Erythropoietin in spinal cord injury

Abstract

Spinal cord injury (SCI) is a devastating condition for individual patients and costly for health care systems requiring significant long-term expenditures. Cytokine erythropoietin (EPO) is a glycoprotein mediating cytoprotection in a variety of tissues, including spinal cord, through activation of multiple signaling pathways. It has been reported that EPO exerts its beneficial effects by apoptosis blockage, reduction of inflammation, and restoration of vascular integrity. Neuronal regeneration has been also suggested. In the present review, the pathophysiology of SCI and the properties of endogenous or exogenously administered EPO are briefly described. Moreover, an attempt to present the current traumatic, ischemic and inflammatory animal models that mimic SCI is made. Currently, a clearly effective pharmacological treatment is lacking. It is highlighted that administration of EPO or other recently generated EPO analogues such as asialo-EPO and carbamylated-EPO demonstrate exceptional preclinical characteristics, rendering the evaluation of these tissue-protective agents imperative in human clinical trials.

Neural stem cell transplantation combined with erythropoietin for the treatment of spinal cord injury in rats

“…It was previously considered that EPO is only a endocrine hormone acting on hematopoietic cells. However, EPO has been demonstrated to be a type of tissue protection factor, which exerts neurotrophic and neuroprotective effects (2,3). Yuan et al (4) observed the effects of erythropoietin on the differentiation of embryonic cerebral cortex neural stem cells of rats cultured in vitro, the results indicated that erythropoietin is able to promote the differentiation of neural stem cells into neurons.…”

Therapeutic Efficacy of Tadalafil and Eriythropoietin in Experimental Spina Cord Injury

“…EPO has been claimed to promote axonal regeneration to increase neoangiogenesis, to inhibit apoptosis, to have anti-inflammatory effects, to have anti-ischemic effects, to decrease microglial infiltration, to inhibit scar formation, and thereby may contribute to neurological improvement. [15][16][17][18][19] Nevertheless, the exact mechanism of neuroprotection of EPO is still not certain. Even if key determinant to EPO secretion is hypoxia, EPO receptors are more sensitive to pro-inflammatory cytokines such as tumor necrosis factor-1 and interleukin-1 beta than hypoxia.…”

Neuroprotection of erythropoietin and methylprednisolone against spinal cord ischemia-reperfusion injury

“…Therefore, it is important to develop new drugs that provide long-term, safe and effective effects against spinal cord I-R injury. Recent research has shown that EPO acts as a new neurotrophic and neuroprotective agent in different experimental settings ranging from in vitro neuronal cell culture model to in vivo animal models [5][6][7][8][9][10][11][12][13] . Most significantly, administration of EPO or its analogues has proven effective against SCI [12] .…”