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Drummer DJ, McNiff JL, Howard EE, Gwin JA, Carrigan CT, Murphy NE, Wilson MA, Michalak J, Ryan BJ, McClung JP, Pasiakos SM, Margolis LM. Exogenous erythropoietin increases hematological status, fat oxidation, and aerobic performance in males following prolonged strenuous training. Physiol Rep 2024; 12:e16038. [PMID: 38757249 PMCID: PMC11099744 DOI: 10.14814/phy2.16038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
This study investigated the effects of EPO on hemoglobin (Hgb) and hematocrit (Hct), time trial (TT) performance, substrate oxidation, and skeletal muscle phenotype throughout 28 days of strenuous exercise. Eight males completed this longitudinal controlled exercise and feeding study using EPO (50 IU/kg body mass) 3×/week for 28 days. Hgb, Hct, and TT performance were assessed PRE and on Days 7, 14, 21, and 27 of EPO. Rested/fasted muscle obtained PRE and POST EPO were analyzed for gene expression, protein signaling, fiber type, and capillarization. Substrate oxidation and glucose turnover were assessed during 90-min of treadmill load carriage (LC; 30% body mass; 55 ± 5% V̇O2peak) exercise using indirect calorimetry, and 6-6-[2H2]-glucose PRE and POST. Hgb and Hct increased, and TT performance improved on Days 21 and 27 compared to PRE (p < 0.05). Energy expenditure, fat oxidation, and metabolic clearance rate during LC increased (p < 0.05) from PRE to POST. Myofiber type, protein markers of mitochondrial biogenesis, and capillarization were unchanged PRE to POST. Transcriptional regulation of mitochondrial activity and fat metabolism increased from PRE to POST (p < 0.05). These data indicate EPO administration during 28 days of strenuous exercise can enhance aerobic performance through improved oxygen carrying capacity, whole-body and skeletal muscle fat metabolism.
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Affiliation(s)
- Devin J. Drummer
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
- Oak Ridge Institute for Science and EducationBelcampMarylandUSA
| | - Julie L. McNiff
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
- Combat Feeding DivisionU.S. Army Combat Capabilities Development Command (DEVCOM)NatickMassachusettsUSA
| | - Emily E. Howard
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Jess A. Gwin
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Christopher T. Carrigan
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Nancy E. Murphy
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Marques A. Wilson
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Julia Michalak
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
- Oak Ridge Institute for Science and EducationBelcampMarylandUSA
| | - Benjamin J. Ryan
- Thermal and Mountain Medicine DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - James P. McClung
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Stefan M. Pasiakos
- Office of Dietary Supplements, National Institutes of HealthU.S. Department of Health and Human ServicesBethesdaMarylandUSA
| | - Lee M. Margolis
- Military Nutrition DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
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Robberechts R, Poffé C. Defining ketone supplementation: the evolving evidence for postexercise ketone supplementation to improve recovery and adaptation to exercise. Am J Physiol Cell Physiol 2024; 326:C143-C160. [PMID: 37982172 DOI: 10.1152/ajpcell.00485.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
Over the last decade, there has been a growing interest in the use of ketone supplements to improve athletic performance. These ketone supplements transiently elevate the concentrations of the ketone bodies acetoacetate (AcAc) and d-β-hydroxybutyrate (βHB) in the circulation. Early studies showed that ketone bodies can improve energetic efficiency in striated muscle compared with glucose oxidation and induce a glycogen-sparing effect during exercise. As such, most research has focused on the potential of ketone supplementation to improve athletic performance via ingestion of ketones immediately before or during exercise. However, subsequent studies generally observed no performance improvement, and particularly not under conditions that are relevant for most athletes. However, more and more studies are reporting beneficial effects when ketones are ingested after exercise. As such, the real potential of ketone supplementation may rather be in their ability to enhance postexercise recovery and training adaptations. For instance, recent studies observed that postexercise ketone supplementation (PEKS) blunts the development of overtraining symptoms, and improves sleep, muscle anabolic signaling, circulating erythropoietin levels, and skeletal muscle angiogenesis. In this review, we provide an overview of the current state-of-the-art about the impact of PEKS on aspects of exercise recovery and training adaptation, which is not only relevant for athletes but also in multiple clinical conditions. In addition, we highlight the underlying mechanisms by which PEKS may improve exercise recovery and training adaptation. This includes epigenetic effects, signaling via receptors, modulation of neurotransmitters, energy metabolism, and oxidative and anti-inflammatory pathways.
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Affiliation(s)
- Ruben Robberechts
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Chiel Poffé
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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Levine JK, Seixas JN, Ritter JM, Liew AY, Tansey CM. Effects of Exogenous Erythropoietin on Rabbit ( Oryctolagus cuniculus) Hematological and Biochemical Parameters. Comp Med 2023; 73:439-445. [PMID: 37967856 PMCID: PMC10752361 DOI: 10.30802/aalas-cm-22-000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 11/17/2023]
Abstract
Rabbits can develop anemia due to serial phlebotomy or secondary to induced disease states. This study evaluated the effects of a single injection and three consecutive injections of erythropoietin in rabbits at 150 IU/kg and 1,000 IU/kg in order to determine whether these dosages produce a sustained increase in hematocrit. Analysis of CBC and chemistry parameters showed significant elevation in hematocrit one week after administration of 1,000 IU/kg erythropoietin for three consecutive days. These results indicate that this dosage regimen can increase hematocrit in apparently healthy, nonanemic rabbits for one week.
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Affiliation(s)
| | | | - Jana M Ritter
- Infectious Disease Pathology Branch, Division of High-Consequence Pathogens and Pathology; and
| | - Amanda Y Liew
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Emery JM, Chicana B, Taglinao H, Ponce C, Donham C, Padmore H, Sebastian A, Trasti SL, Manilay JO. Vhl deletion in Dmp1 -expressing cells alters MEP metabolism and promotes stress erythropoiesis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.25.550559. [PMID: 37546957 PMCID: PMC10402046 DOI: 10.1101/2023.07.25.550559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
In recent years, general hypoxia-inducible factor (HIF)-prolyl hydroxylase (PHD) enzyme inhibitors have been developed for the treatment of anemia due to renal disease and osteoporosis. However, it remains a challenge to target the HIF signaling pathway without dysregulating the skeletal and hematopoietic system. Here, we examined the effects of Vhl deletion in bone by performing longitudinal analyses of Vhl cKO mice at 3, 6, 10, and 24 weeks of age, where at 10 and 24 weeks of age, high bone mass and splenomegaly are present. Using flow cytometry, we observed increased frequency (%) of CD71 lo TER119 hi FSC lo orthochromatophilic erythroblasts and reticulocytes in 10- and 24-week-old Vhl cKO bone marrow (BM), which correlated with elevated erythropoietin levels in the BM and increased number of red blood cells in circulation. The absolute numbers of myeloerythroid progenitors (MEPs) in the BM were significantly reduced at 24 weeks. Bulk RNA-Seq of the MEPs showed upregulation of Epas1 ( Hif1a) and Efnb2 ( Hif2a) in Vhl cKO MEPs, consistent with a response to hypoxia, and genes involved in erythrocyte development, actin filament organization, and response to glucose. Additionally, histological analysis of Vhl cKO spleens revealed red pulp hyperplasia and the presence of megakaryocytes, both of which are features of extramedullary hematopoiesis (EMH). EMH in the spleen was correlated with the presence of mature stress erythroid progenitors, suggesting that stress erythropoiesis is occurring to compensate for the BM microenvironmental irregularities. Our studies implicate that HIF-driven alterations in skeletal homeostasis can accelerate erythropoiesis. Key Points • Dysregulation of HIF signaling in Dmp1+ bone cells induces stress erythropoiesis.• Skeletal homeostasis modulates erythropoiesis.
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Knorr DY, Rodriguez Polo I, Pies HS, Schwedhelm-Domeyer N, Pauls S, Behr R, Heinrich R. The cytokine receptor CRLF3 is a human neuroprotective EV-3 (Epo) receptor. Front Mol Neurosci 2023; 16:1154509. [PMID: 37168680 PMCID: PMC10165946 DOI: 10.3389/fnmol.2023.1154509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/15/2023] [Indexed: 05/13/2023] Open
Abstract
The evolutionary conserved orphan cytokine receptor-like factor 3 (CRLF3) has been implicated in human disease, vertebrate hematopoiesis and insect neuroprotection. While its specific functions are elusive, experimental evidence points toward a general role in cell homeostasis. Erythropoietin (Epo) is a major regulator of vertebrate hematopoiesis and a general cytoprotective cytokine. Erythropoietic functions mediated by classical Epo receptor are understood in great detail whereas Epo-mediated cytoprotective mechanisms are more complex due to involvement of additional Epo receptors and a non-erythropoietic splice variant with selectivity for certain receptors. In the present study, we show that the human CRLF3 mediates neuroprotection upon activation with the natural Epo splice variant EV-3. We generated CRLF3 knock-out iPSC lines and differentiated them toward the neuronal lineage. While apoptotic death of rotenone-challenged wild type iPSC-derived neurons was prevented by EV-3, EV-3-mediated neuroprotection was absent in CRLF3 knock-out neurons. Rotenone-induced apoptosis and EV-3-mediated neuroprotection were associated with differential expression of pro-and anti-apoptotic genes. Our data characterize human CRLF3 as a receptor involved in Epo-mediated neuroprotection and identify CRLF3 as the first known receptor for EV-3.
