Overview of the literature related to Erythropoietin 1/1990. [antikvár]

INTRODUCTION C.G. Winearls Consultant Nephrologist, Renal Unit, Churchill Hospitál, Headington, Oxford OX3 7LJ, Í/X. The advent of recombinant humán erythropoietin (rHuEPO) has stimulated a remarkable increase in the amount of research, not only into its clinical use, but alsó into the physiology of this hormoné. This research has of course been accompanied by a large volume of publications in diverse journals; this yearbook is particularly welcome as it provides an index of the major publications in the field in the last year. Erythropoietin assays The ready availability of pure EPO (albeit recombinant) has made radio-immunoassay of native erythropoietin more widely available. It remains to be seen whether such assays will be useful in clinical practice. In patients with renal failure there is only a poor correlation between the level of EPO and the degree of anaemia, so measurement will not be needed to decide if treatment should be started. Detailed pharmacokinetic studies of administration of r-HuEPO i.v., s.c., and i.p. have now been published, and reveal marked differences in bio-availability. The stability of the hormoné in vivo has been shown to be dependent on the carbohydrate side-chains. So far, comparisons of the s.c. and i.v. routes suggest that they are similar in terms of clinical effect. Assays of EPO are providing interesting insights into the haemoglobin-EPO feedback loop in renal transplant patients and show that the concentrations reached are weil below those achieved by therapeutic administration of r-HuEPO i.v.