Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Stolz, Daiana; Κostikas, Κonstantinos; Blasi, Francesco; Boersma, Wim; Milenković, Branislava; Lacoma, Alícia; Louis, Renaud; Aerts, Joachim; Welte, Tobias; Torres, Antoni; Rohde, Gernot; Boeck, Lucas; Rakic, Janko; Scherr, Andreas; Hertel, Sabine; Giersdorf, Sven; Tamm, Michael

doi:10.1183/09031936.00058713

Cited by 42 publications

(60 citation statements)

References 56 publications

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“…Additionally, recent observational studies demonstrated that in patients during or just recovering from COPD exacerbation [39][40][41] or in patients with stable COPD [40,42], ProADM is a powerful independent prognosticator of long-term non-survival [39][40][41][42]. Some of this work also shows that when combined with demographic and clinical variables, ProADM provides significant incremental mortality prediction accuracy [41,42].…”

Section: Introductionmentioning

confidence: 70%

“…Some of this work also shows that when combined with demographic and clinical variables, ProADM provides significant incremental mortality prediction accuracy [41,42]. Additional data [43][44][45] suggest that ProADM may be a global cardiopulmonary stress marker [45].…”

Section: Introductionmentioning

confidence: 95%

“…ADM is ubiquitously expressed in pulmonary, cardiovascular, renal, gastrointestinal, and endocrine tissue and by endothelial cells, vascular smooth muscle cells, cardiomyocytes, fibroblasts, leukocytes, and placental trophoblast cells, among others [49][50][51][52]. In pulmonary tissue, ADM expression has been found in endothelial cells including type II pneumocytes, chondrocytes, smooth muscle cells, the columnar epithelium, alveolar macrophages, monocytes, T cells, and neurons of the pulmonary parasympathetic nervous system, as well as small-cell and non-small-cell neoplasia [42,53].…”

Section: Adm and Proadmmentioning

confidence: 99%

“…As of May, 2014, observational data regarding ProADM in COPD have been published by four groups [39][40][41][42] (Table 1). Two of these teams, Stolz et al at University Hospital Basel and Zuur-Telgen et al at Medisch Spectrum Twente, Enschede, The Netherlands, reported single-center data; the other two, the Predicting Outcome Using Systemic Markers in Severe Exacerbations of Chronic Obstructive Pulmonary Disease Study (PROM-ISE-COPD) investigators and the ProHOSP investigators, reported multicenter data.…”

Section: Proadm In Risk Assessment Of Patients With Copdmentioning

confidence: 99%

“…It acts systemically and in autocrine and paracrine fashion [54,55], exerting or mediating vasodilatory, natriuretic, diuretic, antioxidative, anti-inflammatory, antimicrobial, and metabolic effects [42,50,[56][57][58]. Upregulated by hypoxia, inflammatory cytokines, bacterial products, and shear stress, ADM has in preclinical and animal models been shown to reduce hypoxic pulmonary vascular structural remodeling and fibrosis and to inhibit bronchoconstriction; the molecule also has been shown to stabilize barrier function in the lungs by downregulating pro-inflammatory factors and reactive oxidative species [42,50,51,[59][60][61][62]. Circulating ADM elevation, e.g., in end-stage pulmonary disease [63], is believed to reflect "high demand" for these compensatory/counter-regulatory effects [28,42].…”

Section: Adm and Proadmmentioning

confidence: 99%

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The prognostic blood biomarker proadrenomedullin for outcome prediction in patients with chronic obstructive pulmonary disease (COPD): a qualitative clinical review

Schuetz¹,

Marlowe²,

Müeller

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Plasma proadrenomedullin (ProADM) is a blood biomarker that may aid in multidimensional risk assessment of patients with chronic obstructive pulmonary disease (COPD). Co-secreted 1:1 with adrenomedullin (ADM), ProADM is a less biologically active, more chemically stable surrogate for this pluripotent regulatory peptide, which due to biological and ex vivo physical characteristics is difficult to reliably directly quantify. Upregulated by hypoxia, inflammatory cytokines, bacterial products, and shear stress and expressed widely in pulmonary cells and ubiquitously throughout the body, ADM exerts or mediates vasodilatory, natriuretic, diuretic, antioxidative, anti-inflammatory, antimicrobial, and metabolic effects. Observational data from four separate studies totaling 1366 patients suggest that as a single factor, ProADM is a significant independent, and accurate, long-term allcause mortality predictor in COPD. This body of work also suggests that combined with different groups of demographic/clinical variables, ProADM provides significant incremental long-term mortality prediction power relative to the groups of variables alone. Additionally, the literature contains indications that ProADM may be a global cardiopulmonary stress marker, potentially supplying prognostic information when cardiopulmonary exercise testing results such as 6-min walk distance are unavailable due to time or other resource constraints or to a patient's advanced disease. Prospective, randomized, controlled interventional studies are needed to demonstrate whether ProADM use in risk-based guidance of site-of-care, monitoring, and treatment decisions improves clinical, qualityof-life, or pharmacoeconomic outcomes in patients with COPD.

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