• Adrenomedullin

    Adrenomedullin

    Key regulator of vascular integrity
    The vasoactive hormone is highly elevated in patients with septic shock
    indicating the body's need to improve endothelial barrier function

Adrenomedullin

Key regulator of vascular integrity

Since its discovery in 1993, the vasoactive peptide hormone Adrenomedullin (ADM) has attracted a great deal of interest as a multifunctional regulator of the vascular system, i.a. regulating angiogenesis and cardiovascular homeostasis [3]. Adrenomedullin is mainly expressed and secreted by vascular endothelial cells and is best known for its vasodilatory activity [3]. In addition, Adrenomedullin has been extensively described as key determinant of vascular integrity [4,5,6].

Molecular Mechanism of Action

Adrenonomedullin exerts its molecular action mainly via the stimulation of cAMP formation. ADM binds the G protein–coupled receptor CRLR (calcitonin receptor-like receptor) that is expressed both on vascular smooth muscle and vascular endothelial cells. CRLR is associated with one of three different accessory single-pass transmembrane proteins called RAMP1-3 [7]. ADM only interacts with CRLR receptors that are accompanied by either RAMP2 or RAMP3 [7]. Binding of Adrenomedullin to CRLR/RAMP2 or CRLR/RAMP3 on endothelial cells triggers downstream signaling pathways that affect endothelial barrier function and blood vessel permeability [8].