Androgens and erythropoiesis: past and present.
Association between androgens and erythropoiesis has been known for more than seven decades. Androgens stimulate hematopoietic system by various mechanisms. These include stimulation of erythropoietin release, increasing bone marrow activity and iron incorporation into the red cells. Before the discovery of recombinant erythropoietin (rhEpo), androgens were used in the treatment of anemia associated with renal disease, bone marrow suppression, and hypopituitarism. Anabolism is an additional advantage of androgen therapy. Furthermore, in light of recent reports regarding adverse effects of rhEpo, the role of androgen therapy in various types of anemias should be readdressed. Polycythemia remains a known side effect of androgen therapy. In this review, we will briefly discuss the initial animal and human studies which demonstrated the role of androgens in the treatment of anemia, their mechanism of action, a detailed account of the efficacy of androgens in the treatment of various anemias, the erythropoietic side effects of androgens and finally, the relationship between hematocrit levels and cardiovascular disease.
Shahani
S
S
Division of Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA.
Braga-Basaria
M
M
Maggio
M
M
Basaria
S
S
D000375:Aging / Q000502:physiology; D000728:Androgens / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000740:Anemia / Q000188:drug therapy; D000741:Anemia, Aplastic / Q000188:drug therapy; D000818:Animals; D001853:Bone Marrow / Q000187:drug effects; D003327:Coronary Disease / Q000139:chemically induced; D004912:Erythrocytes / Q000378:metabolism; D004920:Erythropoiesis / Q000187:drug effects* / Q000502:physiology; D004921:Erythropoietin / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000188:drug therapy; D008297:Male
D000728:Androgens; D004921:Erythropoietin; D007501:Iron