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Affiliation(s)
- Debbra Y. Knorr
- Department of Cellular Neurobiology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg-August University Göttingen, Göttingen, Germany
- *Correspondence: Debbra Y. Knorr,
| | - Ignacio Rodriguez Polo
- Department of Developmental Biology, Göttingen Center for Molecular Biosciences, Georg-August University Göttingen, Göttingen, Germany
- Research Platform Degenerative Diseases, German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- Developmental Models Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Hanna S. Pies
- Department of Cellular Neurobiology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg-August University Göttingen, Göttingen, Germany
| | - Nicola Schwedhelm-Domeyer
- Department of Cellular Neurobiology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg-August University Göttingen, Göttingen, Germany
| | - Stephanie Pauls
- Department of Cellular Neurobiology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg-August University Göttingen, Göttingen, Germany
| | - Rüdiger Behr
- Research Platform Degenerative Diseases, German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Ralf Heinrich
- Department of Cellular Neurobiology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg-August University Göttingen, Göttingen, Germany
- Ralf Heinrich,
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Heldeweg MLA, Medina Feliz JX, Berend K. Altitude Pre-Acclimatization with an Erythropoiesis-Stimulating Agent. Eur J Case Rep Intern Med 2023; 10:003792. [PMID: 37051482 PMCID: PMC10084800 DOI: 10.12890/2023_003792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/02/2023] [Indexed: 04/14/2023] Open
Abstract
Introduction High altitude illness is a complication of rapid ascent above 2,500 m elevation. Ventilatory, circulatory and haematological adjustments, known as acclimatization, occur to maintain adequate delivery of oxygen. Although (non-)pharmaceutical strategies that modulate ventilation and circulation have long been accepted, the haematological approach has not. Case description This report describes the application of a comprehensive strategy, including prior pre-acclimatization using an erythropoiesis-stimulating agent (ESA), in two healthy subjects ascending from sea level to 6,268 m. Following ESA administration 30 days prior to ascent, the subjects had a cumulative haemoglobin rise of 7.1% and 11.9%, respectively. Both subjects experienced minimal symptoms during four incremental ascents to the final altitude and no adverse events occurred. Discussion This report has limited external validity, lacking both a sample size and controls, but can serve as practical exploration of the concept. Administration of an ESA may be a safe and useful pre-acclimatization strategy but cannot be recommended based on current evidence. More comprehensive research is needed. LEARNING POINTS High altitude illness (HAI) is a debilitating syndrome with potentially lethal consequences caused by ascent to a hypobaric atmosphere without acclimatization.Pharmacological strategies aimed at increasing oxygen delivery may be used to prevent and treat HAI.Administration of an erythropoiesis-stimulating agent may be a safe and useful pre-acclimatization strategy but cannot be recommended based on current evidence alone.
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Affiliation(s)
- Micah L A Heldeweg
- Department of Internal Medicine, Curaçao Medical Center, Willemstad, Curaçao
| | | | - Kenrick Berend
- Department of Internal Medicine, Curaçao Medical Center, Willemstad, Curaçao
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Arrebola-Moreno AL, Casuso RA, Bejder J, Bonne TC, Breenfeldt Andersen A, Aragón-Vela J, Nordsborg NB, Huertas JR. Does Hypoxia and Stress Erythropoiesis Compromise Cardiac Function in Healthy Adults? A Randomized Trial. SPORTS MEDICINE - OPEN 2022; 8:137. [PMID: 36334130 PMCID: PMC9637068 DOI: 10.1186/s40798-022-00531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate whether recombinant human erythropoietin (rHuEPO) injections during an altitude training camp impact heart function. METHODS Thirty (12 women) moderately trained subjects stayed at 2320 m altitude for 4 weeks while training. Subjects were randomized to placebo (isotonic saline) or rHuEPO (20 IU/kg body weight) i.v. injections. Transthoracic echocardiography imaging was acquired 3 days after arrival to altitude and prior to the first placebo or rHuEPO injection as well as one day after the last rHuEPO injection three weeks later. RESULTS rHuEPO did not alter cardiovascular morphology parameters, systolic or diastolic function. In the placebo group, altitude exposure improved left ventricle (LV) systolic function due to an increased twist angle but rHuEPO had no additional effects. Pulmonary arterial systolic pressure was unaffected in either group. Notably, rHuEPO hampered LV untwist rate without affecting LV early filling. CONCLUSION rHuEPO provided during mild altitude exposure does not cause any major effects on heart function. The observed alteration in LV untwist induced by rHuEPO is unlikely to have a meaningful clinical effect. Trial Registration Registered on www. CLINICALTRIALS gov (NCT04227665).
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Affiliation(s)
| | - Rafael A. Casuso
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain ,grid.449008.10000 0004 1795 4150Department of Health Sciences, Universidad Loyola Andalucía, Sevilla, Spain
| | - Jacob Bejder
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christian Bonne
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Andreas Breenfeldt Andersen
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jerónimo Aragón-Vela
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Nikolai B. Nordsborg
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jesús R. Huertas
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
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A Review of Pleiotropic Potential of Erythropoietin as an Adjunctive Therapy for COVID-19. JOURNAL OF CLINICAL AND BASIC RESEARCH 2022. [DOI: 10.52547/jcbr.6.1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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Nijholt KT, Meems LMG, Ruifrok WPT, Maass AH, Yurista SR, Pavez-Giani MG, Mahmoud B, Wolters AHG, van Veldhuisen DJ, van Gilst WH, Silljé HHW, de Boer RA, Westenbrink BD. The erythropoietin receptor expressed in skeletal muscle is essential for mitochondrial biogenesis and physiological exercise. Pflugers Arch 2021; 473:1301-1313. [PMID: 34142210 PMCID: PMC8302562 DOI: 10.1007/s00424-021-02577-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/16/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022]
Abstract
Erythropoietin (EPO) is a haematopoietic hormone that regulates erythropoiesis, but the EPO-receptor (EpoR) is also expressed in non-haematopoietic tissues. Stimulation of the EpoR in cardiac and skeletal muscle provides protection from various forms of pathological stress, but its relevance for normal muscle physiology remains unclear. We aimed to determine the contribution of the tissue-specific EpoR to exercise-induced remodelling of cardiac and skeletal muscle. Baseline phenotyping was performed on left ventricle and m. gastrocnemius of mice that only express the EpoR in haematopoietic tissues (EpoR-tKO). Subsequently, mice were caged in the presence or absence of a running wheel for 4 weeks and exercise performance, cardiac function and histological and molecular markers for physiological adaptation were assessed. While gross morphology of both muscles was normal in EpoR-tKO mice, mitochondrial content in skeletal muscle was decreased by 50%, associated with similar reductions in mitochondrial biogenesis, while mitophagy was unaltered. When subjected to exercise, EpoR-tKO mice ran slower and covered less distance than wild-type (WT) mice (5.5 ± 0.6 vs. 8.0 ± 0.4 km/day, p < 0.01). The impaired exercise performance was paralleled by reductions in myocyte growth and angiogenesis in both muscle types. Our findings indicate that the endogenous EPO-EpoR system controls mitochondrial biogenesis in skeletal muscle. The reductions in mitochondrial content were associated with reduced exercise capacity in response to voluntary exercise, supporting a critical role for the extra-haematopoietic EpoR in exercise performance.
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Affiliation(s)
- Kirsten T Nijholt
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Laura M G Meems
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Willem P T Ruifrok
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Alexander H Maass
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Salva R Yurista
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Mario G Pavez-Giani
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Belend Mahmoud
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Anouk H G Wolters
- Department of Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Wiek H van Gilst
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Herman H W Silljé
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands
| | - B Daan Westenbrink
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, HPC AB31, 9700 RB, P.O. Box 30.001, Groningen, The Netherlands.
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10
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Risikesan J, Nellemann B, Christensen B, Jørgensen JOL, Nielsen S. No effect of 10 weeks erythropoietin treatment on lipid oxidation in healthy men. Endocr Connect 2020; 9:1148-1155. [PMID: 33112835 PMCID: PMC7774772 DOI: 10.1530/ec-20-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/13/2020] [Indexed: 11/21/2022]
Abstract
Studies indicate that erythropoietin (EPO) has effect on lipid and energy metabolism; however, the impact of EPO on lipid oxidation in vivo has not been well documented. Here, we evaluate whether long-term erythropoiesis-stimulating agent (ESA) treatment affects the oxidation of plasma very low-density lipoprotein triglycerides (VLDL-TG) fatty acids (FA), plasma free fatty acids (FFA) and non-plasma (residual) FA in healthy, young, sedentary men. Infusion of [1-14C]VLDL-TG and [9,10-3H]palmitate was used in combination with indirect calorimetry to assess resting lipid fuel utilization and kinetics, and resting energy expenditure (REE) before and after 10 weeks of ESA exposure compared with placebo. REE increased significantly during ESA compared with placebo (P = 0.023, RM-ANOVA). Oxidation rates of VLDL-TG FA, FFA, and residual FA remained unchanged during ESA compared with placebo. The relative contribution of the lipid stores was greatest for FFA (47.1%) and the total lipid oxidation rate and was not significantly different between ESA and placebo-treated subjects. We conclude that long-term ESA treatment of healthy young men increases REE but does not alter the oxidation rates of plasma and non-plasma FA sources.
