Increased urinary levels of adrenomedullin in patients with cystitis

Nishitani, Yoshiharu; Kubo, Atsushi; Kaneko, Yoshiteru; Ono, Yukari; Kurioka, Hideyuki; Kurooka, K; Minamino, Naoto; Kangawa, Kenji; Okada, Kazuo; Nonaka, Hideo; Dohi, Kazuhiro

doi:10.1016/s0272-6386(99)70232-5

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…Another possible explanation is that the kidney may be one of the major sites of AM synthesis as a result of systemic inflammation and vasculitis during the course of the disease. It is well known that inflammation stimulates AM production in the urinary tract; this fact provides evidence for the latter hypothesis 26 . In addition, cultured rat mesangial cells and renal tubular cells have been shown to produce AM, indicating again the urinary excretion of AM by the production and secretion from the kidney 27 .…”

Section: Discussionmentioning

confidence: 86%

Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behçet's syndrome

Evereklioğlu¹,

Özbek²,

Er³

et al. 2002

Int J of Urology

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Background: The objective was to measure urinary adrenomedullin (AM) levels in patients with active or inactive Behçet's syndrome and compare them to levels in healthy control subjects. Methods: Forty-five consecutive patients with Behçet's syndrome (20 men and 25 women with a mean age of 37.7 ± 10.8 years) and 20 age-and sex-matched healthy hospital staff volunteers as control subjects (nine men and 11 women with a mean age of 36.2 ± 10.4 years) were studied. Urinary and plasma AM concentrations were measured by high-performance liquid chromatography. We also investigated whether disease activity correlates with urinary and plasma AM levels. The Mann-Whitney U-test was used in statistical analysis and the values were expressed as mean ± SD. Results: Urinary excretion of AM (pmol per mg urinary creatinine) in patients with Behçet's syndrome (81.3 ± 35.1) was significantly higher (P < 0.001) than in control subjects (31.2 ± 16.1). Plasma AM levels (pmol/L) in patients with Behçet's syndrome and controls were 69.1 ± 19.2 and 20.7 ± 11.8, respectively; the difference was significant (P < 0.001). Although active Behçet's syndrome patients (n = 22) had higher urinary AM levels (92.1 ± 41.1) compared to inactive (n = 23; 70.8 ± 32.2), the difference was not significant (P > 0.05). Plasma AM levels in active Behçet's syndrome patients (77.5 ± 21.2) were also higher than in inactive (61.6 ± 17.3), but the difference was not significant (P > 0.05). Conclusion: Urinary AM levels were higher in Behçet's patients than in control subjects. Urinary AM levels were correlated with plasma AM levels. The results suggest that the higher AM levels found in the urine may be produced by the kidney as a result of the stimulation of inflammation during the course of Behçet's syndrome, or may come from plasma, as plasma AM levels were increased. However, the exact sites of AM synthesis by the kidney (e.g. glomeruli, blood vessels and/or tubular cells) could not be determined in this study. Further studies in this respect are necessary.

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Section: Discussionmentioning

confidence: 86%

Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behçet's syndrome

Evereklioğlu¹,

Özbek²,

Er³

et al. 2002

Int J of Urology

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“…Thus, the reduction of locally produced AM may be involved in the pathogenesis of PUJ obstruction. On the contrary, AM expression is stimulated in the urinary tract (bladder and ureter) during infection and inflammation [25].…”

Section: Discussionmentioning

confidence: 99%

Increased endothelin‐1 and decreased adrenomedullin gene expression in the stenotic tissue of congenital pelvi‐ureteric junction obstruction in children

