adrenomedullin and Behcet-Syndrome

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.. 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.. 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).. 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.

Topics: Adolescent; Adrenomedullin; Adult; Behcet Syndrome; Chromatography, High Pressure Liquid; Female; Humans; Kidney; Leukocyte Count; Male; Middle Aged; Peptides; Severity of Illness Index; Vasodilator Agents

Behçet's disease (BD) is a chronic systemic inflammatory disorder affecting multiple organs with a generalized vasculitis of arteries and veins. Endothelial dysfunction is one of the prominent features of BD. Adrenomedullin (AM) is a peptide produced not only in normal adrenal medulla but also in the vascular smooth muscle cells and endothelial cells, and its role in the course of BD has not been previously described.. To detect changes of plasma AM concentrations in patients with BD compared with age- and sex-matched healthy subjects by using high-performance liquid chromatography (HPCL). We also investigated if disease activity or the duration of BD correlates with AM levels.. Forty-two consecutive patients with BD (38.5 +/- 11.1 years, 19 male and 23 female) and 20 healthy age- and 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 acute-phase reactants including alpha(1)-antitrypsin and alpha(2)-macroglobulin, neutrophil count and the erythrocyte sedimentation rate.. Mean +/- SD plasma AM levels in patients with BD (73.22 +/- 25.55 pmol/l) were significantly higher (p < 0.001) than in healthy control volunteers (21.35 +/- 12.37 pmol/l). Patients with active BD had similar plasma AM concentrations (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 of 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 significantly increased in the active disease.. Considering its endothelial cell implications, AM may be involved in reparatory vessel endothelium mechanisms, especially in the chronic disease.

Topics: Adolescent; Adrenomedullin; Adult; alpha 1-Antitrypsin; alpha-Macroglobulins; Behcet Syndrome; Chromatography, High Pressure Liquid; Female; Humans; Leukocyte Count; Male; Middle Aged; Neutrophils; Peptides