Abstract

In literature, it has been reported that adrenomedullin, which is generally thought to have vasodilator, natriuretic and diuretic effects, is synthesized in almost all body, especially CNS, vascular muscles and endothelium, heart, liver, lung, kidney, gastric mocosa, intestinal endothelium and various blood cells. It has been found that the possible effects of adrenomedullin can be demonstrated directly or indirectly by means of active mediators, neuropeptides, enzymes and hormones. It is also suggested that it regulates the endocrine system by affecting the hypothalamic-pituitary axis. It increases in heart failure, acute coronary syndromes, hypertensive conditions, cerebrovascular accessory, chronic renal failure and periodontitis and decreases in peptic ulcer and intestinal diseases. However, it is still not clear whether increase/decrease in adrenomedullin level is a cause of a disease or is a result of damage due to an illness. This peptide, which could be thought to multifunctional, should be considered as a molecule with genetic coding that may have different effects on different tissues and conditions. For all these reasons, we aimed to review the multifonctional behavior of adrenomedullin in the light of the current literature to pioneer new hypotheses and discuss possible mechanisms.

Highlights

  • Adrenomedullin was first described by Japanese scientists in 1993

  • Following researches have revealed that this peptide was found in adrenal medulla but it was detected in heart, vessels, kidneys, lungs, gastrointestinal tract, central nervous system (CNS) and endocrine tissues [2]

  • Altough initially thought a hypotensive and natriuretic peptide related to vascular structures, laterly it was found that adrenomedullin has various effetcs like growth, and differentiation on different tissues like renal, edndocrine, CNS and peripheral tissues [1,2,3,4,5]

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Summary

Introduction

Adrenomedullin was first described by Japanese scientists in 1993. These researchers discovered a new peptide while searching for the effects of peptides on cAMP levels in rat thrombocytes. Altough initially thought a hypotensive and natriuretic peptide related to vascular structures, laterly it was found that adrenomedullin has various effetcs like growth, and differentiation on different tissues like renal, edndocrine, CNS and peripheral tissues [1,2,3,4,5]. It exerts these effects either directly or indirectly via some active mediators, neuropeptides, enzymes and hormones [4, 6,7,8]. There is a need for new hypotheses to discuss possible mechanisms that may explain these effects

Structure and Synthesis
Production and Metabolism
ADM Receptors and Signal Pathways
ADM Measurement
Cardiovascular Effects
Renal Effects
Pulmonary Effects
Effects of Central Nervous System
Reproductive Effects
Effects on Immune System and Inflammation
Conclusion
Circulating Adrenomedullin Is Elevated in Gestational
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