Effects of exogenous ADM on HPA axis in early stage of acute mechanical renal trauma

AIM: To explore the effects of exogenous adrenomedullin(ADM) on hypothalamus-pituitary-adrenal cortex (HPA)axis in the early stage of acute mechanical renal trauma.METHODS: Healthy adult Wistar rats were randomly divided into 4 groups: 8 in control group, 32 in trauma group, 32 in the group injected with ADM before trauma and 32 in the group injected with ADM after trauma. To induce renal trauma, the rats in the latter 3 groups were subjected to mechanical impact directly on the skin of renal region by a free-fall iron hammer. The rats in 2 treatment groups were injected with ADM (0.1 nmol/kg) intraperitoneally 10 min just before and after trauma,respectively. The rats in the 3 groups with kidney injury were executed in batches by drawing all the blood quickly in the hearts at the time points of 1 h, 6 h, 12 h and 24 h after trauma. The hypothalamus tissues were also collected. The expression of corticotropin-releasing hormone(CRH) in hypothalamus and the concentrations of adrenocorticotropic hormone(ACTH) and cortisol(CORT) in plasma were detected by immunohistochemical method and radioimmunoassay. RESULTS: The expression of CRH in hypothalamus and the concentrations of ACTH and CORT in plasma in trauma group,but were slightly higher than those in control group,but without statistical significance. The expression of CRH in hypothalamus at 1 h and 24 h, the concentration of ACTH in plasma at 12 h and CORT at 6 h,12 h and 24 h in the group injected with ADM before trauma significantly higher than those in trauma group and control group (P<0.05). The expression of CRH in hypothalamus at 1 h, 6 h and 12 h and the concentration of CORT in plasma at 12 h and 24 h in the group injected with ADM after trauma were obviously higher than those in trauma group and control group (P<0.05). CONCLUSION: Exogenous ADM stimulates HPA axis and activates the function of HPA axis markedly. However, the different layers of HPA axis have different responses to exogenous ADM. Injection of ADM before or after trauma has different effects on HPA axis.