Increased plasma adrenomedullin levels in patients with Behcet's disease

Background: Behcet's disease (BD) is a chronic systemic inflammatory disord er affecting multiple organs with a generalized vasculitis of arteries and veins. Endothelial dysfunction is one of the prominent features of ED. Adre nomedullin (AM) is a peptide produced not only in normal adrenal medulla bu t also in the vascular smooth muscle cells and endothelial cells, and its r ole in the course of ED has not been previously described. Objective: To de tect changes of plasma AM concentrations in patients with ED compared with age- and sex-matched healthy subjects by using high-performance liquid chro matography (HPCL). We also investigated if disease activity or the duration of ED correlates with ANT levels. Methods: Forty-two consecutive patients with ED (38.5 +/- 11.1 years, 19 male and 23 female) and 20 healthy age- an d sex-matched control subjects (39.5 +/- 10.9 years, 8 male and 12 female) were included in this study. We measured plasma AM levels by HPCL, and acut e-phase reactants including alpha (1)-antitrypsin and alpha (2)-macroglobul in, neutrophil count and the erythrocyte sedimentation rate. Results: Mean +/- SD plasma AM levels in patients with ED (73.22 +/- 25.55 pmol/l) were s ignificantly higher (p < 0.001) than in healthy control volunteers (21.35 < plus/minus> 12.37 pmol/l). Patients with active ED had similar plasma AM co ncentrations (79.32 +/- 21.89 pmol/l) with patients with inactive disease ( 67.44 +/- 29.92 pmol/l). On the other hand, patients with longer duration o f the disease (mean duration, 13.9 +/- 3.8 years) had significantly higher plasma AM levels (83.99 +/- 19.71 pmol/l; p = 0.005) than patients (62.45 /- 26.57 pmol/l) with shorter duration of the disease (mean duration, 5.5 /- 2.3 years). All acute-phase reaction parameters were found to be signifi cantly increased in the active disease. Conclusion: Considering its endothe lial cell implications, AM may be involved in reparatory vessel endothelium mechanisms, especially in the chronic disease. Copyright (C) 2000 S. Karge r G, Basel.