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    Circulating adrenomedullin levels in ankylosing spondylitis and Familial Mediterranean Fever
    (Elsevier France-Editions Scientifiques Medicales Elsevier, 2008) Ureten, Kemal; Ozbek, Mustafa; Ozturk, Mehmet Akif; Dogru, Ilker; Dogru, Arzu; Yurekli, Muhittin; Karakurt, Feridun
    Introduction: Adrenomedullin (AM) is a 52-amino acid peptide with vasorelaxant properties. Apart from its roles on vascular tonus, AM can also contribute to inflammatory events. Plasma AM levels were elevated in connective tissue diseases and vasculitic disorders. Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine initiating in the sacroiliac joints. Familial Mediterranean Fever (FMF) is a hereditary disorder characterized by self-limiting acute attacks of fever and the presence of sustained subclinical inflammation in the attack-free periods. In this study, we investigated plasma AM levels in patients with AS and patients with FMF. Methods: Twenty AS patients with active disease manifestations (mean age: 41.6 +/- 10.9 years, female/male: 7/13), 28 FMF patients with acute attack (mean age: 27.4 +/- 10.7 years, female/male: 17/11), and 26 healthy controls (mean age: 39.9 +/- 5.5 years, female/male: 16/10) were enrolled in this study. AM levels were also measured in 11 FMF patients 2 months after the cessation of their attacks. AM levels of those 11 patients during their FMF attacks and attack-free periods were also compared. Results: Median plasma AM levels were 23.86 (17.24-40.09) pmol/mL, 27.33 (17.24-38.52) pmol/mL, and 26.11 (17.05-37.42) pmol/mL in AS patients, FMF patients with acute attack, and healthy controls, respectively (p > 0.05). AM levels were also similar in the attack-free periods of FMF patients [26.35 (24.35-34.14) pmol/mL]. There was no correlation between plasma AM levels and C-reactive protein, or between plasma AM levels and erythrocyte sedimentation rate. Conclusions: AM does not seem to have any role in the pathogenesis of AS and FMF. Previous reports of elevated levels of AM in connective tissue disorders and vasculitic diseases are probably disease specific, and AM does not seem to be a common component of inflammatory rheumatic disorders. (C) 2008 Elsevier Masson SAS. All rights reserved.
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    Effect of Genotype on Plasma and Urinary Adrenomedullin Levels in Children with Familial Mediterranean Fever
    (Ortadogu Ad Pres & Publ Co, 2012) Kalman, Suleyman; Sakallioglu, Onur; Dogru, Ilker; Gul, Davut; Gok, Faysal
    Objective: Familial Medeitarrenean Fever (FMF) is an autosomal recessive disease characterized with fever and serositis episodes. Renal amyloidosis which is the most important complication of the disease also determines prognosis. Although it is still conflicting, M694V homozygosity is a risk factor for amyloidosis. Adrenomedullin (ADM) is a potent vasodilator and a cytoprotective peptide. It has been proposed that it may have a role in pathogenesis of inflammatory diseases like Behcet's disease, Henoch-Schonlein purpura and its plasma levels are high in pediatric patients with FMF. The aim of this study is to compare plasma and urinary ADM levels of FMF patients who exhibit M694V homozygosity and the patients who have other genotypes. Material and Methods: A total of 37 patients with a mean age of 9.2 +/- 4.7 years were included in the study. Sixteen patients had M694V homozygous mutation (Group I), 10 patients had M694V compound heterozygous (Group II), and 11 patients had other/other mutations (Group III). No patients had an FMF attack at the time of evaluation. Results: Plasma ADM levels in Group 1(26.83 +/- 5.71 pmol/mL) were higher than Group II and Group III (23.25 +/- 3.28 pmol/mL, 22.80 +/- 3.90 pmol/mL; p=0.032, p=0.026, respectively). There were no differences between Group II and Group III (p=0.228). A difference could not be found between three groups in terms of urinary ADM levels (Group I: 18.58 +/- 2.37, Group II: 17.84 +/- 3.36, Group III: 17.96 +/- 3.46 pmol/mg creatinine). White blood cell count, erythrocyte sedimentation rate, C-reactive protein, fibrinogen levels were also similar among the groups. Conclusion: It was concluded that further studies including more cases were needed to determine the role of adrenomedullin in immunoinflammatory process of FMF and to prove coexistence of subclinical inflammation with M694V homozygot mutation and high ADM levels.