Adrenomedullin (ADM) is a multifunctional peptide hormone initially discovered in 1993. primarily produced by vascular endothelial cells, smooth muscle cells, and various tissues under hypoxic or inflammatory conditions. It plays a critical role in regulating vasodilation, angiogenesis, electrolyte balance, and inflammation. Elevated ADM levels are associated with sepsis, cardiovascular diseases, and cancer, where it often serves as a biomarker for disease severity and prognosis. However, excessive ADM can exacerbate pathological processes, such as promoting vascular leakage in sepsis or tumor progression.
ADM-targeting antibodies have emerged as therapeutic tools to neutralize its harmful effects. These antibodies bind ADM or its receptors (e.g., CLR-RAMP complexes), blocking downstream signaling. In sepsis, preclinical studies show that anti-ADM antibodies may stabilize endothelial barrier function and improve microcirculation. Similarly, in oncology, they are explored for inhibiting ADM-driven tumor growth and metastasis. Diagnostic applications include immunoassays to quantify ADM levels in blood, aiding in early disease detection or monitoring.
Current research focuses on optimizing antibody specificity and delivery, with some candidates in clinical trials. Challenges include balancing ADM’s dual roles (protective vs. pathogenic) and minimizing off-target effects. Despite these hurdles, ADM antibodies represent a promising avenue for precision medicine in critical care and oncology.