Erythropoietin in stroke: quo vadis.
BACKGROUND
Recombinant erythropoietin (rEPO) failed in a recent clinical study to protect from damages induced by ischemic stroke. The lack of acute treatments in ischemic stroke and the promising outcome in numerous preclinical studies in vivo demands a more critical evaluation of the future use of EPO as an acute treatment.


METHODS
The current use and administration of rhEPO and its analogs in animal models and the future use of this cytokine in the treatment of ischemic stroke.


RESULTS
In this review the potential reasons for the failure of EPO in the clinical trial are analysed and whether the preclinical trials sufficiently evaluated the true potential of recombinant EPO and its analogs is assessed. Alternative methods for administration of EPO to enhance its potential as a neuroprotective drug in ischemic stroke are discussed.


CONCLUSIONS
Failure in clinical trial does not necessarily indicate the lack of therapeutic potential of EPO. This review encourages further investigation of the true potential of EPO as a candidate drug for the treatment of ischemic stroke by improved preclinical experimental design and utilization of alternative administration methods.
Digicaylioglu
Murat
M
Department of Neurosurgery and Physiology, University of Texas, Health Science Center, 7703 Floyd Curl Drive-7843, San Antonio, TX 78229-3900, USA. muratd@uthscsa.edu
D000281:Administration, Intranasal; D000818:Animals; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy; D016503:Drug Delivery Systems; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007276:Injections, Intraventricular; D053758:Nanoparticles; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011994:Recombinant Proteins; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology
D018696:Neuroprotective Agents; D011994:Recombinant Proteins; D004921:Erythropoietin