Chromogranin A (CgA (CHGA)) is the major soluble protein co-stored and co-released
with catecholamines and can function as a pro-hormone by giving rise to several
bioactive peptides. This review summarizes the physiological functions, the
pathogenic implications, and the recent use of these molecules as biomarkers in
several pathological conditions. A thorough literature review of the electronic
healthcare databases MEDLINE, from January 1985 to September 2013, was conducted to
identify articles and studies concerned with CgA and its processing. The search
strategies utilized keywords such as chromogranin A, vasostatins 1 and 2,
chromofungin, chromacin, pancreastatin, catestatin, WE14, chromostatin, GE25,
parastatin, and serpinin and was supplemented by the screening of references from
included papers and review articles. A total of 209 English-language, peer-reviewed
original articles or reviews were examined. The analysis of the retrospective
literature suggested that CgA and its several bioactive fragments exert a broad
spectrum of regulatory activities by influencing the endocrine, the cardiovascular,
and the immune systems and by affecting the glucose or calcium homeostasis. As some
peptides exert similar effects, but others elicit opposite responses, the regulation
of the CgA processing is critical to maintain homeostasis, whereas an unbalanced
production of peptides that exert opposing effects can have a pathogenic role in
several diseases. These clinical implications entail that CgA and its derived
peptides are now used as diagnostic and prognostic markers or to monitor the response
to pharmacological intervention not only in endocrine tumors, but also in
cardiovascular, inflammatory, and neuropsychiatric diseases.