RT Journal Article SR Electronic T1 Brief adrenomedullin inhalation leads to sustained reduction of pulmonary artery pressure JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 615 OP 623 DO 10.1183/09031936.04.00016103 VO 24 IS 4 A1 K. von der Hardt A1 M.A. Kandler A1 M. Chada A1 A. Cubra A1 E. Schoof A1 K. Amann A1 W. Rascher A1 J. Dötsch YR 2004 UL http://erj.ersjournals.com/content/24/4/615.abstract AB The effect of aerosolised adrenomedullin (ADM), a potent vasodilator peptide, on pulmonary artery pressure was studied for 24 h in a surfactant-depleted piglet model. Animals received either aerosolised ADM (50 ng·kg−1·min−1, ADM, n=6), or aerosolised normal saline solution (control, n=6). Aerosol therapy was performed for a 2 h treatment period followed by a 22 h observation period. Ventilator settings were adapted to keep arterial oxygen tension and carbon dioxide arterial tension between 13.3–14.6 kPa and 4.9–5.7 kPa, respectively. Aerosolised ADM reduced mean pulmonary artery pressure (MPAP) compared with the control group (end-point median 24 h after therapy start: ΔMPAP −14.0 versus −8.0 mmHg; 23.5 h after therapy start). After therapy start, mean systemic arterial pressure (MAP) was not significantly different between the groups (end-point median: MAP ADM 70 (61/74) versus control 72 (54/81) mmHg). Endothelin-1, a potent pulmonary vasoconstrictor, is regulated by ADM via cAMP. Twenty two hours after inhalation of aerosolised ADM, endothelin-1 mRNA in lung tissue and endothelin-1 protein expression in pulmonary arteries was reduced compared with controls (median semi-quantitative immunhistochemical score: ADM 0.21, control 0.76). Aerosolised adrenomedullin significantly reduced mean pulmonary artery pressure independently of arterial oxygen tension. Supported by a grant from the IZKF (center for interdisciplinary clinical research), University Erlangen-Nürnberg, German Ministry for Education and Research, No. 01 KS 0002, Project C11.