Adrenomedullin--physiological regulator of the cardiovascular system or biochemical curiosity?

Adrenomedullin is a potent vasodilator peptide that exerts major effects on cardiovascular function. Adrenomedullin is biosynthesized in a wide variety of organs and cells, although it was initially isolated from human pheochromocytoma tissue. In addition to adrenomedullin, proadrenomedullin N-terminal 20 peptide was found to be processed from adrenomedullin precursor. Both adrenomedullin and proadrenomedullin N-terminal 20 peptide show hypotensive effects in anesthetized rats, but exhibit different hypotensive mechanisms. Further, adrenomedullin possesses multiple biological effects involved in cardiovascular homeostasis. Plasma adrenomedullin concentration is increased in patients with cardiovascular diseases such as hypertension, congestive heart failure, renal failure and septic shock. The present review summarizes the recent advancement of adrenomedullin research and demonstrates that adrenomedullin is one of the important vasoactive peptides involved in the physiology and pathophysiology of circulatory control and control of body fluid.