Adrenomedullin: a new hypotensive peptide.

PROPERTIES OF ADRENOMEDULLIN: We have identified a novel hypotensive peptide, adrenomedullin, in human pheochromocytoma extract. It has potent and long-lasting vasodilatory effects in several vascular systems. In addition to adrenomedullin, another hypotensive peptide, proadrenomedullin-derived peptide (PAMP), was also found to be processed from the adrenomedullin precursor. PAMP inhibits neural transmission at peripheral sympathetic nerve endings, although adrenomedullin directly dilates vascular smooth muscle. POSSIBLE INVOLVEMENT IN PATHOGENESIS: Although initially isolated from human pheochromocytoma tissue, adrenomedullin messenger RNA is highly expressed in several peripheral organs, including cardiovascular tissues. Adrenomedullin and PAMP are both synthesized and secreted from vascular smooth muscle and endothelial cells, and they participate in circulation control through different mechanisms. Taken together with the presence of adrenomedullin-specific receptors on vascular smooth muscle cells and the significant increase in plasma immunoreactive adrenomedullin levels in patients with hypertension, renal failure and congestive heart failure, adrenomedullin may be involved in the pathogenesis of these diseases.