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Updated: Nov 21, 2025
Use of Animal Model of Sepsis to Evaluate Novel Herbal Therapies
Published on: April 11, 2012
Adrenomedullin in Sepsis: Finally, a Friend or an Enemy?
1Department of Critical Care, Manipal Hospitals, Bengaluru, Karnataka, India.
Abstract:
Adrenomedullin (ADM) is a 52 amino acid containing free circulating vasoactive peptide hormone found to be active in various pathophysiological states including sepsis. High ADM levels at admission have been correlated with vasopressor requirements, organ dysfunction, and mortality in sepsis patients. ADM stimulation results in vasodilation and loss of vascular resistance in humans resulting in hypotension with the potential for negative impact in septic shock. However, in vitro human and animal experiments have shown that ADM decreases hyperpermeability and capillary leak, thus having an endothelial barrier stabilizing effect during septic shock. Adrenomedullin thus appears to be a double-edged weapon. This editorial critically reviews the article by Daga et al. who evaluated serum ADM as a prognostic marker to review the gender-related difference in mortality pattern, and also the correlation of ADM level to APACHE II and SOFA scores. The role of adrenomedullin in sepsis and the potential developments in the future have been discussed concisely. How to cite this article: Ajith Kumar AK. Adrenomedullin in Sepsis: Finally, a Friend or an Enemy? Indian J Crit Care Med 2020;24(12):1151-1153.
Insights
Adrenomedullin (ADM) is a peptide hormone that can be both harmful and helpful in sepsis. High ADM levels indicate worse outcomes, but it may also stabilize blood vessels.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Critical Care Medicine
Background:
- Adrenomedullin (ADM) is a vasoactive peptide hormone implicated in sepsis pathophysiology.
- Elevated ADM levels in sepsis correlate with increased vasopressor need, organ dysfunction, and mortality.
- ADM's dual role in vasodilation and endothelial barrier stabilization presents a complex clinical picture.
Discussion:
- This editorial reviews Daga et al.'s study on serum ADM as a prognostic marker in sepsis.
- It examines gender-related mortality differences and ADM correlations with APACHE II and SOFA scores.
- The discussion critically evaluates ADM's "double-edged weapon" nature in septic shock.
Key Insights:
- High admission ADM levels are linked to adverse outcomes in sepsis patients.
- ADM exhibits both vasodilatory effects and a protective endothelial barrier function.
- The prognostic value of ADM in sepsis requires careful consideration of its multifaceted actions.
Outlook:
- Further research is needed to elucidate ADM's precise role in sepsis.
- Understanding ADM's gender-specific effects could refine prognostic models.
- Targeting ADM pathways may offer future therapeutic strategies for septic shock.
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