Novel Approaches in Erythropoietin
Abstract
Erythropoietin, or EPO, is
a glycoprotein hormone that controls erythropoiesis, or red blood cell production.
It is a cytokine for erythrocyte (red blood cell) precursors in the bone
marrow. Also called hematopoietin or hemopoietin, it is producedby the
peritubular capillary endothelial cells in the kidney, and is the hormone that
regulates red blood cell production. The existence of a hormone that controls
RBC production was first suggested by the experiments of Paul Carnot in 1906,
who created anemic rabbits and then transfused their serum into recipient
rabbits. EPO is produced by peritubular cells in the adult kidney, and in hepatocytes
in the fetus. In adults, a small amount is also produced by the liver. The rate
of Epo synthesis and secretion depends on local oxygen concentrations; hypoxia
is the main stimulus for Epo production. Although the use of erythropoietin has
been studied in critically ill patients, erythropoietin has not been shown to be
effective in this setting. In a randomized controlled trial, erythropoietin
insignificantly reduced mortality among critically ill patients.
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