Erythropoietin - measurement and clinical applications

Abstract

Erythropoietin (EPO) is an endogenous hormone produced primarily by the kidney which controls the production of erythrocytes. The main stimulus to production is low tissue oxygen (hypoxia) and EPO triggers the formation of red blood cells by binding to a receptor on erythroid progenitor target cells. Alteration in the EPO regulatory system produces a change in circulating EPO in a variety of disease states, such as renal anaemia and polycythaemia. The availability of recombinant EPO in the 1980s transformed the treatment of anaemia, particularly anaemia of end stage renal disease, and led to the development of more sensitive and specific assays for the measurement of EPO. There are more widespread uses for EPO and preliminary studies indicate that EPO may be useful as a neuroprotective agent by reducing inflammation near the site of injury. The use of EPO to boost endurance in athletes has attracted unwanted publicity, although analytical techniques are now available that can differentiate between endogenous and recombinant EPO. Different types of erythropoietic agents have been developed with a longer plasma half-life and the ability to maintain haemoglobin levels for longer periods and reduce the need for frequent dosing with EPO.

Postmortem chemistry update part II

“…EPO levels increase as early as 2 h post-anaemia and/or systemic hypoxia initiation with a half-life of about 5-9 h. Most anaemic patients have an elevated plasma EPO concentration that depends on the degree and type of anaemia. However, plasma EPO in patients with anaemia from chronic renal failure is usually inappropriately low due to reduced EPO synthesis by the kidney [142,143].…”

Niveles de eritropoyetina y reticulocitos en residentes de bajas alturas migrantes a medianas altura

“…La eritropoyetina (EPO) es una hormona glicoproteíca producida en gran proporción por el riñón, tiene la capacidad de regular la producción de glóbulos rojos siendo altamente específica sobre las células eritroides medulares 1,2 . La principal función de la EPO está dada en la regulación de la eritropoyesis, mediante el control de la proliferación, diferenciación y supervivencia de los progenitores eritroides.…”

Resistance to Recombinant Human Erythropoietin Therapy in Haemodialysis Patients

“…The first clinical trial using rhEPO in the treatment of the anaemia of end-stage renal failure was published in 1987 (Eschbach, 1987), and, nowadays, rhEPO is currently used for the treatment of that anaemia in haemodialysis (HD) patients (Kimel, 2008;Obladen, 2000), as well as for a variety of other clinical situations associated with anaemia. Marsden, 2006).…”