Recombinant human erythropoietin rhuEPO

Erythropoietin, a 34-39 kDA glycoprotein, was the first human hematopoietic growth factor to be isolated. It was originally purified from the urine of patients with severe anemia. Recombinant human erythropoietin (rHuEpo, epoetin alfa) is produced in a mammalian cell expression system... 

Recombinant human erythropoietin (rHuEpo) may increase the risk of thrombosis (201). It has been reported that patients with carcinoma of the cervix who received chemotherapy and rHuEpo have an increased risk of symptomatic venous thrombosis (201). In clinical trials where the maintenance hematocrit was 3% on PROCRIT clotting of the arteriovenous shunts occurred at an annual rate of about 0.25 events per patient per year. However, other thrombotic conditions such as cerebrovascular events, transient ischemic attacks, myocardial infarction, or pulmonary embolism occurred at a rate of 0,04 events per patient per year (202). In a separate study of I, I I I untreated patients on hemodialysis, clotting of arteriovenous shunts occurred at a rate of 0.5 events per patient per year. In patients with chronic renal failure on hemodialysis who also had congestive heart failure, ischemic heart disease and venous thrombosis were increased in patients who were treated with PROCRIT targeted to a hematocrit level of 42 3% compared to those targeted to 30 3% (202). It has also been reported... 

Adamson JW, Eschbach JW. The use of recombinant human erythropoietin (rHuEpo) in humans. Cancer Surv 1990 9(l) 157-67. 

Rendo P, Freigeiro D, Barboni G, Donato H, Drelichman G, Gonzalez F. A multicenter, randomized, double-blind trial with recombinant human erythropoietin (rhuEPO) in anemic HIV-infected children treated with antiretrovirals. Int J Pediatr Hematol Oncol 2001 7 235-9. 

Buemi M, Aloisi C, Cavallaro E, et al. (2002). Recombinant human erythropoietin (rHuEPO) More than just the correction of uremic anemia. /. Nephrol. 15(2) 97-103. 

Anemia Treatments. Anemia is an independent predictor of mortality in chronic kidney disease patients and is also associated with worsening of cardiovascular morbidity and accelerated rate of kidney damage. The administration of recombinant human erythropoietin (rHuEpo) has greatly reduced anemia in patients with chronic kidney disease. 

Abbreviations rhuEPO, recombinant human erythropoietin NESP, novel erythropoiesis stimulating protein derived from genetic modification of rhuEPO to create two additional N-linked gylcosylation sites. 

Human recombinant erythropoietin shows promise in resolving the refractory anemia of chronic disease associated with stage IV pressure ulcers, and further study is suggested. The results may also suggest that rHuEPO acts as a growth factor either alone or in conjunction with intrinsic factors in the wound. Studies of its role at the molecular level are indicated. Further studies of the neurotrophic and neuroprotective properties observed in rat models hold promise in the area of spinal cord injury research. 

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