Clinical & Medical Biochemistry

Abstract

Adrenomedullin in Cerebrospinal Fluid: Potential Role in Central Nervous System Diseases and Reliable Measure Using an Automated Method

Furlani Matteo, Visentini Daniela, Cussigh Anna Rosa, Pesente Fiorenza, Janes Francesco, Tascini Carlo, Curcio Francesco and Fabris Martina*

Background and aim: Adrenomedullin (ADM) is a potent hormone-like peptide induced by hypoxia and inflammatory cytokines, that exerts an important vasodilation effect, which resulted protective in case of myocardial infarction and brain injuries. ADM is rapidly induced in the initial stages of sepsis, so the dosage of its more stable precursor fragment called Mid-Regional (MR)-proADM is currently recommended to assist triaging of patients suspected for sepsis in the emergency department. Much more limited is its use in the context of neurological disease, since its dosage is only certified in plasma. In this report we highlighted ADM functions in neurological pathophysiology in order to support the importance of its dosage also in the Cerebrospinal Fluid (CSF).

Methods: MR-proADM concentrations were measured samples using a fully automated platform (Brahms Kryptor Gold Analyzer, Thermo Scientific, Germany), applying the same analytical condition in plasma and CSF samples, to finally set up an accurate laboratory protocol to validate its dosage in CSF.

Results: MR-proADM is highly stable in CSF samples stored at room temperature for up to 48 hours, allowing it to be measured with confidence also in CSF samples that may be left on the bench for several hours. In addition, the repeatability and within-laboratory precision of the MR-proADM assay using CSF samples appeared equal to or better than those obtained by the manufacturer using plasma samples, allowing the use of this assay, with high precision, also for CSF samples.

Conclusion: To date, there are no reports about MR-proADM routine testing in Cerebrospinal Fluid (CSF). Based on our review of its role in the central nervous system and the reliability of its measure in CSF, we believe that MRproADM is a highly promising biomarker in infectious, inflammatory and degenerative neurological diseases.

Published Date: 2025-03-26; Received Date: 2024-10-20