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CGRP in migraine
The Journal of Headache and Pain volume 10, page 385 (2009)
Dear Editor,
Concentrations of substances in plasma, in this case CGRP, can be presented in several different to ways, such as pmol/l [1–7], pg/ml [8, 9] and just recently as ng/ml [10]. These different concentrations can be compared when one uses the molecular weight of 3,790 for CGRP but it takes 5–10 min of arithmetic to do that. When you normally read a paper you do not stop and do the arithmetic needed in order to check the concentrations.
In a recent paper in Journal of Headache and Pain, the plasma concentration of CGRP in cubital blood is given as 1.03 ng/ml in migraine [10]. This looks apparently reliable, but when the concentration in pmol/l, the standard way of presenting CGRP concentrations [1–7], is calculated the resulting concentration is 272 pmol/l. This was in migraine patients in the cubital vein outside attacks [10] and the CGRP levels are higher than any CGRP levels reported before both in external jugular blood [1–5], and cubital blood [6–9]. The authors state that the analyses were done with a commercially available ELISA kit and that the kit had a good sensitivity (range 0–25 ng/ml), but the detection limit for CGRP is not stated.
The best way to avoid such problems is to present CGRP levels in pmol/l. One can then easily skim the literature and compare results in different studies.
References
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A reply to this letter can be found at doi:10.1007/s10194-009-0141-3.
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Tfelt-Hansen, P., Ashina, M. CGRP in migraine. J Headache Pain 10, 385 (2009). https://doi.org/10.1007/s10194-009-0139-x
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DOI: https://doi.org/10.1007/s10194-009-0139-x