title: Effects of recombinant human erythropoietin in normal humans.
abstract: This review describes some of the physiological effects of recombinant human erythropoietin (EPO) in healthy humans. At the blood level EPO increases the arterial O(2) content not only by increasing red blood cell volume, but also by an equally important decrease in plasma volume. Well before that, EPO causes a prompt decrease in plasma levels of renin and aldosterone. Renal clearance studies suggest that EPO decreases renal proximal tubular reabsorption rate leading to activation of the tubuloglomerular feedback mechanism and a fall in glomerular filtration rate. Thus, treatment with EPO may result in suppression of endogenous EPO production through a decrease in intrarenal oxygen consumption. EPO elevates the arterial blood pressure even in healthy subjects. The receptor for EPO is present in many tissues. However, the functional effects of EPO in the skeletal muscle seem limited, and although it has been speculated that non-erythropoietic effects of EPO (angiogenesis, shift in muscle fibre types, cognitive effects) may be responsible for the increase in exercise performance, this has not been confirmed. EPO-induced haemodynamic effects call for careful monitoring during the administration period. The metabolic, hormonal and renal effects of EPO do not seem to range beyond physiologically acceptable limits and are reversible. Taken together, EPO seems safe to use for experimental purposes in healthy volunteers.
authors.affiliation: Center for Integrative Human Physiology, University of Zurich, Institute of Physiology, Room 23 H 6, Winterthurerstr. 190, 8057 Zürich, Switzerland. carsten.lundby@access.uzh.ch
authors.forename: Carsten
authors.initials: C
authors.lastname: Lundby
authors.forename: Niels Vidiendal
authors.initials: NV
authors.lastname: Olsen
mesh_terms: D000818:Animals; D048429:Cell Size / Q000187:drug effects; D004912:Erythrocytes / Q000166:cytology / Q000187:drug effects / Q000502:physiology*; D004920:Erythropoiesis / Q000187:drug effects / Q000502:physiology; D004921:Erythropoietin / Q000494:pharmacology* / Q000502:physiology*; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology*; D006454:Hemoglobins / Q000096:biosynthesis; D006801:Humans; D018482:Muscle, Skeletal / Q000187:drug effects / Q000502:physiology*; D010953:Plasma Volume / Q000187:drug effects / Q000502:physiology
chemical_list: D006454:Hemoglobins; D004921:Erythropoietin
references.citation: Stroke. 2009 Dec;40(12):e647-56
references.pmid: 19834012
references.citation: Psychopharmacology (Berl). 2009 Nov;207(1):133-42
references.pmid: 19705104
references.citation: J Am Soc Nephrol. 2005 Apr;16(4):892-8
references.pmid: 15728783
references.citation: Clin J Am Soc Nephrol. 2009 Feb;4(2):470-80
references.pmid: 19218474
references.citation: Kidney Int. 1991 Feb;39(2):259-65
references.pmid: 2002640
references.citation: Blood. 2010 May 27;115(21):4264-72
references.pmid: 20124513
references.citation: J Physiol. 2007 Jan 1;578(Pt 1):309-14
references.pmid: 17095558
references.citation: Mol Psychiatry. 2007 Feb;12(2):206-20
references.pmid: 17033631
references.citation: Lancet. 2007 Feb 3;369(9559):381-8
references.pmid: 17276778
references.citation: N Engl J Med. 1999 Sep 16;341(12):913-5
references.pmid: 10486426
references.citation: PLoS One. 2009 Jun 12;4(6):e5894
references.pmid: 19521513
references.citation: Pflugers Arch. 2003 Nov;447(2):231-8
