Wake Forest University, Winston-Salem, North Carolina

Adrenomedullin (AM), a recently discovered vasodilator peptide, was originally isolated from human pheochromo-cytoma, and the initial reports suggested that the adrenal medulla, ventricle, kidney, and lung have the highest levels of AM expression. However, since the discovery that the AM gene expression is twentyfold to fortyfold higher in endothelial cells than even in the adrenal medulla, this pep-tide has been regarded as an important secretory product of vascular endothelium, together with nitric oxide, endothe-lin-1, and other vasoactive metabolites. Recent data from our laboratory indicate that adrenomedullin, as an endothe-lium-derived autocrine/paracrine hormone, plays an important role in the regulation of specific barrier properties of brain endothelial cells. In this chapter, we describe current knowledge about the possible role of AM in blood-brain barrier (BBB) functions.

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