Erythropoietin production by macrophages in the regenerating liver

JAK-STAT pathway in carcinogenesis: Is it relevant to cholangiocarcinoma progression

The features of JAK-STAT signaling in liver cells are discussed in the current review. The role of this signaling cascade in carcinogenesis is accentuated. The possible involvement of this pathway and alteration of its elements are compared for normal cholangiocytes, cholangiocarcinoma predisposition and development. Prolactin and interleukin-6 are described in detail as the best studied examples. In addition, the non-classical nuclear translocation of cytokine receptors is discussed in terms of its possible implication to cholangiocarcinoma development.

Response to repeated phlebotomies in patients with non-insulin-dependent diabetes mellitus

Regardless of type, uncontrolled diabetes represents a serious disruption of fuel homeostasis with consequences throughout the body. This may hamper the applicability of predeposited autologous blood transfusion in diabetic patients because metabolic changes are expected as a consequence of repeated bleeding. We undertook this study to determine whether the presence of non-insulin-dependent diabetes mellitus (NIDDM) influences the erythropoietin (EPO) response to repeated phlebotomies with respect to normal subjects. We included 22 consecutive patients scheduled for major surgery during a 2-year period in which clinical and metabolic complications were excluded and renal and liver function was considered unaffected. Selected biochemical and hematologic variables were serially measured during donation of several units of blood in a 12- to 29-day period. Bleeding produced a significant decrease in serum glucose, cholesterol, triglyceride, and apoprotein B concentration in diabetic patients. Except for glucose, this effect was not observed in controls. Both groups were comparable with respect to initial hemoglobin concentrations and all hematologic variables measured. The decrease in hemoglobin concentration did not produce clinical symptoms in these patients, and recovery was regarded as normal in both groups. Serum EPO levels in diabetic patients were negatively influenced by the initial hemoglobin A1c (HbA1c) proportion. Moreover, three nonrespondent diabetic patients with poor glycemic control responded normally 6 to 13 months later, in a second operation, when glycemic control had improved significantly. In conclusion, NIDDM may limit the donation of requested units for major surgery only if poor glycemic control is present. When possible, phlebotomies should be delayed and metabolic control reinforced.

Hematopoietic growth factors: overview and clinical applications, Part II

The growth and differentiation of blood cells is regulated by a group of at least 12 glycoproteins, collectively known as hematopoietic growth factors. Advances in protein biochemistry and molecular genetics have provided the tools for the bulk production of these hormones for clinical application. Clinical trials of macrophage colony-stimulating factor, granulocyte macrophage colony-stimulating factor, granulocyte colony-stimulating factor, and interleukin-3 have all demonstrated significant effects on the peripheral blood counts of the recipients. The clinical usefulness of at least two of these agents in ameliorating post-chemotherapy myelosuppression, in the treatment of other cytopenias, and in enhancing engraftment after bone marrow transplantation has already been demonstrated. Potential applications to the therapy and diagnosis of other clinical disorders is under study. The history of the elucidation of these growth factors, our current understanding of their properties, interactions, and clinical effects, and the potential prospects for their future use in the manipulation of human blood cell production are the subject of this review.

The regulated expression of erythropoietin by two human hepatoma cell lines

The development of a cell culture system that produces erythropoietin (Epo) in a regulated manner has been the focus of much effort. We have screened multiple renal and hepatic cell lines (including MDCK, LLC-PK1, BHK, WRL 68, CLCL, A704, CRFK, A498, ACHN, TCMK-1, LLC-MK2, CaKi-2, HepG2, and Hep3B) for either constitutive or regulated expression of Epo. Only the human hepatoma cell lines, Hep3B and HepG2, made significant amounts of Epo as measured both by radioimmunoassay and in vitro bioassay (as much as 330 milliunits per 10(6) cells in 24 hr). The constitutive production of Epo increased dramatically as a function of cell density in both cell lines. At cell densities less than 3.3 X 10(5) cells per cm2, there was little constitutive release of Epo in the medium (less than 30 milliunits per 10(6) cells in 24 hr). With Hep3B cells grown at low cell densities, a mean 18-fold increase in Epo expression was seen in response to hypoxia and a 6-fold increase was observed in response to incubation in medium containing 50 microM cobalt(II) chloride. At similar low cell densities, Epo production in HepG2 cells could be enhanced an average of about 3-fold by stimulation with either hypoxia or cobalt(II) chloride. Upon such stimulation, both cell lines demonstrated markedly elevated levels of Epo mRNA. Hence, both Hep3B and HepG2 cell lines provide an excellent in vitro system in which to study the physiological regulation of Epo expression.