Adrenomedullin

Adrenomedullin (ADM) is a 52-amino-acid vasodilatory peptide of the calcitonin gene-related peptide superfamily, originally isolated from human pheochromocytoma tissue. It signals through the calcitonin receptor-like receptor (CALCRL) paired with receptor activity-modifying proteins: the CLR/RAMP2 and CLR/RAMP3 complexes, raising cAMP in vascular smooth muscle and endothelium. Beyond hypotensive actions, adrenomedullin promotes angiogenesis, fluid balance and cytoprotection, and it is upregulated in sepsis, heart failure, hypertension and many tumors, where it supports survival and invasion; plasma ADM levels are being developed as a biomarker for sepsis and heart failure, and ADM pathway inhibitors have been explored in oncology.