zyme that methylates noradrenaline into adrenaline.Acetylcholine liberated from splanchnic nerve terminals induces regulated exocytosis of constituents of chromaffin granules in a Ca 2 -dependent manner. The cholinergic receptor subtypes responsible for catecholamine release differ among species; in cows, nicotinic but not muscarinic stimulation induces catecholamine release (2), while in rats and dogs, both nicotinic and muscarinic stimulation induce catecholamine release (3, 4). In addition, the stimulation of cholinergic receptors increases catecholamine synthesis via the activation of TH, the rate limiting enzyme of catecholamine synthesis (5).In addition to catecholamines, chromaffin cells produce a
IntroductionAdrenal medullary cells are endocrine cells embryologically derived from the neural crest, which synthesize and release catecholamines. They are composed of adrenaline chromaffin cells and noradrenaline chromaffin cells with minor populations of small intensely fluorescent cells and ganglionic neurons (1). Both adrenaline and noradrenaline chromaffin cells express catecholamine synthesizing enzymes, tyrosine hydroxylase (TH) and dopamine β-hydroxylase (DBH). Adrenaline cells, but not noradrenaline cells, have phenylethanolamine-N methyl transferase (PNMT), an envariety of peptides including chromogranins, opioid peptides and neuropeptide Y (6, 7), which have unique functions such as regulating catecholamine release (8), regulating antibacterial activity (9), sorting peptides from the trans-Golgi network to dense core secretory granules (10), and regulating cell adhesion (11). Catecholamines and other constituents in the chromaffin granules from chromaffin cells are released by pathophysiological stress. Hypoglycemia, hemorrhage, cold exposure or hypoxia causes exocytotic release directly via activation of chromaffin cells, as well as indirectly via activation of the preganglionic sympathetic fibers innervating chromaffin cells (1).On the other hand, adrenomedullin (AM) is a hypotensive peptide that was originally identified in human pheochromocytoma by monitoring of its action on 3 ,5 -cyclic adenosine monophosphate (cAMP) in platelets (12). The AM level in plasma is altered in various diseases; for example, it is increased in patients with hypertension and normalized by anti-hypertensive therapy, indicating that AM is involved in protection against injury occurring in various pathological conditions (13,14). The precursor of AM, the preproAM gene, also produces another hypotensive peptide, the proadrenomedullin N-terminal 20 peptide (PAMP20) (15). However, the mechanisms of action of these peptides are different. In the perfused rat mesenteric arteries, AM directly dilates vascular smooth muscle via receptor that reacts with calcitonin gene-related peptide (CGRP) (16), whereas PAMP20 inhibits noradrenaline release from sympathetic nerve endings, resulting in vasodilatation (17).These peptides are produced not only in pheochromocytoma, but also in almost all organs of the body, and regulate a variety...