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Papel de la adrenomedulina en el control de la presión arterial y la homeostasis del líquido extracelular
A. Cases Amenós, N. Esforzado Armengol, W. Jiménez Povedano
Unidad de Hipertensión y Laboratorio de Hormonal. Hospital Clínic i Provincial. Universitat de Barcelona. Barcelona
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La adrenomedulina es un p&#233;ptido de 52 amino&#225;cidos recientemente identificado que presenta un efecto vasodilatador potente y prolongado&#44; as&#237; como una acci&#243;n diur&#233;tica y natriur&#233;tica a nivel renal&#46; El efecto vasodilatador de la adrenomedulina est&#225; mediado por un aumento de los niveles intracelulares de AMP c&#237;clico&#44; as&#237; como por un aumento de la s&#237;ntesis de &#243;xido n&#237;trico&#46; Los efectos diur&#233;tico y natriur&#233;tico de este p&#233;ptido son debidos tanto a sus acciones sobre el flujo sangu&#237;neo renal como sobre la funci&#243;n tubular&#46; Adem&#225;s&#44; la adrenomedulina inhibe la secreci&#243;n de aldosterona estimulada por angiotensina&#44; tiene un efecto inotr&#243;pico positivo sobre el miocardiocito&#44; inhibe la proliferaci&#243;n y migraci&#243;n de la fibra muscular lisa vascular&#44; y a nivel cerebral inhibe la sed y el apetito por la sal&#46; La expresi&#243;n de este p&#233;ptido se ha demostrado en muchos tejidos&#44; pero es especialmente prominente en c&#233;lulas endoteliales&#46; Por ello se cree que la producci&#243;n de este p&#233;ptido en las c&#233;lulas endoteliales&#44; regulada por el estr&#233;s de cizallamiento &#40;flujo&#41;&#44; citoquinas o neurohormonas&#44; act&#250;a de forma paracrina en la fibra muscular lisa subyacente causando vasodilataci&#243;n&#46; Los niveles plasm&#225;ticos de adrenomedulina est&#225;n elevados en la hipertensi&#243;n arterial&#44; insuficiencia card&#237;aca&#44; infarto de miocardio&#44; insuficiencia renal&#44; diabetes complicada&#44; as&#237; como en el shock s&#233;ptico&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los efectos biol&#243;gicos de adrenomedulina&#44; as&#237; como la demostraci&#243;n de niveles plasm&#225;ticos elevados del mismo en diversas patolog&#237;as cardiovasculares y renales parecen confirmar su papel en la regulaci&#243;n de la presi&#243;n arterial y del equilibrio hidroelectrol&#237;tico&#44; aunque todav&#237;a son necesarios m&#225;s estudios para dilucidar su papel fisiopatol&#243;gico en las enfermedades cardiovasculares&#46;</p>"
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es en pt

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