Bahlmann Ferdinand H, Fliser Danilo
Department of Internal Medicine IV, Saarland University Medical Centre, Homburg/Saar, Germany.
Curr Opin Nephrol Hypertens. 2009 Jan;18(1):15-20. doi: 10.1097/MNH.0b013e32831a9dde.
In the haematopoietic system, the principal function of erythropoietin (EPO) is the regulation of RBC production. Consequently, following the cloning of the EPO gene, recombinant human EPO (rHuEPO) forms have been widely used for treatment of anaemia in chronic kidney disease and chemotherapy-induced anaemia in cancer patients. However, a steadily growing body of evidence indicates that the therapeutic benefits of rHuEPO could be far beyond the correction of anaemia. Several articles have been recently published on the tissue-protective, nonhaematological effects of rHuEPO that prevent ischaemia-induced tissue damage in several organs including the kidney.In this review, we focus on nonhaematological effects of rHuEPO in various experimental settings of acute and chronic kidney injury. Because this tissue-protective action of rHuEPO is not the result of correction of anaemia-related tissue hypoxia, we will also discuss potential molecular pathways involved. Finally, we will review the current literature on clinical studies with rHuEPO or analogous substances and progression of chronic kidney disease, and propose possible clinical renoprotective strategies.
在造血系统中，促红细胞生成素（EPO）的主要功能是调节红细胞生成。因此，在EPO基因克隆之后，重组人促红细胞生成素（rHuEPO）制剂已被广泛用于治疗慢性肾脏病患者的贫血以及癌症患者化疗所致的贫血。然而，越来越多的证据表明，rHuEPO的治疗益处可能远远超出纠正贫血的范畴。最近有几篇文章发表，阐述了rHuEPO在组织保护方面的非血液学效应，其可预防包括肾脏在内的多个器官的缺血性组织损伤。在本综述中，我们重点关注rHuEPO在各种急性和慢性肾损伤实验模型中的非血液学效应。由于rHuEPO的这种组织保护作用并非纠正贫血相关组织缺氧的结果，我们还将讨论其中潜在的分子途径。最后，我们将综述目前关于rHuEPO或类似物质的临床研究以及慢性肾脏病进展的文献，并提出可能的临床肾脏保护策略。
