Abstract

ALMEIDA, Filipa; SANTOS, Sofia  and  BEIRAO, Idalina. Regulation of erythropoietin production and recent trends in anaemia therapy. Port J Nephrol Hypert [online]. 2015, vol.29, n.2, pp.113-122. ISSN 0872-0169.

About 30 years ago, the treatment of chronic renal disease anaemia was revolutionized by the introduction of recombinant human erythropoietin, which reduced the need for blood transfusions. In spite of this huge advance, the first recombinant human erythropoietin has a relatively short half-life and needs to be administered two to three times per week. Subsequently, other molecules were developed, such as darbepoetin alfa, continuous erythropoietin receptor activator (CERA) and peginesatide, with longer half-life, but the route of administration still remains a problem. Erythropoietin has an action that exceeds erythropoiesis and plays an important role in cell protection. Based on knowledge of the molecular mechanisms that control erythropoiesis, namely the regulation of EPO gene expression, through HIF system, GATA-2 and NF-kB, several upcoming therapeutic agents and strategies for stimulating and treating anaemia emerged. The main effort in developing these treatments is to achieve other routes of administration, more convenient for the patient, such as oral therapy, not disregarding an easier production, storage and frequency of administration. Some of them are still in laboratory phase and others already in clinical trials phase II or III. In this work, based on a literature search of studies using MEDLINE, our objective is to review the regulation of erythropoietin production and its functions, as well as treatment approach for anaemia of chronic kidney disease, with particular focus on new therapies

Keywords : Anaemia; erythropoietin; GATA-2 inhibitors; hepcidin; hypoxia-inducible factors; kidney disease.

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