Adrenomedullin and total nitrite levels in children with familial Mediterranean fever.
OBJECTIVE
Familial Mediterranean fever (FMF) is the most frequent periodic syndrome characterised by recurrent attacks of polyserositis. However, recent studies revealed that there might be an ongoing subclinical inflammation between the attacks. As nitric oxide (NO) and adrenomedullin (AM) are both synthesised in the endothelium, and mediates many functions within immune system, we considered them to be an interesting target of investigation in FMF.


METHODS
Fifteen children with FMF receiving regular colchicine, ranging in age from 3 to 16 years, were investigated in comparison with 15 healthy age- and sex-matched controls. The mean age of the patients was 9.7 +/- 3.9 years. Total nitrite, a stable product of NO, was quantitated by means of the Griess reaction, while AM was measured by HPLC.


RESULTS
Plasma-urinary AM and total nitrite levels were significantly higher in children with FMF. Plasma AM levels (pmol/mL) in patients and controls were 40.95 +/- 5.99 vs. 34.86 +/- 5.24, P < 0.05, and urinary AM excretion (pmol/mg creatinine) was 51.16 +/- 28.15 vs. 37.5 +/- 24.26, P < 0.05 respectively. Plasma total nitrite levels (micromol/L) in patients and controls were 44.80 +/- 10.36 vs. 32.13 +/- 9.28, P < 0.05, and urinary nitrite excretion (micromol/mg creatinine) was 2.24 +/- 1.71 vs. 1.09 +/- 0.96, P < 0.05 respectively.


CONCLUSIONS
This study considered that AM and NO may have a role in the immuno-inflammatory process of FMF, although, whether these act to preserve, or protect against, further inflammatory injury is not clear. Our results further supports the hypothesis that these patients have subclinical inflammation between attacks.
Balat
Ayşe
A
Department of Pediatrics, Medical Faculty, Gaziantep University, Gaziantep, Turkey. aysebalat@hotmail.com
Işlek
Ismail
I
Cekmen
Mustafa
M
Yürekli
Muhittin
M
Tekin
Deniz
D
Muslu
Ali
A
Sahinöz
Saime
S
D000293:Adolescent; D053607:Adrenomedullin; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003078:Colchicine / Q000627:therapeutic use; D010505:Familial Mediterranean Fever / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D009573:Nitrites / Q000097:blood* / Q000652:urine*; D010455:Peptides / Q000097:blood* / Q000652:urine*; D012016:Reference Values
D009573:Nitrites; D010455:Peptides; D053607:Adrenomedullin; D009569:Nitric Oxide; D002097:C-Reactive Protein; D003078:Colchicine