Adrenomedullin

Adrenomedullin is a 52-amino-acid vasodilatory peptide (MW ~6028 g/mol) originally isolated from human pheochromocytoma tissue. It is widely expressed in the cardiovascular system, lungs, kidneys, and adrenal glands, with potent vasodilatory, natriuretic, and cardioprotective properties. It is currently investigated as a biomarker (MR-proADM) for sepsis and heart failure prognosis, with no approved therapeutic use of the peptide itself.

Category: Cardiovascular / Vasoactive. Evidence rating: D (animal/preclinical only).

Clinical status: Research stage. MR-proADM used as prognostic biomarker in sepsis and heart failure. No approved therapeutic use of adrenomedullin peptide.

Adrenomedullin signals through the calcitonin receptor-like receptor (CLR) complexed with receptor activity-modifying protein 2 or 3 (RAMP2/RAMP3), forming the AM1 and AM2 receptors respectively. Binding activates Gs-coupled adenylyl cyclase, increasing cAMP and activating PKA, which leads to eNOS…

Safety considerations: No human safety data from controlled therapeutic trials; Experimental IV infusion in healthy volunteers caused hypotension and reflex tachycardia; Theoretical risk of excessive vasodilation and hemodynamic instability.

Reviewed by the PeptideAtlas Editorial Team.

Adrenomedullin — measured properties

Molecular weight~6028 g/mol
CAS number137924-43-5
Half-life~22 minutes (plasma)
Production methodsynthetic
Anti-doping statusnot-listed
US regulatory statusNot approved as a therapeutic agent. MR-proADM assay (BRAHMS/Thermo Fisher) available for research and clinical biomarker use.

Related peptides: Angiotensin II, Angiotensin 1-7, Bradykinin.

Frequently asked questions

What is MR-proADM and how is it used clinically?

MR-proADM (mid-regional pro-adrenomedullin) is a stable fragment of the adrenomedullin precursor used as a surrogate biomarker because adrenomedullin itself is too unstable for routine measurement. It is used as a prognostic marker in sepsis, community-acquired pneumonia, and heart failure, helping identify patients at higher risk of mortality or adverse outcomes.

How was adrenomedullin discovered?

Adrenomedullin was isolated from human pheochromocytoma tissue by Kitamura et al. in 1993 (PMID: 8479518). It was identified by its ability to stimulate cAMP in rat platelets and was subsequently found to be a potent vasodilator widely expressed in cardiovascular and other tissues.

Is adrenomedullin being developed as a drug?

Adrecizumab (HAM8101), a non-neutralizing anti-adrenomedullin antibody that modulates adrenomedullin compartmentalization, has been investigated in clinical trials for septic shock (AdrenOSS-2 trial). This approach targets the adrenomedullin pathway indirectly rather than administering exogenous adrenomedullin peptide.

Coverage on this site: Amylins (IAPP): Structure, Receptors, and Key Analogues.