Mahdy Heba M
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
CNS Neurol Disord Drug Targets. 2025;24(9):701-721. doi: 10.2174/0118715273367111250307081826.
Epilepsy is a widespread neurological disorder, particularly affecting children and the elderly, presenting complex and varied challenges in management. Recently, erythropoietin has gained significant attention due to its neuroprotective effects, which have been demonstrated experimentally in various neurological conditions, including epilepsy. This review aims to analyze current literature on the role of erythropoietin in seizures and epilepsy.
A comprehensive literature search was conducted through PubMed, Scopus, and Web of Science databases up to September 30, 2024. The search terms included "Epilepsy AND Erythropoietin", "Seizures AND Erythropoietin," and "Status Epilepticus AND Erythropoietin", applied to titles, abstracts, and keywords.
The review highlights ongoing debates surrounding erythropoietin's effects on epilepsy. While erythropoietin shows potential in mitigating seizure-induced brain damage and modulating cellular processes such as anti-apoptotic and anti-inflammatory pathways, its clinical application is complicated by conflicting evidence. Some studies suggest that erythropoietin may trigger seizures, with factors such as dosage and individual patient characteristics potentially influencing this risk.
Experimental studies suggest that erythropoietin offers neuroprotective benefits in epilepsy. However, its possible pro-convulsant effects-which might be linked to erythropoietin-induced hypertension, rapid increases in hematocrit levels, dosage, or individual patient characteristics-raise safety concerns. These risks complicate its clinical use, making it premature to endorse erythropoietin as a treatment fully. Future research should focus on non-erythropoietic derivatives that retain neuroprotective effects without stimulating red blood cell production, thereby reducing risks, such as hypertension and thrombosis. Well-designed clinical trials and further investigation into erythropoietin's mechanisms are essential to clarify its role and optimize its therapeutic potential in epilepsy.
癫痫是一种广泛存在的神经系统疾病，尤其影响儿童和老年人，在管理方面呈现出复杂多样的挑战。最近，促红细胞生成素因其神经保护作用而备受关注，这种作用已在包括癫痫在内的各种神经系统疾病的实验中得到证实。本综述旨在分析当前关于促红细胞生成素在癫痫发作和癫痫中作用的文献。
截至2024年9月30日，通过PubMed、Scopus和Web of Science数据库进行了全面的文献检索。检索词包括“癫痫与促红细胞生成素”、“癫痫发作与促红细胞生成素”以及“癫痫持续状态与促红细胞生成素”，应用于标题、摘要和关键词。
该综述突出了围绕促红细胞生成素对癫痫影响的持续争论。虽然促红细胞生成素在减轻癫痫发作引起的脑损伤以及调节细胞过程（如抗凋亡和抗炎途径）方面显示出潜力，但其临床应用因证据相互矛盾而变得复杂。一些研究表明促红细胞生成素可能引发癫痫发作，剂量和个体患者特征等因素可能会影响这种风险。
实验研究表明促红细胞生成素在癫痫中具有神经保护作用。然而，其可能的促惊厥作用——这可能与促红细胞生成素诱导的高血压、血细胞比容水平快速升高、剂量或个体患者特征有关——引发了安全问题。这些风险使其临床应用变得复杂，因此完全认可促红细胞生成素作为一种治疗方法还为时过早。未来的研究应聚焦于保留神经保护作用而不刺激红细胞生成的非促红细胞生成素衍生物，从而降低诸如高血压和血栓形成等风险。精心设计的临床试验以及对促红细胞生成素机制的进一步研究对于阐明其在癫痫中的作用并优化其治疗潜力至关重要。
