Cytoprotective doses of erythropoietin or carbamylated erythropoietin have markedly different procoagulant and activities

Thomas R. Coleman, Christof Westenfelder, Florian E. Tögel, Ying Yang, Zhuma Hu, LeAnne Swenson, Henri G D Leuvenink, Rutger J. Ploeg, Livius V. D'Uscio, Zvonimir S Katusic, Pietro Ghezzi, Adriana Zanetti, Kenneth Kaushansky, Norma E. Fox, Anthony Cerami, Michael Brines

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Recombinant human erythropoietin (rhEPO) is receiving increasing attention as a potential therapy for prevention of injury and restoration of function in nonhematopoietic tissues. However, the minimum effective dose required to mimic and augment these normal paracrine functions of erythropoietin (EPO) in some organs (e.g., the brain) is higher than for treatment of anemia. Notably, a dose-dependent risk of adverse effects has been associated with rhEPO administration, especially in high-risk groups, including polycythemia- hyperviscosity syndrome, hypertension, and vascular thrombosis. Of note, several clinical trials employing relatively high dosages of rhEPO in oncology patients were recently halted after an increase in mortality and morbidity, primarily because of thrombotic events. We recently identified a heteromeric EPO receptor complex that mediates tissue protection and is distinct from the homodimeric receptor responsible for the support of erythropoiesis. Moreover, we developed receptor-selective ligands that provide tools to assess which receptor isoform mediates which biological consequence of rhEPO therapy. Here, we demonstrate that rhEPO administration in the rat increases systemic blood pressure, reduces regional renal blood flow, and increases platelet counts and procoagulant activities. In contrast, carbamylated rhEPO, a heteromeric receptor-specific ligand that is fully tissue protective, increases renal blood flow, promotes sodium excretion, reduces injury-induced elevation in procoagulant activity, and does not effect platelet production. These preclinical findings suggest that nonerythropoietic tissue-protective ligands, which appear to elicit fewer adverse effects, may be especially useful in clinical settings for tissue protection.

Original languageEnglish (US)
Pages (from-to)5965-5970
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume103
Issue number15
DOIs
StatePublished - Apr 11 2006

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Erythropoietin
Renal Circulation
Ligands
Erythropoietin Receptors
Polycythemia
Erythropoiesis
Regional Blood Flow
Wounds and Injuries
carbamylated erythropoietin
Platelet Count
Blood Vessels
Anemia
Protein Isoforms
Thrombosis
Therapeutics
Blood Platelets
Sodium
Clinical Trials
Blood Pressure
Hypertension

Keywords

  • β common receptor
  • Cytokine
  • Hypertension
  • Thrombosis
  • Tissue protection

ASJC Scopus subject areas

  • Genetics
  • General

Cite this

Cytoprotective doses of erythropoietin or carbamylated erythropoietin have markedly different procoagulant and activities. / Coleman, Thomas R.; Westenfelder, Christof; Tögel, Florian E.; Yang, Ying; Hu, Zhuma; Swenson, LeAnne; Leuvenink, Henri G D; Ploeg, Rutger J.; D'Uscio, Livius V.; Katusic, Zvonimir S; Ghezzi, Pietro; Zanetti, Adriana; Kaushansky, Kenneth; Fox, Norma E.; Cerami, Anthony; Brines, Michael.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 103, No. 15, 11.04.2006, p. 5965-5970.

Research output: Contribution to journalArticle

Coleman, TR, Westenfelder, C, Tögel, FE, Yang, Y, Hu, Z, Swenson, L, Leuvenink, HGD, Ploeg, RJ, D'Uscio, LV, Katusic, ZS, Ghezzi, P, Zanetti, A, Kaushansky, K, Fox, NE, Cerami, A & Brines, M 2006, 'Cytoprotective doses of erythropoietin or carbamylated erythropoietin have markedly different procoagulant and activities', Proceedings of the National Academy of Sciences of the United States of America, vol. 103, no. 15, pp. 5965-5970. https://doi.org/10.1073/pnas.0601377103
Coleman, Thomas R. ; Westenfelder, Christof ; Tögel, Florian E. ; Yang, Ying ; Hu, Zhuma ; Swenson, LeAnne ; Leuvenink, Henri G D ; Ploeg, Rutger J. ; D'Uscio, Livius V. ; Katusic, Zvonimir S ; Ghezzi, Pietro ; Zanetti, Adriana ; Kaushansky, Kenneth ; Fox, Norma E. ; Cerami, Anthony ; Brines, Michael. / Cytoprotective doses of erythropoietin or carbamylated erythropoietin have markedly different procoagulant and activities. In: Proceedings of the National Academy of Sciences of the United States of America. 2006 ; Vol. 103, No. 15. pp. 5965-5970.
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AU - Yang, Ying

AU - Hu, Zhuma

AU - Swenson, LeAnne

AU - Leuvenink, Henri G D

AU - Ploeg, Rutger J.

AU - D'Uscio, Livius V.

AU - Katusic, Zvonimir S

AU - Ghezzi, Pietro

AU - Zanetti, Adriana

AU - Kaushansky, Kenneth

AU - Fox, Norma E.

AU - Cerami, Anthony

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