Knerr¹,

Nyúl²,

Miller

et al. 2001

BJU International

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Objectives To test the hypothesis that the gene expression of endothelin‐1 and adrenomedullin may be altered in stenotic tissues of patients with congenital hydronephrosis caused by pelvi‐ureteric junction (PUJ) obstruction. Materials and methods Using real‐time reverse transcription‐polymerase chain reaction, mRNA of smooth muscle‐constricting endothelin‐1 and of smooth muscle‐relaxing adrenomedullin was quantified in tissue specimens of 20 patients with PUJ obstruction (mean age 5.1 years, sd 7.0) and of 21 controls with normal PUJs (mean age 23.5 years, sd 24.2). Results The amount of endothelin‐1 mRNA in stenotic specimens was higher than in the controls, indicated by significantly lower threshold cycles (Ct values) in real‐time PCR for the target gene in the obstructive tissue, with mean (sd) values of 24.9 (1.6) and 26.0 (2.1) (P < 0.05), respectively. The endothelin‐1/CD31 ratio was significantly higher in the patients (P < 0.05) than in controls. In addition, adrenomedullin gene expression in the obstructed junctions was significantly lower than in normal junctions, with higher Ct values for the patient group of 26.7 (1.6) vs 25.2 (1.8) (P < 0.05) and lower adrenomedullin mRNA when standardized to glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH) (P < 0.05), CD31 (P < 0.01) and smooth muscle α‐actin mRNA (P < 0.01). The two groups showed no significant differences for GAPDH and CD31 mRNA content, whereas there was about twice as much α‐actin mRNA in stenotic tissues than in unaffected PUJs, shown by the lower Ct values for the patient group of 16.9 (2.0) vs 17.9 (2.6) (P < 0.05). Furthermore, endothelin‐1, adrenomedullin and α‐actin mRNA amounts were independent of age. Conclusion Taken together these results provide evidence that the production of autocrine/paracrine acting endothelin‐1 and adrenomedullin is altered in tissues of patients with genuine PUJ obstruction, and may be involved in the pathogenesis of congenital hydronephrosis.

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“…In small studies, urinary adrenomedullin has been associated with urinary tract infection and inflammation. [12][13][14][15][16] One small study suggests that urinary and plasma proADM levels are correlated. 14 While plasma proADM appears to be a promising biomarker of severity in pediatric CAP, there are no studies examining urinary proADM in children.…”

mentioning

confidence: 99%

Urinary Proadrenomedullin and Disease Severity in Children With Suspected Community-acquired Pneumonia

Florin

Ambroggio

Shah

et al. 2021

Pediatric Infectious Disease Journal

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Background: Plasma proadrenomedullin (proADM) is a promising biomarker to predict disease severity in community-acquired pneumonia (CAP). Urinary biomarkers offer advantages over blood, including ease of collection. We evaluated the association between urinary proADM and disease severity in pediatric CAP. Methods: We performed a prospective cohort study of children 3 months to 18 years with CAP. Urinary proADM/creatinine (Cr) was calculated. Disease severity was defined as: mild (discharged home), mild-moderate (hospitalized but not moderate-severe or severe), moderate-severe (eg, hospitalized with supplemental oxygen and complicated pneumonia) and severe (eg, vasopressors and invasive ventilation). Outcomes were examined using logistic regression within the cohort with suspected CAP and in a subset with radiographic CAP. Results: Of the 427 children included, higher proADM/Cr was associated with increased odds of severe disease compared with nonsevere disease [suspected CAP, odds ratio (OR) 1.02 (95% confidence interval (CI) 1.003, 1.04); radiographic CAP, OR 1.03 (95% CI 1.01, 1.06)] when adjusted for other covariates. ProADM/Cr had an area under the receiver operating characteristic curve of 0.56 (threshold 0.9 pmol/mg) to differentiate severe from nonsevere disease in suspected CAP and 0.65 in radiographic CAP (threshold 0.82 pmol/mg). Healthy controls had less proADM in their urine (median, 0.61 pmol/mg) compared with suspected (0.87 pmol/mg, P = 0.018) and radiographic (0.73 pmol/mg, P = 0.016) CAP. Conclusions: Urinary proADM/Cr ratio measured at the time of emergency department visit was statistically associated with the development of severe outcomes in children with CAP, with stronger discriminatory performance in radiographic disease.

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Increased urinary levels of adrenomedullin in patients with cystitis

Cited by 9 publications

References 24 publications

Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behçet's syndrome

Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behçet's syndrome

Increased endothelin‐1 and decreased adrenomedullin gene expression in the stenotic tissue of congenital pelvi‐ureteric junction obstruction in children

Urinary Proadrenomedullin and Disease Severity in Children With Suspected Community-acquired Pneumonia

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