Santolaya-Forgas J, Vengalil S, Duval J, Gottmann D, Meyer W, Gauthier D, DeChristopher P J
Department of Obstetrics and Gynecology, University of Illinois, Chicago 60612, USA.
J Matern Fetal Med. 1999 May-Jun;8(3):141-5. doi: 10.1002/(SICI)1520-6661(199905/06)8:3<141::AID-MFM14>3.0.CO;2-K.
Erythropoietin (EPO) is a glycoprotein hormone and the principal regulator of erythropoiesis in the fetus, newborn, and adult. EPO-alfa is erythropoietin manufactured by recombinant human DNA technology (rhEPO). After counseling, a pregnant woman with anti-Js(b) in her serum was started on rhEPO (600 U/Kg, biweekly) to prevent anemia secondary to serial donations of her blood for fetal transfusions. After a total of 25 rhEPO infusions and autologous donation of 8 units of whole blood, maternal hemoglobin prior to the elective cesarean section at 37 weeks was 11.3 gm/dL. Serum EPO concentration was determined in paired maternal and fetal blood samples, before ultrasound guided intravascular transfusions, in this alloimmunized Js(b)-negative and another Rh(D) alloimmunized pregnancy to determine possible correlations between maternal and fetal serum EPO. rhEPO prevented anemia in a patient who donated 8 units of blood from 18-37 weeks of pregnancy without inducing adverse biological effects such as hypertension or thrombotic complications in the placenta. Data presented in this study suggest that EPO does not cross the human placenta.
促红细胞生成素（EPO）是一种糖蛋白激素，是胎儿、新生儿及成人红细胞生成的主要调节因子。阿法依泊汀是通过重组人DNA技术（rhEPO）制造的促红细胞生成素。经过咨询后，一名血清中含有抗Js(b)的孕妇开始接受rhEPO治疗（600 U/Kg，每两周一次），以预防因多次为胎儿输血而导致的贫血。在总共进行了25次rhEPO输注并自体捐献了8单位全血后，这位孕妇在37周进行择期剖宫产术前的血红蛋白水平为11.3 gm/dL。在超声引导下进行血管内输血前，采集了该Js(b)阴性同种免疫孕妇以及另一例Rh(D)同种免疫孕妇的母血和胎儿血配对样本，测定血清促红细胞生成素浓度，以确定母血和胎儿血清促红细胞生成素之间可能存在的相关性。rhEPO预防了一名在妊娠18至37周期间捐献了8单位血液的患者发生贫血，且未引发如高血压或胎盘血栓形成并发症等不良生物学效应。本研究提供的数据表明，促红细胞生成素不会穿过人胎盘。
