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on January 17, 2005

Circulation. 2005
Published online before print January 17, 2005, doi: 10.1161/01.CIR.0000153352.29335.B9
A more recent version of this article appeared on January 25, 2005
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Right arrow Angiogenesis

Submitted on June 18, 2004
Revised on September 9, 2004
Accepted on November 3, 2004

Adrenomedullin Enhances Angiogenic Potency of Bone Marrow Transplantation in a Rat Model of Hindlimb Ischemia

Takashi Iwase MD, Noritoshi Nagaya MD*, Takafumi Fujii MD, Takefumi Itoh MD, Hatsue Ishibashi-Ueda MD, Masakazu Yamagishi MD, Kunio Miyatake MD, Toshio Matsumoto MD, Soichiro Kitamura MD, and Kenji Kangawa PhD

From the Departments of Regenerative Medicine and Tissue Engineering (T. Iwase, N.N., T. Itoh), Cardiac Physiology (T.F.), and Biochemistry (K.K.), National Cardiovascular Center Research Institute, Osaka, Japan; Departments of Internal Medicine (N.N., M.Y., K.M.), Pathology (H.I.-U.), and Cardiovascular Surgery (S.K.), National Cardiovascular Center, Osaka, Japan; and Department of Medicine and Bioregulatory Sciences (T. Iwase, T.M.), University of Tokushima Graduate School of Medicine, Tokushima, Japan.

* To whom correspondence should be addressed. E-mail: nagayann{at}hsp.ncvc.go.jp.

Background--Previous studies have shown that adrenomedullin (AM) inhibits vascular endothelial cell apoptosis and induces angiogenesis. We investigated whether AM enhances bone marrow cell-induced angiogenesis.

Methods and Results--Immediately after hindlimb ischemia was created, rats were randomized to receive AM infusion plus bone marrow-derived mononuclear cell (MNC) transplantation (AM+MNC group), AM infusion alone (AM group), MNC transplantation alone (MNC group), or vehicle infusion (control group). The laser Doppler perfusion index was significantly higher in the AM and MNC groups than in the control group (0.74±0.11 and 0.69±0.07 versus 0.59±0.07, respectively, P<0.01), which suggests the angiogenic potency of AM and MNC. Importantly, improvement in blood perfusion was marked in the AM+MNC group (0.84±0.08). Capillary density was highest in the AM+MNC group, followed by the AM and MNC groups. In vitro, AM inhibited MNC apoptosis, promoted MNC adhesiveness to a human umbilical vein endothelial cell monolayer, and increased the number of MNC-derived endothelial progenitor cells. In vivo, AM administration not only enhanced the differentiation of MNC into endothelial cells but also produced mature vessels that included smooth muscle cells.

Conclusions--A combination of AM infusion and MNC transplantation caused significantly greater improvement in hindlimb ischemia than MNC transplantation alone. This effect may be mediated in part by the angiogenic potency of AM itself and the beneficial effects of AM on the survival, adhesion, and differentiation of transplanted MNCs.


Key words: peptides • angiogenesis • peripheral vascular disease




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