Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54, Shogoin-Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Curr Protein Pept Sci. 2013 Jun;14(4):256-67. doi: 10.2174/13892037113149990045.
Many neurohumoral factors play important roles in the regulation of the cardiovascular system and in the pathophysiology of cardiovascular disease. Adrenomedullin (AM) is a potent vasodilatory peptide originally discovered in the acid extract of human pheochromocytoma tissue but now known to exert a variety of effects within the cardiovascular system. AM expression is widely distributed throughout the cardiovascular system and has been identified in the heart, lungs, blood vessels and kidneys. In addition, the co-localization of AM and its receptor components suggest AM acts as an autocrine and/or paracrine factor to play a key role in the regulation of cardiovascular function. Evidence also strongly suggests that cardiovascular disease is associated with elevated levels of AM in plasma and tissue. In this review, we describe the pathophysiological changes in plasma and local AM associated with myocardial infarction, heart failure and pulmonary hypertension. We also describe the clinical application of AM in cardiovascular disease from the viewpoints of diagnosis and treatment.
许多神经体液因素在心血管系统的调节和心血管疾病的病理生理学中发挥着重要作用。肾上腺髓质素（adrenomedullin，AM）是一种有效的血管舒张肽，最初在人嗜铬细胞瘤组织的酸性提取物中发现，但现在已知在心血管系统中具有多种作用。AM 的表达广泛分布于心血管系统，并已在心脏、肺、血管和肾脏中得到鉴定。此外，AM 及其受体成分的共定位表明 AM 作为自分泌和/或旁分泌因子发挥作用，在调节心血管功能方面发挥关键作用。有证据还强烈表明，心血管疾病与血浆和组织中 AM 水平升高有关。在这篇综述中，我们描述了与心肌梗死、心力衰竭和肺动脉高压相关的血浆和局部 AM 的病理生理变化。我们还从诊断和治疗的角度描述了 AM 在心血管疾病中的临床应用。