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Affiliation(s)
- Jeyanthini Risikesan
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Birgitte Nellemann
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Britt Christensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Søren Nielsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Correspondence should be addressed to S Nielsen:
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Haider T, Diaz V, Albert J, Alvarez-Sanchez M, Thiersch M, Maggiorini M, Hilty MP, Spengler CM, Gassmann M. A Single 60.000 IU Dose of Erythropoietin Does Not Improve Short-Term Aerobic Exercise Performance in Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial. Front Physiol 2020; 11:537389. [PMID: 33117187 PMCID: PMC7550763 DOI: 10.3389/fphys.2020.537389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 08/26/2020] [Indexed: 01/13/2023] Open
Abstract
Erythropoietin (EPO) boosts exercise performance through increase in oxygen transport capacity following regular administration of EPO but preclinical study results suggest that single high dose of EPO also may improve exercise capacity. Twenty-nine healthy subjects (14 males/15 females; age: 25 ± 3 years) were included in a randomized, double-blind, placebo-controlled crossover study to assess peak work load and cardiopulmonary variables during submaximal and maximal cycling tests following a single dose of 60.000 IU of recombinant erythropoietin (EPO) or placebo (PLA). Submaximal exercise at 40%/60% of peak work load revealed no main effect of EPO on oxygen uptake (27.9 ± 8.7 ml min–1⋅kg–1/ 37.1 ± 13.2 ml min–1⋅kg–1) versus PLA (25.2 ± 3.7 ml min–1⋅kg–1/ 33.1 ± 5.3 ml min–1⋅kg–1) condition (p = 0.447/p = 0.756). During maximal exercise peak work load (PLA: 3.5 ± 0.6 W⋅kg–1 vs. EPO: 3.5 ± 0.6 W kg–1, p = 0.892) and peak oxygen uptake (PLA: 45.1 ± 10.4 ml⋅min–1 kg–1 vs. EPO: 46.1 ± 14.2 ml⋅min–1 kg–1, p = 0.344) reached comparable values in the two treatment conditions. Other cardiopulmonary variables (ventilation, cardiac output, heart rate) also reached similar levels in the two treatment conditions. An interaction effect was found between treatment condition and sex resulting in higher peak oxygen consumption (p = 0.048) and ventilation (p = 0.044) in EPO-treated males. In conclusion, in a carefully conducted study using placebo-controlled design the present data failed to support the hypothesis that a single high dose of EPO has a measurable impact on work capacity in healthy subjects.
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Affiliation(s)
- Thomas Haider
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland.,Department of Cardiology, University Hospital Zürich, Zurich, Switzerland
| | - Victor Diaz
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Jamie Albert
- Institute of Human Movement Science and Sport, ETH Zürich, Zurich, Switzerland
| | - Maria Alvarez-Sanchez
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Markus Thiersch
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Maggiorini
- Institute of Intensive Care Medicine, University Hospital of Zürich, Zurich, Switzerland
| | - Matthias P Hilty
- Institute of Intensive Care Medicine, University Hospital of Zürich, Zurich, Switzerland
| | - Christina M Spengler
- Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland.,Institute of Human Movement Science and Sport, ETH Zürich, Zurich, Switzerland
| | - Max Gassmann
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland
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12
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Montero D, Haider T, Barthelmes J, Goetze JP, Cantatore S, Sudano I, Ruschitzka F, Flammer AJ. Hypovolemia and reduced hemoglobin mass in patients with heart failure and preserved ejection fraction. Physiol Rep 2020; 7:e14222. [PMID: 31724335 PMCID: PMC6854115 DOI: 10.14814/phy2.14222] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 01/28/2023] Open
Abstract
A fundamental tenet of heart failure (HF) pathophysiology hinges on a propensity for fluid retention leading to blood volume (BV) expansion and hemodilution. Whether this can be applied to heart failure patients with preserved ejection fraction (HFpEF) remains uncertain. The present study sought to determine BV status and key hormones regulating fluid homeostasis and erythropoiesis in HFpEF patients. BV and hemoglobin mass (Hbmass) were determined with high‐precision, automated carbon monoxide (CO) rebreathing in 20 stable HFpEF patients (71.5 ± 7.3 years, left ventricular ejection fraction = 55.7 ± 4.0%) and 15 healthy age‐ and sex‐matched control individuals. Additional measurements comprised key circulating BV‐regulating hormones such as pro‐atrial natriuretic peptide (proANP), copeptin, aldosterone and erythropoietin (EPO), as well as central hemodynamics and arterial stiffness via carotid–femoral pulse wave velocity (PWV). Carotid–femoral PWV was increased (+20%) in HFpEF patients versus control individuals. With respect to hematological variables, plasma volume (PV) did not differ between groups, whereas BV was decreased (−14%) in HFpEF patients. In consonance with the hypovolemic status, Hbmass was reduced (−27%) in HFpEF patients, despite they presented more than a twofold elevation of circulating EPO (+119%). Plasma concentrations of BV‐regulating hormones, including proANP (+106%), copeptin (+99%), and aldosterone (+62%), were substantially augmented in HFpEF patients. HFpEF patients may present with hypovolemia and markedly reduced Hbmass, underpinned by a generalized overactivation of endocrine systems regulating fluid homeostasis and erythropoiesis. These findings provide a novel perspective on the pathophysiological basis of the HFpEF condition.
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Affiliation(s)
- David Montero
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Haider
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Jens Barthelmes
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Silviya Cantatore
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Isabella Sudano
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Frank Ruschitzka
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Andreas J Flammer
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
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13
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Pugh J, Pugh C. Neurostimulation, doping, and the spirit of sport. NEUROETHICS-NETH 2020; 14:141-158. [PMID: 34824648 PMCID: PMC8590673 DOI: 10.1007/s12152-020-09435-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/27/2020] [Indexed: 12/19/2022]
Abstract
There is increasing interest in using neuro-stimulation devices to achieve an ergogenic effect in elite athletes. Although the World Anti-Doping Authority (WADA) does not currently prohibit neuro-stimulation techniques, a number of researchers have called on WADA to consider its position on this issue. Focusing on trans-cranial direct current stimulation (tDCS) as a case study of an imminent so-called ‘neuro-doping’ intervention, we argue that the emerging evidence suggests that tDCS may meet WADA’s own criteria (pertaining to safety, performance-enhancing effect, and incompatibility with the ‘spirit of sport’) for a method’s inclusion on its list of prohibited substances and methods. We begin by surveying WADA’s general approach to doping, and highlight important limitations to the current evidence base regarding the performance-enhancing effect of pharmacological doping substances. We then review the current evidence base for the safety and efficacy of tDCS, and argue that despite significant shortcomings, there may be sufficient evidence for WADA to consider prohibiting tDCS, in light of the comparable flaws in the evidence base for pharmacological doping substances. In the second half of the paper, we argue that the question of whether WADA ought to ban tDCS turns significantly on the question of whether it is compatible with the ‘spirit of sport’ criterion. We critique some of the previously published positions on this, and advocate our own sport-specific and application-specific approach. Despite these arguments, we finally conclude by suggesting that tDCS ought to be monitored rather than prohibited due to compelling non-ideal considerations.
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Affiliation(s)
- Jonathan Pugh
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Suite 8, Littlegate House, St Ebbes Street, Oxford, OX1 1PT UK
| | - Christopher Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University, Cardiff, UK
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14
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HAILE DIRESIBACHEWW, DURUSSEL JÉRÔME, MEKONEN WONDYEFRAW, ONGARO NEFORD, ANJILA EDWIN, MOOSES MARTIN, DASKALAKI EVANGELIA, MOOSES KERLI, MCCLURE JOHND, SUTEHALL SHAUN, PITSILADIS YANNISP. Effects of EPO on Blood Parameters and Running Performance in Kenyan Athletes. Med Sci Sports Exerc 2019; 51:299-307. [DOI: 10.1249/mss.0000000000001777] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Aachmann‐Andersen NJ, Christensen SJ, Lisbjerg K, Oturai P, Johansson PI, Holstein‐Rathlou N, Olsen NV. Recombinant erythropoietin acutely decreases renal perfusion and decouples the renin-angiotensin-aldosterone system. Physiol Rep 2018; 6:e13573. [PMID: 29504258 PMCID: PMC5835499 DOI: 10.14814/phy2.13573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 11/24/2022] Open
Abstract
The effect of recombinant erythropoietin (rhEPO) on renal and systemic hemodynamics was evaluated in a randomized double-blinded, cross-over study. Sixteen healthy subjects were tested with placebo, or low-dose rhEPO for 2 weeks, or high-dose rhEPO for 3 days. Subjects refrained from excessive salt intake, according to instructions from a dietitian. Renal clearance studies were done for measurements of renal plasma flow, glomerular filtration rate (GFR) and the segmentel tubular handling of sodium and water (lithium clearance). rhEPO increased arterial blood pressure, total peripheral resistance, and renal vascular resistance, and decreased renal plasma flow in the high-dose rhEPO intervention and tended to decrease GFR. In spite of the decrease in renal perfusion, rhEPO tended to decrease reabsorption of sodium and water in the proximal tubule and induced a prompt decrease in circulating levels of renin and aldosterone, independent of changes in red blood cell mass, blood volumes, and blood pressure. We also found changes in biomarkers showing evidence that rhEPO induced a prothrombotic state. Our results suggest that rhEPO causes a direct downregulation in proximal tubular reabsorption that seems to decouple the activity of the renin-angiotensin-aldosterone system from changes in renal hemodynamics. This may serve as a negative feed-back mechanism on endogenous synthesis of EPO when circulating levels of EPO are high. These results demonstrates for the first time in humans a direct effect of rhEPO on renal hemodynamics and a decoupling of the renin-angiotensin-aldosterone system.
