Furlani Matteo, Visentini Daniela, Cussigh Anna Rosa, Pesente Fiorenza, Janes Francesco, Tascini Carlo, Curcio Francesco, Fabris Martina
Department of Medicine (DMED), University of Udine, Udine, Italy.
Institute of Clinical Pathology, Department of Laboratory Medicine, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy.
J Clin Lab Anal. 2025 Jul;39(13):e70058. doi: 10.1002/jcla.70058. Epub 2025 May 19.
Adrenomedullin (ADM) is a potent hormone-like peptide rapidly induced by hypoxia and inflammatory cytokines in the early stages of sepsis. For this reason, the dosage of its more stable precursor fragment called mid-regional (MR)-proADM is currently recommended to assist in triaging patients in the emergency department. Since MR-proADM dosage is currently only approved for use in plasma, we validated its dosage in cerebrospinal fluid (CSF) samples to improve the diagnosis of central nervous system (CNS) diseases.
MR-proADM concentrations were measured in samples using a fully automated platform (Brahms Kryptor Gold Analyzer, Thermo Scientific, Germany), applying the same analytical conditions in plasma and CSF samples, to finally set up an accurate laboratory protocol to validate its dosage in CSF.
MR-proADM is highly stable in CSF samples stored at room temperature for up to 48 h, allowing it to be measured with confidence also in CSF samples that may be left on the bench for several hours. In addition, the repeatability and within-laboratory precision of the MR-proADM assay using CSF samples appeared equal to or better than those obtained by the manufacturer using plasma samples, allowing the use of this assay, with high precision, also for CSF samples.
The reliable measure of MR-proADM in CSF and the role of this molecule in CNS will allow its introduction in the diagnostic process of infectious, inflammatory, and degenerative neurological diseases.
肾上腺髓质素（ADM）是一种强效的类激素肽，在脓毒症早期可被缺氧和炎性细胞因子迅速诱导产生。因此，目前推荐使用其更稳定的前体片段——中段（MR）-proADM的剂量，以协助急诊科对患者进行分诊。由于MR-proADM剂量目前仅被批准用于血浆，我们对其在脑脊液（CSF）样本中的剂量进行了验证，以改善中枢神经系统（CNS）疾病的诊断。
使用全自动平台（德国赛默飞世尔科技公司的Brahms Kryptor Gold分析仪）测量样本中的MR-proADM浓度，在血浆和CSF样本中应用相同的分析条件，最终建立一个准确的实验室方案来验证其在CSF中的剂量。
MR-proADM在室温下保存长达48小时的CSF样本中高度稳定，这使得在可能在实验台上放置数小时的CSF样本中也能可靠地进行测量。此外，使用CSF样本进行的MR-proADM检测的重复性和实验室内精密度似乎等于或优于制造商使用血浆样本所获得的结果，从而允许该检测也能高精度地用于CSF样本。
CSF中MR-proADM的可靠测量以及该分子在CNS中的作用将使其能够被引入感染性、炎性和退行性神经疾病的诊断过程。
