tailieunhanh - Báo cáo y học: "Science review: Recombinant human erythropoietin in critical illness: a role beyond anemia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Science review: Recombinant human erythropoietin in critical illness: a role beyond anemia? | Available online http content 8 5 337 Review Science review Recombinant human erythropoietin in critical illness a role beyond anemia Thomas Coleman1 and Michael Brines2 Member The Kenneth S Warren Institute Kitchawan New York USA 2Senior Member The Kenneth S Warren Institute Kitchawan New York USA Corresponding author Thomas Coleman tcoleman@ Published online 16 June 2004 This article is online at http content 8 5 337 2004 BioMed Central Ltd See Commentary page 325 Critical Care 2004 8 337-341 DOI cc2897 Abstract Erythropoiesis usually fails during severe illness because of a blunting of the kidney-erythropoietin EPO -bone marrow axis. In this setting clinical studies have shown that recombinant human erythropoietin rhEPO administered in pharmacological amounts significantly reduces the need for blood transfusions. In addition to the kidney however EPO is also produced locally by other tissues in a paracrine-autocrine manner. Here similar to its role in the bone marrow EPO rescues cells from apoptosis. Additionally EPO reduces inflammatory responses restores vascular autoregulation and promotes healing. The results of many studies including a phase II clinical trial in ischemic stroke demonstrate that rhEPO protects the brain spinal cord retina heart and kidney from ischemic and other types of injury. Although rhEPO is efficacious in the treatment of EPO-deficient anemia during illness inadequate effort has been devoted to determining whether direct tissue protection might also result from its administration. Here we speculate on the potential utility of EPO as a protective cytokine in the context of acute critical illness and suggest key parameters required for a proof-of-concept clinical study. Keywords apoptosis clinical study critical illness cytokine erythropoietin Introduction Erythropoietin EPO a member of the type I cytokine superfamily was first identified as the hormone that stimulates erythroid progenitors within