title: Adrenomedullin is increased in alveolar macrophages and released from the lungs into the circulation in severe heart failure.
abstract: Adrenomedullin (AM) is a potent vasorelaxing peptide with natriuretic, diuretic, and growth inhibitory properties. Plasma concentrations and myocardial AM expression are increased in heart failure (HF). Since AM and AM binding sites are abundantly expressed in the lungs, we investigated to what extent pulmonary AM and AM receptor subtypes [CRLR/RAMP2 (AM1) and CRLR/RAMP3 (AM2)] are changed in HF and whether the lungs contribute to the increased plasma concentrations of AM reported in HF. Pulmonary AM mRNA and protein expression were increased by 2.8- and 2.6-fold, respectively, whereas mRNA expression of RAMP2 and CRLR was decreased in rats with HF 7 days after induction of MI compared to sham-operated rats (P < 0.05). Pulmonary AM receptor density was substantially decreased in HF rats compared to sham (3.7 +/-0.6 vs. 29.9 +/- 1.1 fmol/mg membrane protein; P < 0.05). Immunoreactivities against AM and the AM receptor components CRLR, RAMP2, and RAMP3 in the pulmonary tissue were seen in vascular smooth muscle cells, vascular endothelial cells, and in alveolar macrophages. AM mRNA expression in alveolar macrophages obtained from HF rats by bronchoalveolar lavage was 2.9-fold higher than in sham-operated rats (P < 0.05). An even more substantial increase of AM mRNA expression was found in alveolar macrophages from patients with HF (10-fold, P < 0.05), and this increase displayed a negative correlation to left ventricular systolic function (P < 0.05). Furthermore, a net release of AM from the lungs into the circulation was only found in HF patients with the most severe left ventricular systolic dysfunction. Thus, our data demonstrate increased expression and decreased receptor binding of AM in the lungs in severe HF. Furthermore, our data indicate that alveolar macrophages are an important source of pulmonary AM in both experimental and clinical HF. Finally, a net release of AM from the lungs into the circulation was only found in patients with severe systolic dysfunction.
authors.affiliation: Department of Cardiology, Rikshospitalet University Hospital,University of Oslo, 0027 Oslo, Norway. erik.oie@medisin.uio.no
authors.forename: Erik
authors.initials: E
authors.lastname: Øie
authors.forename: Mohammed Shakil
authors.initials: MS
authors.lastname: Ahmed
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.forename: Liv Ingunn Bjoner
authors.initials: LI
authors.lastname: Sikkeland
authors.forename: Christen P
authors.initials: CP
authors.lastname: Dahl
authors.forename: Else Marie Valbjørn
authors.initials: EM
authors.lastname: Hagelin
authors.forename: Thomas
authors.initials: T
authors.lastname: von Lueder
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.forename: Arne K
authors.initials: AK
authors.lastname: Andreassen
authors.forename: Lars
authors.initials: L
authors.lastname: Gullestad
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.forename: Arne
authors.initials: A
authors.lastname: Yndestad
authors.forename: Leif Erik
authors.initials: LE
authors.lastname: Vinge
authors.forename: Håvard
authors.initials: H
authors.lastname: Attramadal
mesh_terms: D053607:Adrenomedullin / Q000378:metabolism*; D000818:Animals; D001665:Binding Sites; D001794:Blood Pressure; D058286:Calcitonin Receptor-Like Protein; D015870:Gene Expression; D006333:Heart Failure / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D047908:Intracellular Signaling Peptides and Proteins / Q000378:metabolism; D008168:Lung / Q000378:metabolism* / Q000473:pathology; D016676:Macrophages, Alveolar / Q000378:metabolism*; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D009203:Myocardial Infarction / Q000378:metabolism / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D058263:Receptor Activity-Modifying Protein 2; D058264:Receptor Activity-Modifying Protein 3; D058261:Receptor Activity-Modifying Proteins; D058265:Receptors, Adrenomedullin; D018003:Receptors, Calcitonin / Q000378:metabolism; D018000:Receptors, Peptide / Q000378:metabolism*; D013599:Systole; D016277:Ventricular Function, Left
chemical_list: C545578:CALCRL protein, human; D058286:Calcitonin Receptor-Like Protein; D047908:Intracellular Signaling Peptides and Proteins; D008565:Membrane Proteins; C545503:RAMP2 protein, human; C545504:RAMP3 protein, human; D012333:RNA, Messenger; D058263:Receptor Activity-Modifying Protein 2; D058264:Receptor Activity-Modifying Protein 3; D058261:Receptor Activity-Modifying Proteins; D058265:Receptors, Adrenomedullin; D018003:Receptors, Calcitonin; D018000:Receptors, Peptide; D053607:Adrenomedullin