ADM-specific receptors can be activated through a variety of cell signal transduction pathways to achieve their biological functions, the most important cell signaling pathway is increasing the biological activity of adenylyl cyclase through the activation of Gs protein. Finally, it can increase the synthesis and secretion of second messenger cAMP in cells to exert biological functions or increase the biological activity of phospholipase C in vascular endothelial cells, thereby further increasing the levels of intracellular second messenger 1,4,5 - inositol trisphosphate (IP3) to achieve its many biological functions. ADM mainly increases the production of intracellular second messenger cAMP in vascular smooth muscle cells, which further causes vascular endothelial cells to release nitric oxide (NO), an intracellular signaling pathway, and finally achieves its biological role in dilating blood vessels and lowering blood pressure.
In isolated perfused kidneys of rats, endothelial-derived hyperpolarizing factor (EDHF) seems to be involved in P13 by opening the K+ channel. In addition, there are intracellular Ca2+ pathways, mitogen-activated kinase (MAPK) pathway and adenosine triphosphate (ATP)-dependent K+ pathway in rat aorta, ADM can induce epithelial-dependent vasodilation, and this biological function is achieved through the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) intracellular signal transduction pathway. In studies of rat myocardial ischemia-reperfusion models, it was found that ADM has an important protective effect on myocardial ischemic-reperfused rat cardiomyocytes, and this protective function is also through PBK/AKT intracellular signal transduction. MAPK/ERKl/2 channels are also associated with ADM-induced epithelial vascular proliferation and cell proliferation in the rat adrenal bulb.
ADM has many complex functions, including cell proliferation, contraction, migration, and interactions with other neuroendocrine factors. ADM circulates in plasma, and its exact role as a circulating hormone is unclear. The concentration of ADM in plasma is not directly measured because it has a half-life in plasma of only 22 minutes. The immunoreactive ADM in the plasma is actually derived from the enzymatically digested ADM with different biological activities. In addition, ADM is also known to bind to complement factor H in plasma. ADM plays an important role in the regulation of the water-electrolyte balance, and it can also inhibit the expression of atrial natriuretic peptide also in muscle cells. ADM regulates also the hypertrophy of muscle cells and the growth of fibroblasts. It also exerts antibacterial effects by binding to bacterial cell walls. In addition to regulating vascular tone, ADM also regulates vascular proliferation and remodeling.
ADM can inhibit the proliferation of vascular smooth muscle cells. This biological function is achieved by inhibiting platelet-derived growth factor (PDGF)-induced thymidine incorporation. This effect can reduce blood pressure and increase heart rate with increasing dose of ADM. In the process of studying the pathophysiological effects of ADM on renal cells, immunohistochemical techniques were used to find that ADM was localized in glomerular mesangial cells, capillary endothelial cells, vascular smooth muscle cells, and renal tubular epithelial cells. ADM can be produced by mesangial cells. ADM can inhibit the proliferation of glomerular mesangial cells, promote apoptosis, inhibit cell migration, inhibit oxidative stress, and promote glomerular mesangial cells to secrete hyaluronic acid, exerting a protective effect on the kidney. This biological effect may be mediated through cAMP intracellular signal transduction pathways. The expression of ADM in the stomach can regulate gastric acid secretion and change with fasting and starvation. After fast starvation, its expression is increased at the bottom of the stomach. After chronic starvation, it is increased at the euphoria. ADM regulates the ileal rhythm and inhibits its contraction, which may be mediated through activation of the ATP-dependent K+ channel by the β3 adrenergic receptor and protein kinase A.