Shannon J S, Lappin T R
Med Hypotheses. 1986 May;20(1):29-36. doi: 10.1016/0306-9877(86)90083-6.
It is proposed that the anaemia of chronic renal failure and the apparent lack of erythropoietin response is a result of increased proteolytic and lysosomal enzyme action on both the red cell and erythropoietin itself. Removal of the sialic acid from the red cell membrane is known to cause sequestration and a shortened cell survival. Similarly removal of sialic acid from the carbohydrate coat of erythropoietin both increases clearance by the liver and renders it susceptible to cleavage into inactive fragments by proteolytic attack. If the hypothesis is correct therapeutic intervention using enzyme inhibitors may offer hope for the amelioration of the anaemia.
有人提出，慢性肾衰竭贫血以及明显缺乏促红细胞生成素反应是蛋白水解酶和溶酶体酶对红细胞和促红细胞生成素本身作用增强的结果。已知从红细胞膜上去除唾液酸会导致红细胞被隔离且细胞存活时间缩短。同样，从促红细胞生成素的糖衣上去除唾液酸，既会增加肝脏对其的清除，又会使其易于受到蛋白水解攻击而裂解成无活性的片段。如果该假说是正确的，那么使用酶抑制剂进行治疗干预可能为改善贫血带来希望。
