Erythropoietin use and abuse

John, Mary; Jaison, Vineeth; Jain, Kunal; Kakkar, Naveen; Jacob, Jubbin Jagan

doi:10.4103/2230-8210.93739

Cited by 31 publications

(13 citation statements)

References 73 publications

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“…Because of its significant biological functions, recombinant human erythropoietin (rhEPO) was first hematopoietic growth factor to be cloned[5] and has been extensively used as pharmaceutical product for the treatment of anemia in chronic kidney disease, cancer chemotherapy and many other diseases[6], ever since it first became available as a drug in 1988[7]. Moreover, it is well-known for its misuse in endurance sports, and has been forbidden by the World Anti-Doping Agency since 1989[8].…”

Section: Introductionmentioning

confidence: 99%

Site-specific qualitative and quantitative analysis of the N- and O-glycoforms in recombinant human erythropoietin

et al. 2014

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Recombinant human erythropoietin (rhEPO) has been extensively used as pharmaceutical product for treatment of anemia. Glycosylation of rhEPO affects the biological activity, immunogenicity, pharmacokinetics and in vivo clearance rate of rhEPO. Characterization of the glycosylation status of rhEPO is of great importance for its quality control. In this study, we established a fast and comprehensive approach for reliable characterization and relative quantitation of rhEPO glycosylation, which combines multiple enzyme digestion, hydrophilic interaction chromatography (HILIC) enrichment of glycopeptides, and tandem mass spectrometry (MS) analysis. The N-linked and O-linked intact glycopeptides were analyzed with high resolution and high accuracy (HR/AM) mass spectrometry on an Orbitrap. Totally, 74 intact glycopeptides from four glycosylation sites at N24, N38, N83 and O126 were identified with the simultaneous determination of peptide sequences and glycoform compositions. The extracted ion chromatograms based on the HR/AM data allowed relative quantification of glycoforms. Our results could be extended to the quality control of rhEPO or help to establish detection approaches for glycosylation of other proteins.

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Section: Introductionmentioning

confidence: 99%

Site-specific qualitative and quantitative analysis of the N- and O-glycoforms in recombinant human erythropoietin

et al. 2014

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“…Like endogenous EPO, rHuEPO binds to the EPO receptor on erythroid progenitor cells, initiating a signaling cascade that leads to the binding of key transcription factors that induce the production of more red blood cells [ 36 ]. Increasing the number of red blood cells increases the total oxygen available and aerobic power [ 1 ]. Thus, we hypothesized that we would identify significantly differential transcripts that were involved in erythropoiesis.…”

Section: Discussionmentioning

confidence: 99%

“…Erythropoietin (EPO) is a protein predominantly secreted from the kidney to stimulate red blood cell (RBC) production in the bone marrow. As such, it increases hemoglobin mass, arterial oxygen content, and thus aerobic power [ 1 ]. Recombinant rHuEPO has been developed for clinical use to replace endogenous EPO in human patients suffering from various conditions associated with a decline in red blood cell counts [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Transcriptomic Markers of Recombinant Human Erythropoietin Micro-Dosing in Thoroughbred Horses

Dahlgren

Knych

Arthur

et al. 2021

Genes

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Recombinant human erythropoietin (rHuEPO) is a well-known performance enhancing drug in human athletes, and there is anecdotal evidence of it being used in horse racing for the same purpose. rHuEPO, like endogenous EPO, increases arterial oxygen content and thus aerobic power. Micro-doping, or injecting smaller doses over a longer period of time, has become an important concern in both human and equine athletics since it is more difficult to detect. Horses offer an additional challenge of a contractile spleen, thus large changes in the red blood cell mass occur naturally. To address the challenge of detecting rHuEPO doping in horse racing, we determined the transcriptomic effects of rHuEPO micro-dosing over seven weeks in exercised Thoroughbreds. RNA-sequencing of peripheral blood mononuclear cells isolated at several time points throughout the study identified three transcripts (C13H16orf54, PUM2 and CHTOP) that were significantly (PFDR < 0.05) different between the treatment groups across two or three time point comparisons. PUM2 and CHTOP play a role in erythropoiesis while not much is known about C13H16orf54, but it is primarily expressed in whole blood. However, gene expression differences were not large enough to detect via RT-qPCR, thereby precluding their utility as biomarkers of micro-doping.

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“…These include recombinant human erythropoietin (RhEpo), iron, B12 and folic acid. The use of RhEpo is particularly useful although patients must be aware of the risks associated with infusion, including the risk of sudden death due to anaphylaxis[3]. Also, some formulations of RhEpo are suspended in human albumin, and therefore this should be specifically discussed with JW patients.…”

Section: Pre-operative Assessment and Optimisationmentioning

confidence: 99%

Review of abdominal solid organ transplantation in Jehovah’s Witness patients

Figueiredo

Thakkar

Ainley

2019

WJT

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Managing blood loss in Jehovah’s Witness (JW) patients is a matter of controversy. These patients will not accept transfusions of red blood cells, white blood cells, platelets or plasma, even if that is required to save their lives. There are many discussions regarding safety of operating upon JW patients in general surgical procedures, but in solid organ transplantation there is a paucity of literature on this subject. We have reviewed individual case reports and small series documenting on experience with solid organ transplantation in JW patients and the strategies adopted to facilitate that. It is clear that such patients require the surgical team to dedicate more time to ensure their safe management. This begins with a thorough, detailed consent of exactly which products and interventions they will or will not accept. Planning must begin weeks before surgery if possible. Each case must be assessed individually, but provided they meet fitness requirements, there are no absolute contraindications to abdominal organ transplantation.

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Erythropoietin use and abuse

Cited by 31 publications

References 73 publications

Site-specific qualitative and quantitative analysis of the N- and O-glycoforms in recombinant human erythropoietin

Site-specific qualitative and quantitative analysis of the N- and O-glycoforms in recombinant human erythropoietin

Transcriptomic Markers of Recombinant Human Erythropoietin Micro-Dosing in Thoroughbred Horses

Review of abdominal solid organ transplantation in Jehovah’s Witness patients

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