Moradi Zahra, Maali Amirhosein, Shad Javad Sadeghi, Farasat Alireza, Kouchaki Reza, Moghadami Mona, Ahmadi Mohamad Hosein, Azad Mehdi
1Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
2Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
Indian J Hematol Blood Transfus. 2020 Jan;36(1):26-36. doi: 10.1007/s12288-019-01170-1. Epub 2019 Sep 16.
Erythropoietin (EPO) is an important hormone responsible for the stimulation of hematopoiesis which is impaired in a variety of diseases, such as chronic kidney disease, cancer chemotherapy, and the use of some anti-HIV drugs. Difficulties in the purification of endogenous EPO due to problems such as technical limitations, heterogeneity of target cells, inadequate amount and immunogenicity of the resultant product, had limited the entry of endogenous EPO in the clinical applications. The integration of medical biotechnology and hematology has introduced novel procedures for the production of human recombinant erythropoietin (rHuEPO), and other erythropoiesis-stimulating agents (ESAs). To investigate and produce rHuEPO, the first step is to recognize the molecular biology and functional pathways, structure, metabolism, and basic physiology of EPO. In this review, all clinical indications, side effects, challenges and notable points regarding EPO, rHuEPO, and other ESAs have also been addressed along with its molecular characterization, such as the modifications needed to optimize their rHuEPO biosynthesis.
促红细胞生成素（EPO）是一种重要的激素，负责刺激造血作用，而造血作用在多种疾病中会受到损害，如慢性肾病、癌症化疗以及某些抗艾滋病毒药物的使用。由于技术限制、靶细胞异质性、所得产物量不足和免疫原性等问题，内源性EPO的纯化存在困难，这限制了内源性EPO在临床应用中的使用。医学生物技术与血液学的结合引入了生产人重组促红细胞生成素（rHuEPO）和其他促红细胞生成刺激剂（ESA）的新方法。为了研究和生产rHuEPO，第一步是了解EPO的分子生物学、功能途径、结构、代谢和基本生理学。在这篇综述中，还讨论了关于EPO、rHuEPO和其他ESA的所有临床适应症、副作用、挑战和要点，以及它们的分子特征，如优化rHuEPO生物合成所需的修饰。