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Affiliation(s)
| | - Soren J. Christensen
- Department of Neuroscience and PharmacologyUniversity of CopenhagenCopenhagenDenmark
| | - Kristian Lisbjerg
- Department of Neuroscience and PharmacologyUniversity of CopenhagenCopenhagenDenmark
| | - Peter Oturai
- Department of Clinical Physiology, Nuclear Medicine and PETThe Diagnostic Centre, RigshospitaletCopenhagenDenmark
| | - Pär I. Johansson
- Section for Transfusion MedicineCapital Region Blood BankThe Diagnostic Centre, RigshospitaletCopenhagenDenmark
- Department of SurgeryUniversity of Texas Health Medical SchoolHoustonTexas
| | | | - Niels V. Olsen
- Department of Neuroscience and PharmacologyUniversity of CopenhagenCopenhagenDenmark
- Department of NeuroanaesthesiaThe Neuroscience Centre, RigshospitaletCopenhagenDenmark
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Abstract
An accumulating body of evidence suggests that renin-expressing cells have developed throughout evolution as a mechanism to preserve blood pressure and fluid volume homeostasis as well as to counteract a number of homeostatic and immunological threats. In the developing embryo, renin precursor cells emerge in multiple tissues, where they differentiate into a variety of cell types. The function of those precursors and their progeny is beginning to be unravelled. In the developing kidney, renin-expressing cells control the morphogenesis and branching of the renal arterial tree. The cells do not seem to fully differentiate but instead retain a degree of developmental plasticity or molecular memory, which enables them to regenerate injured glomeruli or to alter their phenotype to control blood pressure and fluid-electrolyte homeostasis. In haematopoietic tissues, renin-expressing cells might regulate bone marrow differentiation and participate in a circulating leukocyte renin-angiotensin system, which acts as a defence mechanism against infections or tissue injury. Furthermore, renin-expressing cells have an intricate lineage and functional relationship with erythropoietin-producing cells and are therefore central to two endocrine systems - the renin-angiotensin and erythropoietin systems - that sustain life by controlling fluid volume and composition, perfusion pressure and oxygen delivery to tissues. However, loss of the homeostatic control of these systems following dysregulation of renin-expressing cells can be detrimental, with serious pathological events.
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Vestergaard MB, Henriksen OM, Lindberg U, Aachmann-Andersen NJ, Lisbjerg K, Christensen SJ, Olsen NV, Law I, Larsson HBW, Rasmussen P. No evidence for direct effects of recombinant human erythropoietin on cerebral blood flow and metabolism in healthy humans. J Appl Physiol (1985) 2018; 124:1107-1116. [PMID: 29357480 DOI: 10.1152/japplphysiol.00869.2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Erythropoietin (EPO) is expressed in human brain tissue, but its exact role is unknown. EPO may improve the efficiency of oxidative metabolism and has neuroprotective properties against hypoxic injuries in animal models. We aimed to investigate the effect of recombinant human EPO (rHuEPO) administration on healthy cerebral metabolism in humans during normoxia and during metabolic stress by inhalation of 10% O2 hypoxic air. Twenty-four healthy men participated in a two-arm double-blind placebo-controlled trial. rHuEPO was administered as a low dose (5,000 IU) over 4 wk ( n = 12) or as a high dose (500 IU·kg body wt-1·day-1) for three consecutive days ( n = 12). Global cerebral blood flow (CBF) and metabolic rate of glucose (CMRglc) were measured with positron emission tomography. CBF, metabolic rate of oxygen ([Formula: see text]), and cerebral lactate concentration were measured by magnetic resonance imaging and spectroscopy. Low-dose treatment increased hemoglobin and was associated with a near-significant decrease in CBF during baseline normoxia. High-dose treatment caused no change in CBF. Neither treatment had an effect on normoxia CMRglc, [Formula: see text], or lactate concentration or an effect on the cerebral metabolic response to inhalation of hypoxic air. In conclusion, the study found no evidence for a direct effect of rHuEPO on cerebral metabolism. NEW & NOTEWORTHY We demonstrate with magnetic resonance imaging and positron emission tomography that administration of erythropoietin does not have a substantial direct effect on healthy human resting cerebral blood flow or effect on cerebral glucose and oxygen metabolism. Also, administration of erythropoietin did not have a direct effect on the metabolic response to acute hypoxic stress in healthy humans, and a suggested neuroprotective effect from erythropoietin is therefore likely not a direct effect of erythropoietin on cerebral metabolism.
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Affiliation(s)
- Mark Bitsch Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Otto Mølby Henriksen
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Niels Jacob Aachmann-Andersen
- Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Kristian Lisbjerg
- Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Søren Just Christensen
- Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Niels Vidiendal Olsen
- Department of Neuroanaesthesia, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet Blegdamsvej , Copenhagen , Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark
| | - Henrik Bo Wiberg Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Peter Rasmussen
- Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
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18
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Perrey S. Do we perform better when we increase red blood cells? LANCET HAEMATOLOGY 2017; 4:e344-e345. [PMID: 28693986 DOI: 10.1016/s2352-3026(17)30123-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
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19
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Santos-Morales O, Díaz-Machado A, Jiménez-Rodríguez D, Pomares-Iturralde Y, Festary-Casanovas T, González-Delgado CA, Pérez-Rodríguez S, Alfonso-Muñoz E, Viada-González C, Piedra-Sierra P, García-García I, Amaro-González D, García-Rodríguez JC, Sosa-Testé I, Lagarto-Parra A, Barrero-Viera L, David-Baldo M, Tamayo-Rodríguez M, Rivero-Vázquez I, González-Gamiz G, Martín-Trujillo A, Rodríguez-Fernández Y, Ledo-de la Luz AA, Álvarez-Delgado M, Howland-Álvarez I, Cruz-Gómez Y. Nasal administration of the neuroprotective candidate NeuroEPO to healthy volunteers: a randomized, parallel, open-label safety study. BMC Neurol 2017; 17:129. [PMID: 28676085 PMCID: PMC5496637 DOI: 10.1186/s12883-017-0908-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Delivery of therapeutic agents as erythropoietin (EPO) into Central Nervous System through intranasal route could benefit patients with neurological disorders. A new nasal formulation containing a non-hematopoietic recombinant EPO (NeuroEPO) has shown neuroprotective actions in preclinical models. In the current study, the safety of NeuroEPO was evaluated for the first time in humans. METHODS A phase I, randomized, parallel, open-label study was carried out in healthy volunteers. They received, intranasally, 1 mg of NeuroEPO every 8 h during 4 days (Group A) or 0.5 mg of NeuroEPO (Group B) with the same schedule. The working hypothesis was that intranasal NeuroEPO produce <10% of severe adverse reactions in the evaluated groups. Therefore, a rigorous assessment of possible adverse events was carried out, which included tolerance of the nasal mucosa and the effect on hematopoietic activity. Clinical safety evaluation was daily during treatment and laboratory tests were done before and on days 5 and 14 after starting treatment. RESULTS Twenty-five volunteers, 56% women, with a mean age of 27 yrs. were included. Twelve of them received the highest NeuroEPO dose. Twenty types of adverse events occurred, with headache (20%) and increase of hepatic enzymes (20%) as the most reported ones. Nasopharyngeal itching was the most common local event but only observed in four patients (16%), all of them from the lowest dose group. About half of the events were very probably or probably caused by the studied product. Most of the events were mild (95.5%), did not require treatment (88.6%) and were completely resolved (81.8%). No severe adverse events were reported. During the study the hematopoietic variables were kept within reference values. CONCLUSIONS NeuroEPO was a safe product, well tolerated at the nasal mucosa level and did not stimulate erythropoiesis in healthy volunteers. TRIAL REGISTRATION Cuban Public Registry of Clinical Trials RPCEC00000157 , June 10, 2013.