references.pmid: 14551773
references.citation: Blood. 2009 Jun 25;113(26):6707-15
references.pmid: 19264680
references.citation: Eur J Appl Physiol. 2002 Mar;86(5):442-9
references.pmid: 11882931
references.citation: Anal Biochem. 2002 Dec 15;311(2):119-26
references.pmid: 12470670
references.citation: Nephrol Dial Transplant. 1997 May;12(5):924-32
references.pmid: 9175044
references.citation: J Appl Physiol (1985). 2010 Aug;109(2):476-83
references.pmid: 20522733
references.citation: Am J Obstet Gynecol. 2003 Apr;188(4):993-6
references.pmid: 12712099
references.citation: Eur J Appl Physiol. 2007 Dec;102(1):41-4
references.pmid: 17882450
references.citation: J Intern Med. 1991 Feb;229(2):125-30
references.pmid: 1997637
references.citation: Exp Brain Res. 2008 Jan;184(3):313-21
references.pmid: 17828390
references.citation: Haematologica. 2000 Jun;85(6):564-72
references.pmid: 10870111
references.citation: Am J Physiol. 1991 Nov;261(5 Pt 2):F880-9
references.pmid: 1951720
references.citation: Med Sci Sports Exerc. 1999 May;31(5):639-45
references.pmid: 10331881
references.citation: Nephrol Dial Transplant. 1998 May;13(5):1200-5
references.pmid: 9623554
references.citation: J Investig Med. 2009 Jun;57(5):650-4
references.pmid: 19491629
references.citation: Nephrol Dial Transplant. 1993;8(1):93
references.pmid: 8381946
references.citation: Eur J Haematol. 2007 Mar;78(3):183-205
references.pmid: 17253966
references.citation: J Appl Physiol (1985). 2008 Aug;105(2):417-9
references.pmid: 18583375
references.citation: Hypertension. 1999 Mar;33(3):894-9
references.pmid: 10082505
references.citation: Kidney Int. 1996 Oct;50(4):1255-61
references.pmid: 8887285
references.citation: Kidney Int. 2001 Jul;60(1):83-6
references.pmid: 11422739
references.citation: Scand J Med Sci Sports. 2006 Feb;16(1):35-40
references.pmid: 16430679
references.citation: Am J Physiol. 1995 Mar;268(3 Pt 2):F455-60
references.pmid: 7900845
references.citation: Eur J Appl Physiol. 2007 Nov;101(4):481-6
references.pmid: 17668232
references.citation: Med Sci Sports Exerc. 2000 Jul;32(7):1238-43
references.pmid: 10912888
references.citation: Pflugers Arch. 2000 Apr;439(6):838-44
references.pmid: 10784360
references.citation: N Engl J Med. 2009 Nov 19;361(21):2019-32
references.pmid: 19880844
references.citation: Eur J Endocrinol. 2009 Sep;161(3):427-34
references.pmid: 19515792
references.citation: PLoS One. 2008 Aug 20;3(8):e2996
references.pmid: 18714372
references.citation: Am J Med Sci. 2007 Jul;334(1):65-71
references.pmid: 17630596
references.citation: J Appl Physiol (1985). 2008 Apr;104(4):1154-60
references.pmid: 18218911
references.citation: J Sports Sci. 2006 Apr;24(4):383-91
references.pmid: 16492602
references.citation: Adv Exp Med Biol. 2003;543:73-87
references.pmid: 14713115
references.citation: Am J Nephrol. 1996;16(4):304-8
references.pmid: 8739283
references.citation: Blood. 2007 Jun 1;109(11):4724-31
references.pmid: 17311997
references.citation: Curr Opin Oncol. 2010 Jul;22(4):307-11
references.pmid: 20498598
references.citation: J Physiol. 2011 Mar 15;589(Pt 6):1273-81
references.pmid: 20724370
references.citation: J Physiol. 2005 Oct 15;568(Pt 2):639-52
references.pmid: 16081477
references.citation: Am J Hypertens. 1990 Jan;3(1):76-80
references.pmid: 2405885
references.citation: J Appl Physiol (1985). 2008 Aug;105(2):581-7
references.pmid: 18535134
references.citation: Br J Clin Pharmacol. 1992 Oct;34(4):363-5
references.pmid: 1457271