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Adrenomedullin: Multiple functions in human pregnancy

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Abstract

Adrenomedullin is a 52 amino acid peptide originally isolated from human phaeochromocytoma in 1993. It was initially demonstrated to have profound effects on the vasculature including vasodilatation and subsequently promotion of angiogenesis. Since then it has become apparent that it has a wide range of other biological actions including regulation of cell growth and differentiation. Successful pregnancy outcome relies on establishing and maintaining throughout gestation an efficient blood supply to the fetus. This allows the exchange of nutrients, oxygenation of fetal blood and removal of cytotoxins from the fetus, such as carbon dioxide. One of the most important local adaptations to pregnancy is the change in maternal blood flow to the implantation site. Evidence now points towards a vital role for adrenomedullin in the regulation of placentation. It appears that adrenomedullin may play important roles in the regulation of fetal perfusion both in normal and in compromised pregnancies. However, most studies have focused on measuring adrenomedullin levels and studying its expression as well as that of its receptors. More functional studies are now required to elucidate the underlying mechanisms involved.

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Abbreviations

AM:

adrenomedullin

AMBP-1:

AM binding protein

bFGF:

basic fibroblast growth factor

CGRP:

calcitonin gene-related peptide

CRLR:

calcitonin receptor like-receptor

EGF:

epidermal growth factor

IL-1α:

interleukin-1α

IL-1β:

interleukin-1β

NO:

nitric oxide

NOS:

nitric oxide synthase

PAMP:

proadrenomedullin

PI3K/Akt:

phosphatidylinositol 3-kinase/AKt

RAMP:

receptor activity modifying protein

TNFα:

tumour necrosis factor α

TNFβ:

tumour necrosis factor β

VEGF:

vascular endothelial growth factor

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  1. Department of Obstetrics and Gynaecology Level 3, The Women’s Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK

    Caroline Wilson, Leonid L. Nikitenko, Ian L. Sargent & Margaret C. P. Rees

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  1. Caroline Wilson
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  2. Leonid L. Nikitenko
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  3. Ian L. Sargent
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  4. Margaret C. P. Rees
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Correspondence to Margaret C. P. Rees.

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Wilson, C., Nikitenko, L.L., Sargent, I.L. et al. Adrenomedullin: Multiple functions in human pregnancy. Angiogenesis 7, 203–212 (2004). https://doi.org/10.1007/s10456-004-4183-5

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