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Affiliation(s)
| | - Alina Díaz-Machado
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
| | - Daise Jiménez-Rodríguez
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | | | - Tatiana Festary-Casanovas
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | | | - Sonia Pérez-Rodríguez
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
| | - Eulalia Alfonso-Muñoz
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
| | - Carmen Viada-González
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
| | | | - Idrian García-García
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Daniel Amaro-González
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
| | - for the NeuroEPO Study Group
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Julio César García-Rodríguez
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Iliana Sosa-Testé
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Alicia Lagarto-Parra
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Laura Barrero-Viera
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Marlene David-Baldo
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Maura Tamayo-Rodríguez
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Ivonne Rivero-Vázquez
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Gricel González-Gamiz
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Alis Martín-Trujillo
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Yasmila Rodríguez-Fernández
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Ana Alfa Ledo-de la Luz
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Maylén Álvarez-Delgado
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Ivón Howland-Álvarez
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
| | - Yolanda Cruz-Gómez
- NeuroEPO Research and Development Group, Center of Molecular Immunology, Havana, Cuba
- National Center for Toxicology, “Carlos J. Finlay” University Hospital, Havana, Cuba
- Clinical Trials Group, Research Direction, Center for Drug Research and Development (CIDEM), Ave. 26 and Puentes Grandes, No. 1605, Nuevo Vedado, Havana, Cuba
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Marchand A, Buisson C, Martin L, Martin J, Molina A, Ressiot D. Report on an anti‐doping operation in Guadeloupe: High number of positive cases and inferences about doping habits. Drug Test Anal 2017; 9:1753-1761. [DOI: 10.1002/dta.2185] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/01/2017] [Accepted: 03/07/2017] [Indexed: 11/05/2022]
Affiliation(s)
- A. Marchand
- Analysis DepartmentAgence Française de Lutte contre le Dopage (AFLD) 143 avenue Roger Salengro 92290 Châtenay‐Malabry France
| | - C. Buisson
- Analysis DepartmentAgence Française de Lutte contre le Dopage (AFLD) 143 avenue Roger Salengro 92290 Châtenay‐Malabry France
| | - L. Martin
- Analysis DepartmentAgence Française de Lutte contre le Dopage (AFLD) 143 avenue Roger Salengro 92290 Châtenay‐Malabry France
| | - J.‐A. Martin
- Analysis DepartmentAgence Française de Lutte contre le Dopage (AFLD) 143 avenue Roger Salengro 92290 Châtenay‐Malabry France
| | - A. Molina
- Analysis DepartmentAgence Française de Lutte contre le Dopage (AFLD) 143 avenue Roger Salengro 92290 Châtenay‐Malabry France
| | - D. Ressiot
- Control DepartmentAgence Française de Lutte contre le Dopage (AFLD) 8 rue Auber 75009 Paris France
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Kayser B, Tolleneer J. Ethics of a relaxed antidoping rule accompanied by harm-reduction measures. JOURNAL OF MEDICAL ETHICS 2017; 43:282-286. [PMID: 28154003 DOI: 10.1136/medethics-2015-102659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/08/2016] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
Harm-reduction approaches are used to reduce the burden of risky human behaviour without necessarily aiming to stop the behaviour. We discuss what an introduction of harm reduction for doping in sports would mean in parallel with a relaxation of the antidoping rule. We analyse what is ethically at stake in the following five levels: (1) What would it mean for the athlete (the self)? (2) How would it impact other athletes (the other)? (3) How would it affect the phenomenon of sport as a game and its fair play basis (the play)? (4) What would be the consequences for the spectator and the role of sports in society (the display)? and (5) What would it mean for what some consider as essential to being human (humanity)? For each level, we present arguments for and against doping and then discuss what a harm-reduction approach, within a dynamic regime of a partially relaxed antidoping rule, could imply. We find that a harm-reduction approach is morally defensible and potentially provides a viable escape out of the impasse resulting from the impossibility of attaining the eradication of doping. The following question remains to be answered: Would a more relaxed position, when combined with harm-reduction measures, indeed have less negative consequences for society than today's all-out antidoping efforts that aim for abstinence? We provide an outline of an alternative policy, allowing a cautious step-wise change to answer this question and then discuss the ethical aspects of such a policy change.
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Affiliation(s)
- Bengt Kayser
- ISSUL, Université de Lausanne, Lausanne, Switzerland
- FABER, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jan Tolleneer
- FABER, Katholieke Universiteit Leuven, Leuven, Belgium
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22
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Heinrich R, Günther V, Miljus N. Erythropoietin-Mediated Neuroprotection in Insects Suggests a Prevertebrate Evolution of Erythropoietin-Like Signaling. VITAMINS AND HORMONES 2017. [PMID: 28629517 DOI: 10.1016/bs.vh.2017.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The cytokine erythropoietin (Epo) mediates protective and regenerative functions in mammalian nervous systems via activation of poorly characterized receptors that differ from the "classical" homodimeric Epo receptor expressed on erythroid progenitor cells. Epo genes have been identified in vertebrate species ranging from human to fish, suggesting that Epo signaling evolved earlier than the vertebrate lineage. Studies on insects (Locusta migratoria, Chorthippus biguttulus, Tribolium castaneum) revealed Epo-mediated neuroprotection and neuroregeneration. Recombinant human Epo (rhEpo) prevents apoptosis by binding to a janus kinase-associated receptor, stimulation of STAT transcription factors, and generation of factors that prevent the activation of proapoptotic caspases. Insect neurons were also protected by a neuroprotective but nonerythropoietic Epo splice variant, suggesting similarity with mammalian neuroprotective but not with homodimeric "classical" Epo receptors. Additionally, rhEpo promotes the regeneration of neurites in primary cultured insect brain neurons and after nerve crush in an in vivo preparation. In contrast to neuroprotective and regenerative effects shared with mammalian species, no evidence for a role of Epo signaling in the regulation of neuro- or gliogenesis was found in insects. Similar structural and functional characteristics of the Epo binding receptors, partly shared transduction pathways that prevent apoptosis and the functional implication in neuroprotective and neuroregenerative processes in both mammalian and insect species, suggest that Epo-like signaling was already established in their last common ancestor. Originally functioning as a tissue-protective response to unfavorable physiological situations, cell injury, and pathogen invasion, Epo was later adapted as a humoral regulator of erythropoiesis in the vertebrate lineage.
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Affiliation(s)
- Ralf Heinrich
- Institute for Zoology and Anthropology, Georg-August-University Goettingen, Goettingen, Germany.
| | - Verena Günther
- Institute for Zoology and Anthropology, Georg-August-University Goettingen, Goettingen, Germany
| | - Natasa Miljus
- Institute for Zoology and Anthropology, Georg-August-University Goettingen, Goettingen, Germany
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Miljus N, Massih B, Weis MA, Rison JV, Bonnas CB, Sillaber I, Ehrenreich H, Geurten BRH, Heinrich R. Neuroprotection and endocytosis: erythropoietin receptors in insect nervous systems. J Neurochem 2017; 141:63-74. [DOI: 10.1111/jnc.13967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/23/2016] [Accepted: 01/24/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Natasa Miljus
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
| | - Bita Massih
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
| | - Marissa A. Weis
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
| | - Jan Vincent Rison
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
| | | | | | - Hannelore Ehrenreich
- Clinical Neuroscience; Max Planck Institute of Experimental Medicine; Goettingen Germany
- DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB); Goettingen Germany
| | - Bart R. H. Geurten
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
| | - Ralf Heinrich
- Department of Cellular Neurobiology; Institute for Zoology; University of Goettingen; Goettingen Germany
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Effect of Erythropoietin on Postresuscitation Renal Function in a Swine Model of Ventricular Fibrillation. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3567275. [PMID: 27847811 PMCID: PMC5099488 DOI: 10.1155/2016/3567275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/13/2016] [Accepted: 09/21/2016] [Indexed: 12/26/2022]
Abstract
Purpose. To investigate the effect of EPO administration on postresuscitation renal function. Methods. Twenty-four female Landrace/Large-White piglets aged 10–15 weeks with average weight of 19 ± 2 kg were randomly assigned to 2 different groups of 12 subjects each. After the end of an 8-minute ventricular fibrillation, the control group (Group C) received saline as placebo, whereas the EPO group (Group E) received EPO 5000 U/kg. The animals were resuscitated according to the 2010 European Resuscitation Council Guidelines for Resuscitation. Results. Five animals (41.67%) from Group C and 11 animals (91.67%) from Group E achieved ROSC (p = 0.027). Eight animals (66.67%, 5 surviving and 3 nonsurviving) from Group C suffered severe kidney damage or AKI compared to animals from Group E, in which none of the swine had evidence of severe kidney damage or AKI (p = 0.001). There was a statistically significant difference in all tested biochemical markers between the two groups, as well as a positive correlation of creatinine with NGAL, L-FABP, and IL-18 (summed mean values' p = 0.049, 0.01, and 0.004, resp.). Conclusions. Administration of EPO protected swine from postresuscitation acute kidney injury.
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Sieljacks P, Thams L, Nellemann B, Larsen MS, Vissing K, Christensen B. Comparative Effects of Aerobic Training and Erythropoietin on Oxygen Uptake in Untrained Humans. J Strength Cond Res 2016; 30:2307-17. [DOI: 10.1519/jsc.0000000000001314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Rephaeli A, Tarasenko N, Fibach E, Rozic G, Lubin I, Lipovetsky J, Furman S, Malik Z, Nudelman A. Bi-functional prodrugs of 5-aminolevulinic acid and butyric acid increase erythropoiesis in anemic mice in an erythropoietin-independent manner. Eur J Pharm Sci 2016; 91:91-7. [DOI: 10.1016/j.ejps.2016.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/09/2016] [Accepted: 06/04/2016] [Indexed: 11/28/2022]
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Martin L, Ashenden M, Bejder J, Hoffmann M, Nordsborg N, Karstoft K, Morkeberg J, Sharpe K, Lasne F, Marchand A. New insights for identification of doping with recombinant human erythropoietin micro-doses after high hydration. Drug Test Anal 2016; 8:1119-1130. [DOI: 10.1002/dta.2004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/13/2016] [Accepted: 05/12/2016] [Indexed: 01/13/2023]
Affiliation(s)
- L. Martin
- Analysis Department-Agence Française de Lutte contre le Dopage (AFLD); Châtenay-Malabry France
| | - M. Ashenden
- SIAB Research Consortium; Gold Coast QLD Australia
| | - J. Bejder
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Denmark
| | - M. Hoffmann
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Denmark
- Institute of Sports Science and Clinical Biomechanics; University of Southern Denmark; Denmark
| | - N. Nordsborg
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Denmark
| | - K. Karstoft
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet; University of Copenhagen; Denmark
| | - J. Morkeberg
- Metabolic Mass Spectrometry Facility; Rigshospitalet Denmark
| | - K. Sharpe
- Statistical Consulting Centre, Department of Mathematics and Statistics; University of Melbourne; VIC Australia
| | - F. Lasne
- Analysis Department-Agence Française de Lutte contre le Dopage (AFLD); Châtenay-Malabry France
| | - A. Marchand
- Analysis Department-Agence Française de Lutte contre le Dopage (AFLD); Châtenay-Malabry France
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Pichon A, Jeton F, El Hasnaoui-Saadani R, Hagström L, Launay T, Beaudry M, Marchant D, Quidu P, Macarlupu JL, Favret F, Richalet JP, Voituron N. Erythropoietin and the use of a transgenic model of erythropoietin-deficient mice. HYPOXIA 2016; 4:29-39. [PMID: 27800506 PMCID: PMC5085313 DOI: 10.2147/hp.s83540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Despite its well-known role in red blood cell production, it is now accepted that erythropoietin (Epo) has other physiological functions. Epo and its receptors are expressed in many tissues, such as the brain and heart. The presence of Epo/Epo receptors in these organs suggests other roles than those usually assigned to this protein. Thus, the aim of this review is to describe the effects of Epo deficiency on adaptation to normoxic and hypoxic environments and to suggest a key role of Epo on main physiological adaptive functions. Our original model of Epo-deficient (Epo-TAgh) mice allowed us to improve our knowledge of the possible role of Epo in O2 homeostasis. The use of anemic transgenic mice revealed Epo as a crucial component of adaptation to hypoxia. Epo-TAgh mice survive well in hypoxic conditions despite low hematocrit. Furthermore, Epo plays a key role in neural control of ventilatory acclimatization and response to hypoxia, in deformability of red blood cells, in cerebral and cardiac angiogenesis, and in neuro- and cardioprotection.
