Circulating levels of adrenomedullin in patients with Addison's disease before and after corticosteroid treatment.
OBJECTIVE
A novel hypotensive peptide, adrenomedullin (AM), had recently been isolated, purifed and its encoding gene sequenced from a human phaeochromocytoma. In humans AM circulates in physiological levels and possesses a distinct vasodilatatory activity. The purpose of this study was to examine the behaviour of AM levels in primary adrenal failure.


METHODS
Plasma AM levels were measured in patients with proven Addison's disease using a specific radioimmunoassay and compared to those in healthy normotensive subjects.


METHODS
Eighteen patients with Addison's disease (10 men and eight women; ages 21 to 72 years) and 21 healthy control subjects (13 men and eight women; ages 20 to 71 years) were enrolled in the study. All patients were studied under basal conditions and 10 were reassessed following corticosteroid treatment.


RESULTS
All patients with Addison's disease showed increased levels of AM compared to the control group. Mean plasma AM levels were correspondingly higher in patients with Addison's disease than in normal subjects (102.1 +/- 33.4 (SD) ng/l versus 13.7 +/- 6.1 ng/l; P < 0.0001). In 10 patients studied after corticosteroid treatment, plasma AM levels were significantly reduced (P < 0.0001: 110.3 +/- 35.8 ng/l versus 32.4 +/- 10.3 ng/l) after 2 weeks of treatment. A weak correlation (r = 0.458; P = 0.048) was observed between systolic blood pressure and plasma AM concentrations in all patients with Addison's disease.


CONCLUSIONS
These results indicate a consistent but reversible increase of adrenomedullin in patients with Addison's disease.
Letizia
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2nd Department of Internal Medicine, University La Sapienza, Rome, Italy.
Cerci
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D000224:Addison Disease / Q000097:blood* / Q000188:drug therapy; D053607:Adrenomedullin; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D005438:Fludrocortisone / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008901:Mineralocorticoids / Q000627:therapeutic use; D010455:Peptides / Q000097:blood*; D011863:Radioimmunoassay; D012044:Regression Analysis
D008901:Mineralocorticoids; D010455:Peptides; D053607:Adrenomedullin; D005438:Fludrocortisone; D006854:Hydrocortisone