Erythropoietin

Erythropoietin is a haemopoietic glycoprotein growth factor derived from a single gene on chromosome seven which is expressed in cells of the renal cortex. Some 10% is produced by the liver by unknown cells; this amount is not enough for normal functioning. Its key action is to control erythropoiesis.

Normally erythropoietin is produced as a result hypoxia detected by an oxygen sensor; it then acts back on an effector receptor. There is normally a rise in levels in anaemia.

Recombinant erythropoietin is clinically useful in a range of conditions including chronic renal failure. It must be grown in mammalian cell lines so that proper glycosylation can occur.

Notes:

• there are concerns about using erythopoietin in patients with cancer:
  • study evidence revealed that erythropoiesis-stimulating agent administration to patients with cancer is associated with increased risks of venous thromboembolism (VTE) and mortality (1)

Reference:

• 1. Bennett CL et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA. 2008 Feb 27;299(8):914-24