Shannon K M
Department of Pediatrics of Naval Hospital, Oakland, CA 94627.
Am J Pediatr Hematol Oncol. 1990 Spring;12(1):14-20. doi: 10.1097/00043426-199021000-00004.
Recombinant human erythropoietin (r-HuEPO) is of interest to pediatric hematologists and neonatologists because it may prove to be an effective alternative to blood transfusions in preventing and treating anemia in premature infants. The anemia of prematurity is the most promising setting for initial clinical trials. However, it is conceivable that recombinant erythropoietin will be given at birth to low-birth-weight infants in an effort to stimulate endogenous erythropoiesis and thereby prevent some of the erythrocyte transfusions required to replace blood sampled for laboratory tests. Beyond its appeal as a therapeutic alternative to red blood cell transfusions, recombinant human erythropoietin is likely to be the first member of an entirely new class of drugs to be used widely in neonatal medicine. These are drugs produced by cloning normal human genes and expressing them in the laboratory. Because many of the problems of premature birth are caused by developmental immaturity, transiently replacing crucial proteins with exact copies produced by the techniques of recombinant DNA technology is an approach that may have a major impact on morbidity and mortality of neonates. Carefully designed, controlled clinical trials will be essential to determine the role of new agents like r-HuEPO in the treatment of medical problems of premature infants.
重组人促红细胞生成素（r-HuEPO）引起了儿科血液学家和新生儿科医生的关注，因为在预防和治疗早产儿贫血方面，它可能被证明是输血的一种有效替代方法。早产儿贫血是进行初步临床试验最有前景的领域。然而，可以想象，为了刺激内源性红细胞生成，从而避免一些因采集实验室检测用血而需要进行的红细胞输血，出生时就会给低体重婴儿使用重组促红细胞生成素。除了作为红细胞输血的治疗替代方法具有吸引力外，重组人促红细胞生成素很可能成为在新生儿医学中广泛使用的全新一类药物中的首个成员。这类药物是通过克隆正常人基因并在实验室中表达而产生的。由于许多早产问题是由发育不成熟引起的，用重组DNA技术生产的精确复制品暂时替代关键蛋白质，这种方法可能会对新生儿的发病率和死亡率产生重大影响。精心设计、严格控制的临床试验对于确定r-HuEPO等新药在治疗早产儿医学问题中的作用至关重要。
