Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Roch, Antoine

doi:10.1007/s00134-009-1613-2

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…There exists a substantial observational literature regarding ProADM use as an all-cause mortality predictor in patients with sepsis [11][12][13][14][15][16][17][18][19], in patients with a variety of underlying diseases presenting to the emergency department (ED) with acute dyspnea [20][21][22][23][24][25][26], and especially in patients with community-acquired pneumonia (CAP) [13,[27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

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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Section: Introductionmentioning

confidence: 99%

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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“…ADM release is therefore referred to as a protective adaption to systemic inflammation [ 11 ] and circulatory shock [ 12 ]. Nevertheless, its overproduction may cause circulatory collapse and organ failure [ 13 ] due to peripheral vasodilation [ 14 ]: arterial hypotension and reduced systemic vascular resistance correlated with increased ADM concentrations in volunteers injected with endotoxin [ 15 ] and patients with sepsis [ 16 ]. Moreover, ADM levels were directly related to morbidity and mortality [ 17 – 21 ], and persistently high concentrations allowed predicting infectious complications after septic shock [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Adrenomedullin binding improves catecholamine responsiveness and kidney function in resuscitated murine septic shock

Wagner¹,

Wachter²,

Vogt³

et al. 2013

ICMx

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PurposeAdrenomedullin (ADM) has been referred to as a double-edged sword during septic shock: On one hand, ADM supplementation improved organ perfusion and function, attenuated systemic inflammation, and ultimately reduced tissue apoptosis and mortality. On the other hand, ADM overproduction can cause circulatory collapse and organ failure due to impaired vasoconstrictor response and reduced myocardial contractility. Since most of these data originate from un-resuscitated shock models, we tested the hypothesis whether the newly developed anti-ADM antibody HAM1101 may improve catecholamine responsiveness and thus attenuate organ dysfunction during resuscitated murine, cecal ligation and puncture (CLP)-induced septic shock.MethodsImmediately after CLP, mice randomly received vehicle (phosphate-buffered saline, n = 11) or HAM1101 (n = 9; 2 μg·g−1). Fifteen hours after CLP, animals were anesthetized, mechanically ventilated, instrumented, and resuscitated with hydroxyethylstarch and continuous i.v. norepinephrine to achieve normotensive hemodynamics (mean arterial pressure > 50 to 60 mmHg).ResultsHAM1101 pretreatment reduced the norepinephrine infusion rates required to achieve hemodynamic targets, increased urine flow, improved creatinine clearance, and lowered neutrophil gelatinase-associated lipocalin blood levels, which coincided with reduced expression of the inducible nitric oxide synthase and formation of peroxynitrite (nitrotyrosine immunostaining) in the kidney and aorta, ultimately resulting in attenuated systemic inflammation and tissue apoptosis.ConclusionsDuring resuscitated murine septic shock, early ADM binding with HAM1101 improved catecholamine responsiveness, blunted the shock-related impairment of energy metabolism, reduced nitrosative stress, and attenuated systemic inflammatory response, which was ultimately associated with reduced kidney dysfunction and organ injury.Electronic supplementary materialThe online version of this article (doi:10.1186/2197-425X-1-2) contains supplementary material, which is available to authorized users.

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“…It is felt that there is need for further evaluation to find out whether they reflect an adaptive response to shock since both the molecules partly reflect the level of stress in an individual. 53 In an analysis of 12 studies 54 using brain natriuretic peptide (BNP) and N-terminal pro-B type natriuretic peptide (NT-pro BNP) comprising of 1865 sepsis patients, both were found to be significantly associated with increased risk of mortality (OR 8.65, 95% CI 4.94-15.13, p<0.00001). The pooled sensitivity was 79% and specificity was 60%.…”

Section: Other Novel Biomarkers For Sepsis On the Horizonmentioning

confidence: 99%

Procalcitonin in sepsis and bacterial infections

Chaudhury¹,

Sumant²,

Jayaprada³

et al. 2013

JCSR

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The differentiation of sepsis and systemic bacterial infections from other causes of systemic inflammatory response is crucial from the therapeutic point of view. The clinical signs and symptoms are non-specific and traditional biomarkers like white cell count, erythrocyte sedimentation rate and C-reactive protein are not sufficiently sensitive or specific to guide therapeutic decisions. Procalcitonin (PCT) is considered a reliable marker for the diagnosis and prognosis of moderate to severe bacterial infections, and it has also been evaluated to guide the clinicians in the rational usage of antibiotics. This review describes the diagnostic and prognostic role of PCT as a biomarker in various clinical settings along with the laboratory aspects and its usefulness in risk stratification and antibiotic stewardship.

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Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Cited by 4 publications

References 15 publications

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

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

Adrenomedullin binding improves catecholamine responsiveness and kidney function in resuscitated murine septic shock

Procalcitonin in sepsis and bacterial infections

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