Down with the erythropoietin. Long live the erythropoietin!
In recent years the use of erythropoietin has exploded, and the anaemia of patients with chronic renal failure has been practically resolved with the administration of rHuEpo (recombinant human, Erythropoietin). However, as a result of an intense commercial campaign, strong therapies with this growth hormone, prescribed to achieve surprising sporting performances, got athletes to run the risk of thrombosis and vascular accidents because of red blood cells increase. Erythropoietin represents a significant subject of research. In fact, besides the ability of stimulating erythrocyte production, it has many pleiotropic effects. Several studies allow the assertion that EPO, in different concentrations, has protective effects mainly on central nervous system and cardiovascular system through various mechanisms, among which a key role seems to be held by the ability to stimulate angiogenesis. The consequent problem is that anaemia therapy with rHuEpo in patients with cancer may accelerate the progression of neoplastic disease by promoting tumour angiogenesis and, thus, metastasization. The study of angiogenic process in tumours led to the synthesis of drugs that, blocking VEGF, exert an anti-angiogenic action, contrasting cancer spread. However, benefits are relatively modest. Is erythropoietin perhaps the further angiogenic hormone to block in tumour pathology? Therefore, Epo plays a role in Regenerative Medicine since it intervenes in a persistent natural regenerative activity of humans: angiogenesis. The understanding of the regeneration mechanisms of complex structures in the adult salamander has opened original lines of research. Regenerative Medicine tries to develop therapeutic pathways through the stimulation of natural regenerative processes in humans.
Chair of Nephrology, Department of Internal Medicine, University of Messina. Messina, Italy. buemim@unime.it
Michele
M
Buemi
Antonio
A
Lacquaniti
Davide
D
Bolignano
Valeria
V
Cernaro
Susanna
S
Campo
Giovanni
G
Grasso
Antoine
A
Buemi
Valentina
V
Donato
Alessio
A
Sturiale
D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D043925:Angiogenesis Inducing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000818:Animals; D054874:Athletic Performance; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D011994:Recombinant Proteins; D044968:Regenerative Medicine / Q000379:methods*; D014562:Caudata
D043925:Angiogenesis Inducing Agents; D011994:Recombinant Proteins; D004921:Erythropoietin