Adrenomedullin (ADM) was originally identified as an endogenous peptide having vasodilating functions. Following that, ADM has been shown to possess pleiotropic functions including angiogenic potency. The vascular function of ADM is mainly regulated by a receptor activity-modifying protein 2 (RAMP2). However, pathophysiological roles of ADM-RAMP2 system in retinal angiogenesis remain to be clarified.
We analyzed (1) a oxygen-induced retinopathy (OIR) model using heterozygous ADM and RAMP2 knockout mice (ADM^+/- and RAMP2^+/-, respectively), (2) proliferation and migration of retinal endothelial cells in vitro, (3) retinal angiogenesis during developmental stage using drug-inducible endothelial cell-specific RAMP2 knockout mice (DI-E-RAMP2^-/-), and (4) an OIR model treated with intravitreal injection of anti-ADM antibody.
We found that ADM mRNA expression was upregulated under hypoxic conditions in OIR model. In ADM^+/-, pathological neovascularization as well as VEGF and eNOS mRNA expression was suppressed. In addition, proliferation and migration effects of ADM on retinal endothelial cells were confirmed in vitro. We found that ADM-RAMP2 system also plays important roles in retinal vascular development, and Notch signaling is possibly involved. Finally, we revealed that intravitreal injection of anti-ADM antibody reduced pathological retinal angiogenesis in OIR model.
From these results, we clarified that ADM-RAMP2 system plays important roles in both the pathological and physiological retinal angiogenesis. ADM-RAMP2 system is a hopeful new therapeutic method for controlling pathological retinal angiogenesis in ocular diseases.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 119: 761-771, 2015.