Adrenomedullin

also known as: ADM, AM, pro-Adrenomedullin

A multi-organ protective peptide — a potent vasodilator and emerging sepsis biomarker (MR-proADM) with roles in cardiac, pulmonary, and renal protection.

A 52-amino-acid ring-structured peptide related to calcitonin gene-related peptide (CGRP), acting on CLR/RAMP2 and RAMP3 complexes to produce vasodilation, natriuresis, and cytoprotective effects across multiple organ systems.

Mechanism of action

Binds CLR (calcitonin receptor-like receptor) complexed with RAMP2 (forming AM1 receptor) and RAMP3 (AM2 receptor). Activates Gs → cAMP and eNOS → NO pathways. Produces vasodilation, positive inotropy, bronchodilation, natriuresis, angiogenesis, and anti-apoptotic effects. Upregulated in sepsis, heart failure, and renal injury as a compensatory protective response.

Primary uses

Sepsis biomarker (MR-proADM)
Cardiovascular protective research
Pulmonary vascular biology
Renal protective peptide research

Typical dosing

Not established

Endogenous biomarker. No therapeutic dosing established.

Regulatory status

Not approved therapeutically. MR-proADM is CE-marked as an in-vitro diagnostic biomarker in Europe for sepsis risk stratification. Adrecizumab (anti-adrenomedullin antibody) in clinical trials for septic shock.

References

[pubmed] Kitamura K, et al. "Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma." Biochem Biophys Res Commun, 1993;192:553-560.
[review] Geven C, et al. "Adrenomedullin and adrenomedullin-targeted therapy as treatment strategies relevant for sepsis." Front Immunol, 2018;9:292.

Related peptides

BNP

The heart failure biomarker — an endogenous cardiac peptide whose blood levels are the gold standard for diagnosing and monitoring heart failure severity.

ANP

The atrial pressure sensor — the first discovered natriuretic peptide, maintaining blood pressure and fluid balance through renal sodium excretion and vasodilation.

Endothelin-1

The most powerful vasoconstrictor in the body — an endothelial peptide central to pulmonary hypertension, targeted by bosentan, ambrisentan, and macitentan.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.