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Affiliation(s)
- Aurélien Pichon
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex; Laboratory of Excellence GR-Ex, Paris; Laboratory MOVE EA 6314, FSS, Poitiers University, Poitiers, France
| | - Florine Jeton
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex; Laboratory of Excellence GR-Ex, Paris
| | | | - Luciana Hagström
- Laboratório Interdisciplinar de Biociências, Universidade de Brasília, Brasília, Brazil
| | - Thierry Launay
- Unité de Biologie Intégrative des Adaptations à l'Exercice, University Paris Saclay and Genopole , University Sorbonne-Paris-Cité, Paris, France
| | - Michèle Beaudry
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex
| | - Dominique Marchant
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex
| | - Patricia Quidu
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex
| | - Jose-Luis Macarlupu
- High Altitude Unit, Laboratories for Research and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fabrice Favret
- Laboratory "Mitochondrie, Stress Oxydant et Protection Musculaire" EA 3072, University of Strasbourg, Strasbourg, France
| | - Jean-Paul Richalet
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex; Laboratory of Excellence GR-Ex, Paris
| | - Nicolas Voituron
- Laboratory "Hypoxia and Lung" EA 2363, University Paris 13, Sorbonne Paris Cité, Bobigny Cedex; Laboratory of Excellence GR-Ex, Paris
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Ribeiro S, Garrido P, Fernandes J, Vala H, Rocha-Pereira P, Costa E, Belo L, Reis F, Santos-Silva A. Impaired renal endothelial nitric oxide synthase and reticulocyte production as modulators of hypertension induced by rHuEPO in the rat. Life Sci 2016; 151:147-156. [PMID: 26924494 DOI: 10.1016/j.lfs.2016.02.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/12/2016] [Accepted: 02/24/2016] [Indexed: 01/15/2023]
Abstract
Our aim was to study the effect of a broad range of recombinant human erythropoietin (rHuEPO) doses on hematological and biochemical parameters, blood pressure (BP), renal function and damage in the rat, focusing on endothelial nitric oxide synthase (eNOS) and hypoxia-inducible factors (HIFs). Male Wistar rats were divided in 5 groups receiving different doses of rHuEPO (100, 200, 400 and 600IU/kg body weight (BW)/week) and saline solution (control), during 3weeks. Blood and 24h urine were collected to perform hematological and biochemical analysis. BP was measured by the tail-cuff method. Kidney tissue was collected to mRNA and protein expression assays and to characterize renal lesions. A dose-dependent increase in red blood cells count, hematocrit and hemoglobin levels was found with rHuEPO therapy, in rHuEPO200, rHuEPO400 and rHuEPO600 groups. Increased reticulocyte count was found in rHuEPO400 and rHuEPO600 groups. BP raised in all groups receiving rHuEPO. The rHuEPO200 and rHuEPO600 groups presented increased kidney protein levels of HIF2α, a reduction in kidney protein levels of eNOS, and the highest grade of vascular and tubular renal lesions. Our study showed that rHuEPO-induced hypertension is present before significant hematological changes occur and, therefore, might involve direct (renal) and indirect (hematological) effects, which varies according to the dose used. The presence of renal hypoxia reduces eNOS activity. Excessive erythrocytosis increases blood hyperviscosity, which can be modulated by an increase in reticulocytes. Hypertension leads to early renal damage without alterations in traditional markers of renal function, thus underestimating the serious adverse effects and risks.
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Affiliation(s)
- Sandra Ribeiro
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Patrícia Garrido
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Fernandes
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology-Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) Research Unit, University of Coimbra, Coimbra, Portugal
| | - Helena Vala
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Center for Studies in Education and Health Technologies (CI&DETS), Agrarian School of Viseu, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Petronila Rocha-Pereira
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luís Belo
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Flávio Reis
- Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology-Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) Research Unit, University of Coimbra, Coimbra, Portugal
| | - Alice Santos-Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), REQUIMTE, Department of Biological Sciences, Laboratory of Biochemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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Shah R, Ye C, Woo M, Connelly PW, Hanley AJ, Sermer M, Zinman B, Retnakaran R. Erythropoietin and glucose homeostasis in women at varying degrees of future diabetic risk. J Diabetes Complications 2015; 29:26-31. [PMID: 25440262 DOI: 10.1016/j.jdiacomp.2014.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 09/04/2014] [Accepted: 09/06/2014] [Indexed: 11/25/2022]
Abstract
AIMS/BACKGROUND Recently, there has been considerable interest in the potential anti-diabetic effects of erythropoietin in animal models. It is not known, however, whether endogenous erythropoietin is associated with glucose regulation in humans. METHODS We evaluated the longitudinal relationship between endogenous erythropoietin at 3-months postpartum and glucose homeostasis at 12-months postpartum in a cohort of 229 women with varying degrees of glucose intolerance in their recent pregnancy, a model of the early natural history of pre-diabetes/diabetes. The women reflected the full spectrum of glucose tolerance in pregnancy from normal (n=63) to mildly abnormal (n=65) to gestational impaired glucose tolerance (n=46) to gestational diabetes (n=55), and hence a broad range of future diabetic risk. RESULTS At 3-months postpartum, there was no difference in serum erythropoietin between these 4 groups (p=0.22). After covariate adjustment, erythropoietin was not associated with beta-cell function, insulin sensitivity, or glycemia at either 3- or 12-months postpartum. On multiple linear regression analyses, however, erythropoietin at 3-months emerged as an independent predictor of both systolic (beta=0.51326, p=0.003) and diastolic blood pressure (beta=0.3321, p=0.01) at 12-months. CONCLUSION Endogenous erythropoietin is not associated with glucose homeostasis early in the natural history of metabolic disease, but may be relevant to vascular health.
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Affiliation(s)
- Reema Shah
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Chang Ye
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
| | - Minna Woo
- Department of Medicine, University of Toronto, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada
| | - Philip W Connelly
- Department of Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada
| | - Anthony J Hanley
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto Ontario, Canada
| | - Mathew Sermer
- Division of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Canada
| | - Bernard Zinman
- Department of Medicine, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Ravi Retnakaran
- Department of Medicine, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
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Bishop-Bailey D. Mechanisms governing the health and performance benefits of exercise. Br J Pharmacol 2014; 170:1153-66. [PMID: 24033098 DOI: 10.1111/bph.12399] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 07/18/2013] [Accepted: 07/23/2013] [Indexed: 12/18/2022] Open
Abstract
Humans are considered among the greatest if not the greatest endurance land animals. Over the last 50 years, as the population has become more sedentary, rates of cardiovascular disease and its associated risk factors such as obesity, type 2 diabetes and hypertension have all increased. Aerobic fitness is considered protective for all-cause mortality, cardiovascular disease, a variety of cancers, joint disease and depression. Here, I will review the emerging mechanisms that underlie the response to exercise, focusing on the major target organ the skeletal muscle system. Understanding the mechanisms of action of exercise will allow us to develop new therapies that mimic the protective actions of exercise.
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Affiliation(s)
- D Bishop-Bailey
- Comparative Biomedical Sciences, The Royal Veterinary College, London, UK
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Aachmann-Andersen NJ, Just Christensen S, Lisbjerg K, Oturai P, Meinild-Lundby AK, Holstein-Rathlou NH, Lundby C, Vidiendal Olsen N. Recombinant erythropoietin in humans has a prolonged effect on circulating erythropoietin isoform distribution. PLoS One 2014; 9:e110903. [PMID: 25335123 PMCID: PMC4204994 DOI: 10.1371/journal.pone.0110903] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/24/2014] [Indexed: 11/18/2022] Open
Abstract
The membrane-assisted isoform immunoassay (MAIIA) quantitates erythropoietin (EPO) isoforms as percentages of migrated isoforms (PMI). We evaluated the effect of recombinant human EPO (rhEPO) on the distribution of EPO isoforms in plasma in a randomized, placebo-controlled, double-blinded, cross-over study. 16 healthy subjects received either low-dose Epoetin beta (5000 IU on days 1, 3, 5, 7, 9, 11 and 13); high-dose Epoetin beta (30.000 IU on days 1, 2 and 3 and placebo on days 5, 7, 9, 11 and 13); or placebo on all days. PMI on days 4, 11 and 25 was determined by interaction of N-acetyl glucosamine with the glycosylation dependent desorption of EPO isoforms. At day 25, plasma-EPO in both rhEPO groups had returned to values not different from the placebo group. PMI with placebo, reflecting the endogenous EPO isoforms, averaged 82.5 (10.3) % (mean (SD)). High-dose Epoetin beta decreased PMI on days 4 and 11 to 31.0 (4.2)% (p<0.00001) and 45.2 (7.3)% (p<0.00001). Low-dose Epoetin beta decreased PMI on days 4 and 11 to 46.0 (12.8)% (p<0.00001) and 46.1 (10.4)% (p<0.00001). In both rhEPO groups, PMI on day 25 was still decreased (high-dose Epoetin beta: 72.9 (19.4)% (p = 0.029); low-dose Epoetin beta: 73.1 (17.8)% (p = 0.039)). In conclusion, Epoetin beta leaves a footprint in the plasma-EPO isoform pattern. MAIIA can detect changes in EPO isoform distribution up til at least three weeks after administration of Epoetin beta even though the total EPO concentration has returned to normal.
