mosca A et al. Potential value of circulating chromogranin A in patients with prostate carcinoma. Ann Oncol 2001; 12: Suppl 2: S153–7.

Wu JT, Wu TL, Chang CP, Tsao KC, Sun CF. Different patterns of serum chromatogranin A in patients with prostate cancer with and without undergoing hormonal therapy. J Clin Lab Anal 1999; 13: 308–11.

Berutti A, Dogliotti L, Mosca A et al. Effects of the somatostatin analog lanreotide on the circulating levels of chromogranin-A, prostate-specific antigen, and insulin-like growth factor-1 in advanced prostate cancer patients. Prostate 2001; 47: 205–11.

O’Connor DT. Plasma chromogranin A. Initial studies in human hypertension. Hypertension 1985; 7: 176–9.

Dimsdale J, O’Connor DT, Ziegler M, Mills P. Chromogranin A correlates with norepinephrine release rate. Life Sci 1992; 51: 519–25.

Tramonti G, Ferdeghini M, Annichiarico C et al. Relationship between renal function and blood level of chromogranin A. Renal Fail 2001; 23: 449–57.

Nobels FRE, Kwekkeboom DJ, Coopmans W et al. A comparison between the diagnostic value of gonadotropins, alpha-subunit, and chromogranin-A and their response to thyrotropin-releasing hormone in clinically nonfunctioning, alpha-subunit-secreting, and gonadotroph pituitary adenomas. J Clin Endocrin Met 1993; 77: 784–9.

Kingham PJ, Cuzner ML, Pocock JM. Apoptotic pathways mobilized in microglia and neurones as a consequence of chromogranin A – induced microglial activation. J Neurochem 1993; 73: 538–47.

Yasuhara O, Kawamata T, Aimi Y, McGeer EG, McGeer PL. Expression of chromogranin A in lesions in the central nervous system from patients with neurological diseases. Neurosci Lett 1994; 170: 13–6.

Tomassetti P, Migliori M, Simoni P et al. Diagnostic value of plasma chromogranin A in neuroendocrine tumours. Eur J Gastroent Hepat 2001; 13: 55–8.

Takiyyuddin MA, Parmer RJ, Kailasam MT et al. Chromogranin A in human hypertension. Influence of heredity. Hypertension 1995; 26: 213–20.

How to Cite
1.
Pavlin R. CROMOGRANIN A AND ITS CLINICAL USE. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];72(9). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1868
Section
Review