Erythropoietin: novel approaches to neuroprotection in human brain disease.
With the increased life expectancy in western industrialized countries, the incidence and prevalence of brain diseases dramatically increased. Stroke and a wide spectrum of neuropsychiatric illnesses such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, traumatic head injury, and schizophrenia all lead to severe disability. However, targeted effective therapies for treatment of these diseases are lacking. Even more frustrating is the fact that we do not yet clearly understand the basic mechanisms underlying the disease processes in these conditions. We propose a hypothesis of loss of neuronal function via a final common deleterious pathway in this clinically very heterogeneous disease group. This review presents a novel neuroprotective concept for treatment of brain disease: Erythropoietin (EPO). EPO is a natural body-own-protein hormone that has been used for treatment of anemia for more than a decade. The neuroprotective approach using EPO in brain disease represents a totally new frontier. The "Göttingen EPO-stroke trial" represents the first effective use in man of a neuroprotective therapy in an acute brain disease while the experimental EPO therapy to combat cognitive decline in patients with schizophrenia will be introduced as an example of a neuroprotective strategy for a chronic brain disease.
Ehrenreich
Hannelore
H
Clinical Neuroscience Laboratory, Max-Planck-Institute for Experimental Medicine, Göttingen, Germany. ehrenreich@em.mpg.de
Aust
Carlotta
C
Krampe
Henning
H
Jahn
Henriette
H
Jacob
Sonja
S
Herrmann
Manfred
M
Sirén
Anna-Leena
AL
D000818:Animals; D001927:Brain Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D002986:Clinical Trials as Topic; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009410:Nerve Degeneration / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D012038:Regeneration / Q000187:drug effects / Q000502:physiology; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology; D020521:Stroke / Q000188:drug therapy / Q000503:physiopathology
D018696:Neuroprotective Agents; D004921:Erythropoietin