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Affiliation(s)
| | - Søren Just Christensen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Lisbjerg
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Peter Oturai
- Clinic of Clinical Physiology, Nuclear Medicine and PET, Centre of Clinical Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Kristine Meinild-Lundby
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Institute of Physiology, Zürich, Switzerland
| | | | - Carsten Lundby
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Institute of Physiology, Zürich, Switzerland
| | - Niels Vidiendal Olsen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Neuroanaesthesia, The Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark
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Posluszny JA, Napolitano LM. How do we treat life-threatening anemia in a Jehovah's Witness patient? Transfusion 2014; 54:3026-34. [DOI: 10.1111/trf.12888] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/17/2014] [Accepted: 08/18/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Joseph A. Posluszny
- Division of Acute Care Surgery [Trauma, Burns, Critical Care, Emergency Surgery]; Department of Surgery; University of Michigan; Ann Arbor Michigan
| | - Lena M. Napolitano
- Division of Acute Care Surgery [Trauma, Burns, Critical Care, Emergency Surgery]; Department of Surgery; University of Michigan; Ann Arbor Michigan
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Samillan V, Haider T, Vogel J, Leuenberger C, Brock M, Schwarzwald C, Gassmann M, Ostergaard L. Combination of erythropoietin and sildenafil can effectively attenuate hypoxia-induced pulmonary hypertension in mice. Pulm Circ 2014; 3:898-907. [PMID: 25006406 DOI: 10.1086/674758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 08/22/2013] [Indexed: 12/12/2022] Open
Abstract
Pulmonary hypertension (PH) is an incurable disease that often leads to right ventricular hypertrophy and right heart failure. This study investigated single versus combined therapy with sildenafil and erythropoietin on hypoxia-induced pulmonary hypertension in mice. Mice were randomized into 5 groups and exposed to either hypoxia (10% oxygen) or normoxia for a total of 5 weeks. Hypoxic mice were treated with saline solution, erythropoietin (500 IU/kg 3 times weekly), sildenafil (10 mg/kg daily), or a combination of the two drugs for the last 2 weeks of hypoxic exposure. We measured right ventricular pressures using right heart catheterization, and the ventilatory response to hypoxia was recorded via whole-body plethysmography. Histological analyses were performed to elucidate changes in pulmonary morphology and appearance of right heart hypertrophy. Plasma levels of cardiotrophin-1 and atrial natriuretic peptide were quantified. Treatment with either erythropoietin or sildenafil alone lowered the hypoxia-induced increase of pulmonary pressure and reduced pulmonary edema formation, pulmonary vascular remodeling, and right ventricular hypertrophy. Notably, the combination of the two drugs had the most prominent effect. Changes in cardiotrophin-1 and atrial natriuretic protein levels confirmed these observations. The combination treatment with erythropoietin and sildenafil demonstrated an attenuation of the development of hypoxia-induced PH in mice that was superior to that observed for either drug when given alone.
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Affiliation(s)
- Victor Samillan
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Zurich Center for Integrative Human Physiology, Zurich, Switzerland ; Human Physiology Department, Medical School, Universidad Alas Peruanas, Lima, Peru
| | - Thomas Haider
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Zurich Center for Integrative Human Physiology, Zurich, Switzerland
| | - Johannes Vogel
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Zurich Center for Integrative Human Physiology, Zurich, Switzerland
| | - Caroline Leuenberger
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Matthias Brock
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Colin Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Max Gassmann
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Zurich Center for Integrative Human Physiology, Zurich, Switzerland ; Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Louise Ostergaard
- Institute for Veterinary Physiology, Vetsuisse Faculty, Zurich, Switzerland ; Zurich Center for Integrative Human Physiology, Zurich, Switzerland
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Segura J, Lundby C. Blood doping: potential of blood and urine sampling to detect autologous transfusion. Br J Sports Med 2014; 48:837-41. [DOI: 10.1136/bjsports-2014-093601] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Heo K, Kang JK, Choi CM, Lee MS, Noh KW, Kim SB. Prophylactic effect of erythropoietin injection to prevent acute mountain sickness: an open-label randomized controlled trial. J Korean Med Sci 2014; 29:416-22. [PMID: 24616593 PMCID: PMC3945139 DOI: 10.3346/jkms.2014.29.3.416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 01/08/2014] [Indexed: 11/20/2022] Open
Abstract
This study was performed to evaluate whether increasing hemoglobin before ascent by prophylactic erythropoietin injections prevents acute mountain sickness (AMS). This open-label, randomized, controlled trial involved 39 healthy volunteers with hemoglobin ≤ 15.5 g/dL who were divided randomly into erythropoietin (n=20) and control (n=19) groups. Epoetin alpha 10,000 IU injections were given weekly for four consecutive weeks. On day 1, and 7 days after the last injection (day 29), oxygen saturation (SaO2), and hemoglobin were measured. The subjects departed Seoul on day 30 and arrived at Annapurna base camp (ABC, 4,130 m) on day 34. AMS was diagnosed when headache and Lake Louise score (LLS) of ≥ 3 were present. Immediate descent criteria followed US Army recommendations. Two groups differ in hemoglobin levels on day 29 (15.4 ± 1.1 vs 14.2 ± 1.0 g/dL, P=0.001). At ABC, erythropoietin group had a significantly lower mean LLS, AMS incidence, and number of subjects who met immediate descent criteria. Multiple logistic regression analysis showed that SaO2<87% and control group, but not hemoglobin<15.0 g/dL, independently predicted satisfaction of immediate descent criteria. Erythropoietin-related adverse effects were not observed. In conclusion, erythropoietin may be an effective prophylaxis for AMS.(Clinical Trial Registry Number; NCT 01665781).
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Affiliation(s)
- Kyoung Heo
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joong Koo Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Min Choi
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Moo Song Lee
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Woo Noh
- Division of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Bae Kim
- Division of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Erythropoietin and the heart: physiological effects and the therapeutic perspective. Int J Cardiol 2013; 171:116-25. [PMID: 24377712 DOI: 10.1016/j.ijcard.2013.12.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 10/08/2013] [Accepted: 12/10/2013] [Indexed: 01/22/2023]
Abstract
Erythropoietin (Epo) has been thought to act exclusively on erythroid progenitor cells. The identification of Epo receptor (EpoR) in non-haematopoietic cells and tissues including neurons, astrocytes, microglia, immune cells, cancer cell lines, endothelial cells, bone marrow stromal cells, as well as cells of myocardium, reproductive system, gastrointestinal tract, kidney, pancreas and skeletal muscle indicates that Epo has pleiotropic actions. Epo shows signals through protein kinases, anti-apoptotic proteins and transcription factors. In light of interest of administering recombinant human erythropoietin (rhEpo) and its analogues for limiting infarct size and left ventricular (LV) remodelling after acute myocardial infarction (AMI) in humans, the foremost studies utilising rhEpo are reviewed. The putative mechanisms involved in Epo-induced cardioprotection are related to the antiapoptotic, anti-inflammatory and angiogenic effects of Epo. Thus, cardioprotective potentials of rhEpo are reviewed in this article by focusing on clinical applicability. An overview of non-haematopoietic Epo analogues, which are a reliable alternative to the classic EpoR agonists and may prevent undesired side effects, is also provided.
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Seear K. What do we really know about doping ‘effects’? An argument for doping effects as co-constituted ‘phenomena’. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.peh.2014.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Christiansen AV, Gleaves J. What do the humanities (really) know about doping? Questions, answers and cross-disciplinary strategies. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.peh.2014.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sanchis-Gomar F, Perez-Quilis C, Lippi G. Erythropoietin receptor (EpoR) agonism is used to treat a wide range of disease. Mol Med 2013; 19:62-4. [PMID: 23615965 DOI: 10.2119/molmed.2013.00025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 04/11/2013] [Indexed: 11/06/2022] Open
Abstract
The erythropoietin receptor (EpoR) was discovered and described in red blood cells (RBCs), stimulating its proliferation and survival. The target in humans for EpoR agonists drugs appears clear-to treat anemia. However, there is evidence of the pleitropic actions of erythropoietin (Epo). For that reason, rhEpo therapy was suggested as a reliable approach for treating a broad range of pathologies, including heart and cardiovascular diseases, neurodegenerative disorders (Parkinson's and Alzheimer's disease), spinal cord injury, stroke, diabetic retinopathy and rare diseases (Friedreich ataxia). Unfortunately, the side effects of rhEpo are also evident. A new generation of nonhematopoietic EpoR agonists drugs (asialoEpo, Cepo and ARA 290) have been investigated and further developed. These EpoR agonists, without the erythropoietic activity of Epo, while preserving its tissue-protective properties, will provide better outcomes in ongoing clinical trials. Nonhematopoietic EpoR agonists represent safer and more effective surrogates for the treatment of several diseases such as brain and peripheral nerve injury, diabetic complications, renal ischemia, rare diseases, myocardial infarction, chronic heart disease and others.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia, Research Foundation of the University Clinic Hospital of Valencia/INCLIVA, Valencia, Spain.
