Erythropoietic Response in Chronic Pulmonary Disease

Epilogue: A Journey with Blood Cells and Viruses

“…Because viruses had been found many times before by several investigators in established cell lines, only to be subsequently shown to be accidental laboratory contaminants (a not uncommon occurrence in virology), by the late 1970s we were well aware that much more had to be done before this work was presentable. For instance, we had to (1) show that the same virus could be isolated from primary tissue samples of the same patient; (2) demonstrate that the virus was novel, i.e., not any of the known animal retroviruses; (3) show it could infect human T cells in vitro; (4) demonstrate specific antibodies to the virus in the serum of the patient; (5) demonstrate that proviral DNA could be found integrated in the DNA of the cells from which the virus was isolated; and (6) provide evidence that this was not a one-time affair by showing serological evidence of specific antibodies not only in the patient but in others as well. These results were successfully obtained in 1979-1980 and available by the time we submitted and published our first report in 1980 (25), enabling us to follow quickly with the several other essential reports in 1981 (26)(27)(28)(29)(30), also including an independent isolate from a patient of Caribbean origin (31).…”

“…Indeed, it might be justifiably stated that he was the discoverer of erythropoietin. We worked together on the impaired erythropoietic response in chronic lung disease (1). Alan advised me to head to either the Boston City Hospital or the University of Chicago for my internship and residency in medicine because these were "The centers of excellence in blood cell biology," and I jumped at the suggestion.…”

Haematologic Adaptation in Patients with Chronic Bronchitis and Pulmonary Insufficiency

“…This could be due to an increase in total red cell volume being masked by an increase in plasma volume (29,33). However, the total red cell volume and the haemoglobin mass were often found to be less than expected (12, 19,33); a suboptimal haematologic response was shown despite normal erythrocyte life (7,12,29,33) and apparently adequate production of erythropoietin (6,7,23,33). Only in a group of ex-miners with chronic bronchitis and/or silicosis did a close correlation between arterial oxygen saturation and the haematologic data point to an adequate polycythaemic response (4).…”

Erythropoietin Level and Macrocytosis in Patients with Chronic Pulmonary Insufficiency

“…Erythrocytosis is seen less commonly in patients with chronic pulmonary diseases with hypoxia [Gallo et al, 1964;PavlovicKentera et al, 1965;Erslev, 1972], although the level of erythropoietin in plasma has been reported by Gallo et al 11964] to be propor tional to the hyposaturation of arterial blood, and the increased PaCO, has been shown not to inhibit the erythropoietin effect on the bone marrow [Hume, 1968]. The lower in cidence of erythrocytosis in chronic pulmo nary hypoxic patients could be due to a lesser degree of tissue hypoxia than it would be expected from PaO, values.…”