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Circulation Research. 2002;91:618-625
Published online before print September 12, 2002, doi: 10.1161/01.RES.0000036603.61868.F9
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(Circulation Research. 2002;91:618.)
© 2002 American Heart Association, Inc.


Integrative Physiology

Adrenomedullin Reduces Endothelial Hyperpermeability

Stefan Hippenstiel, Martin Witzenrath, Bernd Schmeck, Andreas Hocke, Mathias Krisp, Matthias Krüll, Joachim Seybold, Werner Seeger, Wolfgang Rascher, Hartwig Schütte, Norbert Suttorp

From Charité, Department of Internal Medicine (S.H., M.W., B.S., A.H., M. Krisp, M. Krüll, J.S., N.S.), Humboldt-University, Berlin, Germany; the Department of Pediatrics (W.R.), University of Erlangen-Nürnberg, Erlangen, Germany; and the Department of Internal Medicine (W.S., H.S.), Justus-Liebig University, Giessen, Germany.

Correspondence to Stefan Hippenstiel, MD, Charité, Department of Internal Medicine/Infectious Diseases, Humboldt-University, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail stefan.hippenstiel{at}charite.de

Endothelial hyperpermeability induced by inflammatory mediators is a hallmark of sepsis and adult respiratory distress syndrome. Increased levels of the regulatory peptide adrenomedullin (ADM) have been found in patients with systemic inflammatory response. We analyzed the effect of ADM on the permeability of cultured human umbilical vein endothelial cell (HUVEC) and porcine pulmonary artery endothelial cell monolayers. ADM dose-dependently reduced endothelial hyperpermeability induced by hydrogen peroxide (H2O2), thrombin, and Escherichia coli hemolysin. Moreover, ADM pretreatment blocked H2O2-related edema formation in isolated perfused rabbit lungs and increased cAMP levels in lung perfusate. ADM bound specifically to HUVECs and porcine pulmonary artery endothelial cells and increased cellular cAMP levels. Simultaneous inhibition of cAMP-degrading phosphodiesterase isoenzymes 3 and 4 potentiated ADM-dependent cAMP accumulation and synergistically enhanced ADM-dependent reduction of thrombin-induced hyperpermeability. However, ADM showed no effect on endothelial cGMP content, basal intracellular Ca2+ levels, or the H2O2-stimulated, thrombin-stimulated, or Escherichia coli hemolysin–stimulated Ca2+ increase. ADM diminished thrombin- and H2O2-related myosin light chain phosphorylation as well as stimulus-dependent stress fiber formation and gap formation in HUVECs, suggesting that ADM may stabilize the barrier function by cAMP-dependent relaxation of the microfilament system. These findings identify a new function of ADM and point to ADM as a potential interventional agent for the reduction of vascular leakage in sepsis and adult respiratory distress syndrome.


Key Words: adrenomedullin • cultured endothelial cells • endothelial permeability • endothelial barrier dysfunction




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