Neuroinflammation and RAMP1: the Role of the Peripheral and Central Nervous System in Tumor Progression.
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Cavalcante Pedro Daniel Moumesso, da Silva Jonas Lucas Dias, Oliveira Laryssa Rosy Santos, da Silva Rikelly Barbosa, Costa Lima Juliana Acioli, Souza Guilherme de Brito, Silva Santos Davi Ramon da, de Abrantes Júllia Victória Nascimento, de Farias Mateus Lima, Oliveira Sofia Amancio de Almeida, da Silva João Paulo Emiliano, Calaça Farias Rafael de Oliveira, de Almeida Leonardo Prudêncio Coutinho, de Melo Salomão Belfort Sparapan, de Araújo Sandra Taveiros, de França-Júnior Raimundo Rodrigues, Xavier José Emerson, Carvalho Fraga Carlos Alberto de
Аннотация
Calcitonin gene-related peptide (CGRP) and receptor activity modifier protein 1 (RAMP1) form a critical neuroimmunoendocrine axis in the modulation of neuroinflammation, pain, and tumor progression. CGRP, released by sensory and sympathetic fibers, is a potent vasodilator and nociceptive modulator; its action depends on the receptor composed of CALCRL and RAMP1. In the central nervous system, the activation of microglia and astrocytes and the induction of pathways such as NF-κB and MAPK culminate in the production of proinflammatory cytokines (TNF-α, IL-6), differing from systemic inflammation due to the presence of the blood-brain barrier and the glial microenvironment. Preclinical evidence demonstrates RAMP1 expression in neurons, glial cells, endothelium, and macrophages; CGRP/RAMP1 signaling promotes vascular permeability, cytokine release, and angiogenesis, potentially synergizing with VEGF. In animal models and cell cultures, genetic or pharmacological manipulations of the axis reduce tumor angiogenesis, pro-tumor immune infiltration, tumor growth, and nociceptive behavior. Given the clinical availability of CGRP antagonists and monoclonal antibodies, blocking the CGRP/RAMP1 axis is a promising translational strategy for modulating tumor progression and cancer pain. This review summarizes preclinical evidence on mechanisms and therapeutic feasibility. The article includes preclinical and clinical safety and biomarker studies.