Barosi G
Ann Hematol. 1994 May;68(5):215-23. doi: 10.1007/BF01737420.
The development of a specific and sensitive immunoassay for the measurement of serum erythropoietin (s-Epo) allows to improve our understanding of the model of in vivo regulation of erythropoiesis. In most anemias, circulating hemoglobin level determines Epo production which in turn stimulates erythropoietic activity. The disruption of the expected feedback mechanism of Epo production leads to an inadequately low s-Epo. The definition of inadequate Epo response to anemia relies on the documentation of a downregulated dependence of s-Epo on Hb with respect to the same dependence in patients with a physiologically regulated erythropoiesis. Literature reports a wide range of so called adequate s-Epo response to anemia and a number of criteria for judging on the adequateness of s-Epo at a certain degree of anemia. The O/P (observed/predicted) ratio allows categorization of each individual patient. The clinical syndromes in which an inadequate Epo response has been reported are numerous and the mechanisms of defective Epo production are different. A number of evidences clearly point to a relation between responsiveness to r-Hu-Epo and inadequate Epo response. This inequivocabily confirms the role inadequate Epo response plays in the pathogenesis of anemia.
一种用于测定血清促红细胞生成素（s-Epo）的特异性和灵敏性免疫测定方法的开发，有助于提高我们对体内红细胞生成调节模型的理解。在大多数贫血中，循环血红蛋白水平决定促红细胞生成素的产生，而促红细胞生成素又反过来刺激红细胞生成活性。促红细胞生成素产生的预期反馈机制的破坏会导致s-Epo水平过低。对贫血的促红细胞生成素反应不足的定义依赖于记录s-Epo对血红蛋白的下调依赖性，相对于生理调节红细胞生成的患者中的相同依赖性。文献报道了对贫血的多种所谓适当的s-Epo反应以及在一定程度贫血时判断s-Epo适当性的一些标准。观察值/预测值（O/P）比率允许对每个患者进行分类。已报道促红细胞生成素反应不足的临床综合征众多，促红细胞生成素产生缺陷的机制也不同。许多证据清楚地表明对重组人促红细胞生成素（r-Hu-Epo）的反应性与促红细胞生成素反应不足之间存在关联。这明确证实了促红细胞生成素反应不足在贫血发病机制中所起的作用。
