Erythropoietin (EPO) is a neuroprotective cytokine in models of ischemic and nervous system injury, where it reduces neuronal apoptosis and inflammatory cytokines and increases neurogenesis and angiogenesis. EPO also improves cognition in healthy volunteers and schizophrenic patients. We studied the effect of EPO administration on the gene-expression profile in the ischemic cortex of rats after cerebral ischemia at early time points (2 and 6 h). EPO treatment up-regulated genes already increased by ischemia. Hierarchical clustering and analysis of overrepresented functional categories identified genes implicated in synaptic plasticity-Arc, BDNF, Egr1, and Egr2, of which Egr2 was the most significantly regulated. Up-regulation of Arc, BDNF, Dusp5, Egr1, Egr2, Egr4, and Nr4a3 was confirmed by quantitative PCR. We investigated the up-regulation of Egr2/Krox20 further because of its role in neuronal plasticity. Its elevation by EPO was confirmed in an independent in vivo experiment of cerebral ischemia in rats. Using the rat neuroblastoma B104, we found that wild-type cells that do not express EPO receptor (EPOR) do not respond to EPO by inducing Egr2. However, EPOR-expressing B104 cells induce Egr2 early upon incubation with EPO, indicating that Egr2 induction is a direct effect of EPO and that EPOR mediates this effect. Because these changes occur in vivo before decreased inflammatory cytokines or neuronal apoptosis is evident, these findings provide a molecular mechanism for the neuroreparative effects of cytokines and suggest a mechanism of neuroprotection by which promotion of a plastic phenotype results in decreased inflammation and neuronal death.microarrays | ischemia-reperfusion injury | neurotrophins | early genes | neuronal cells S ince our first report (1), several studies have documented the neuroprotective effect of erythropoietin (EPO) in models of ischemic and traumatic brain injury (reviewed in refs. 2-4) and the role of endogenous EPO in ischemic preconditioning (5). Multiple mechanisms can account for the action of EPO, including inhibition of neuronal apoptosis (6) and decreased neuroinflammation (7,8). EPO also activates repair, in particular through promotion of neurogenesis, oligodendrogenesis, and angiogenesis (9, 10), as well as mobilization of endothelial progenitor cells (11). It also improves cognition, long-term potentiation (LTP), and synaptic plasticity (4,(12)(13)(14).However, the early effects of EPO responsible for its neuroprotective activities are not understood, and there even is debate whether the classical EPO receptor (EPOR) alone mediates these effects or an additional tissue-protective coreceptor is required (15-18).In the study presented here, we investigated the effect of EPO on the gene-expression profile of the brain using the rat model of cerebral ischemia induced by middle cerebral artery occlusion (MCAO) with which we performed most of the studies on EPO.To identify early events induced by EPO, experiments were carried out at the time points 2 and 6 h post-MCAO, when ...