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Haemoglobin mass and running time trial performance after recombinant human erythropoietin administration in trained men. PLoS One 2013; 8:e56151. [PMID: 23418527 PMCID: PMC3571963 DOI: 10.1371/journal.pone.0056151] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/05/2013] [Indexed: 11/19/2022] Open
Abstract
Recombinant human erythropoietin (rHuEpo) increases haemoglobin mass (Hbmass) and maximal oxygen uptake ( O2 max).
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Three weeks of erythropoietin treatment hampers skeletal muscle mitochondrial biogenesis in rats. J Physiol Biochem 2012; 68:593-601. [PMID: 22627788 DOI: 10.1007/s13105-012-0178-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 05/10/2012] [Indexed: 12/23/2022]
Abstract
The blood O(2)-carrying capacity is maintained by the O(2)-regulated production of erythropoietin (Epo), which stimulates the proliferation and survival of red blood cell progenitors. Epo has been thought to act exclusively on erythroid progenitor cells. However, recent studies have identified the erythropoietin receptor (EpoR) in other cells, such as neurons, astrocytes, microglia, heart, cancer cell lines, and skeletal muscle provides evidence for a potential role of Epo in other tissues. In this study we aimed to determine the effect of recombinant human erythropoietin (rHuEpo) on skeletal muscle adaptations such as mitochondrial biogenesis, myogenesis, and angiogenesis in different muscle fibre types. Fourteen male Wistar rats were randomly divided into two experimental groups, and saline or rHuEpo (300 IU) was administered subcutaneously three times a week for 3 weeks. We evaluated the protein expression of intermediates involved in the mitochondrial biogenesis cascade, the myogenic cascade, and in angiogenesis in the oxidative soleus muscle and in the glycolytic gastrocnemius muscle. Contrary to our expectations, rHuEpo significantly hampered the mitochondrial biogenesis pathway in gastrocnemius muscle (PGC-1α, mTFA and cytochrome c). We did not find any effect of the treatment on cellular signals of myogenesis (MyoD and Myf5) or angiogenesis (VEGF) in either soleus or gastrocnemius muscles. Finally, we found no significant effect on the maximal aerobic velocity at the end of the experiment in the rHuEpo-treated animals. Our findings suggest that 3 weeks of rHuEpo treatment, which generates an increase of oxygen carrying capacity, can affect mitochondrial biogenesis in a muscle fibre-specific dependent manner.
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Lundby C, Robach P, Saltin B. The evolving science of detection of 'blood doping'. Br J Pharmacol 2012; 165:1306-15. [PMID: 22225538 PMCID: PMC3372716 DOI: 10.1111/j.1476-5381.2011.01822.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 11/15/2011] [Accepted: 11/25/2011] [Indexed: 12/21/2022] Open
Abstract
Blood doping practices in sports have been around for at least half a century and will likely remain for several years to come. The main reason for the various forms of blood doping to be common is that they are easy to perform, and the effects on exercise performance are gigantic. Yet another reason for blood doping to be a popular illicit practice is that detection is difficult. For autologous blood transfusions, for example, no direct test exists, and the direct testing of misuse with recombinant human erythropoietin (rhEpo) has proven very difficult despite a test exists. Future blood doping practice will likely include the stabilization of the transcription factor hypoxia-inducible factor which leads to an increased endogenous erythropoietin synthesis. It seems unrealistic to develop specific test against such drugs (and the copies hereof originating from illegal laboratories). In an attempt to detect and limit blood doping, the World Anti-Doping Agency (WADA) has launched the Athlete Biological Passport where indirect markers for all types of blood doping are evaluated on an individual level. The approach seemed promising, but a recent publication demonstrates the system to be incapable of detecting even a single subject as 'suspicious' while treated with rhEpo for 10-12 weeks. Sad to say, the hope that the 2012 London Olympics should be cleaner in regard to blood doping seems faint. We propose that WADA strengthens the quality and capacities of the National Anti-Doping Agencies and that they work more efficiently with the international sports federations in an attempt to limit blood doping.
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Affiliation(s)
- Carsten Lundby
- Center for Integrative Human Physiology, Institute of Physiology, University of Zurich, Switzerland.
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Christensen B, Lundby C, Jessen N, Nielsen TS, Vestergaard PF, Møller N, Pilegaard H, Pedersen SB, Kopchick JJ, Jørgensen JOL. Evaluation of functional erythropoietin receptor status in skeletal muscle in vivo: acute and prolonged studies in healthy human subjects. PLoS One 2012; 7:e31857. [PMID: 22384088 PMCID: PMC3285196 DOI: 10.1371/journal.pone.0031857] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 01/18/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Erythropoietin receptors have been identified in human skeletal muscle tissue, but downstream signal transduction has not been investigated. We therefore studied in vivo effects of systemic erythropoietin exposure in human skeletal muscle. METHODOLOGY/PRINCIPAL FINDINGS The protocols involved 1) acute effects of a single bolus injection of erythropoietin followed by consecutive muscle biopsies for 1-10 hours, and 2) a separate study with prolonged administration for 16 days with biopsies obtained before and after. The presence of erythropoietin receptors in muscle tissue as well as activation of Epo signalling pathways (STAT5, MAPK, Akt, IKK) were analysed by western blotting. Changes in muscle protein profiles after prolonged erythropoietin treatment were evaluated by 2D gel-electrophoresis and mass spectrometry. The presence of the erythropoietin receptor in skeletal muscle was confirmed, by the M20 but not the C20 antibody. However, no significant changes in phosphorylation of the Epo-R, STAT5, MAPK, Akt, Lyn, IKK, and p70S6K after erythropoietin administration were detected. The level of 8 protein spots were significantly altered after 16 days of rHuEpo treatment; one isoform of myosin light chain 3 and one of desmin/actin were decreased, while three isoforms of creatine kinase and two of glyceraldehyd-3-phosphate dehydrogenase were increased. CONCLUSIONS/SIGNIFICANCE Acute exposure to recombinant human erythropoietin is not associated by detectable activation of the Epo-R or downstream signalling targets in human skeletal muscle in the resting situation, whereas more prolonged exposure induces significant changes in the skeletal muscle proteome. The absence of functional Epo receptor activity in human skeletal muscle indicates that the long-term effects are indirect and probably related to an increased oxidative capacity in this tissue.
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Affiliation(s)
- Britt Christensen
- Department of Endocrinology and Internal Medicine, NBG/THG, Aarhus University Hospital, Aarhus, Denmark.
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Rasmussen P, Kim Y, Krogh‐Madsen R, Lundby C, Olsen NV, Secher NH, Lieshout JJ. Both acute and prolonged administration of EPO reduce cerebral and systemic vascular conductance in humans. FASEB J 2011; 26:1343-8. [DOI: 10.1096/fj.11-193508] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Rasmussen
- Copenhagen Muscle Research CenterUniversity of CopenhagenCopenhagenDenmark
- Department of AnesthesiaUniversity of CopenhagenCopenhagenDenmark
- Zurich Center for Integrative Human PhysiologyUniversity of ZurichZurichSwitzerland
| | - Yu‐Sok Kim
- Department of Internal MedicineAMC Center for Heart Failure Research, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
- Laboratory for Cardiovascular PhysiologyAMC Center for Heart Failure Research, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Rikke Krogh‐Madsen
- Copenhagen Muscle Research CenterUniversity of CopenhagenCopenhagenDenmark
- Department of Infectious DiseasesCenter of Inflammation and Metabolism, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Carsten Lundby
- Copenhagen Muscle Research CenterUniversity of CopenhagenCopenhagenDenmark
- Zurich Center for Integrative Human PhysiologyUniversity of ZurichZurichSwitzerland
| | - Niels V. Olsen
- Department of AnesthesiaUniversity of CopenhagenCopenhagenDenmark
- Department of Neuroscience and PharmacologyUniversity of CopenhagenCopenhagenDenmark
| | - Niels H. Secher
- Copenhagen Muscle Research CenterUniversity of CopenhagenCopenhagenDenmark
- Department of AnesthesiaUniversity of CopenhagenCopenhagenDenmark
| | - Johannes J. Lieshout
- Department of Internal MedicineAMC Center for Heart Failure Research, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
- Laboratory for Cardiovascular PhysiologyAMC Center for Heart Failure Research, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
- School of Biomedical SciencesUniversity of Nottingham Medical SchoolQueen's Medical CentreNottinghamUK
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Chateauvieux S, Grigorakaki C, Morceau F, Dicato M, Diederich M. Erythropoietin, erythropoiesis and beyond. Biochem Pharmacol 2011; 82:1291-303. [DOI: 10.1016/j.bcp.2011.06.045] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 12/21/2022]
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Abstract
AbstractHemoglobin mass is a key factor for maximal exercise capacity. Some athletes apply prohibited techniques and substances with intent to increase hemoglobin mass and physical performance, and this is often difficult to prove directly. Autologous red blood cell transfusion cannot be traced on reinfusion, and also recombinant erythropoietic proteins are detectable only within a certain timeframe. Novel erythropoietic substances, such as mimetics of erythropoietin (Epo) and activators of the Epo gene, may soon enter the sports scene. In addition, Epo gene transfer maneuvers are imaginable. Effective since December 2009, the World Anti-Doping Agency has therefore implemented “Athlete Biologic Passport Operating Guidelines,” which are based on the monitoring of several parameters for mature red blood cells and reticulocytes. Blood doping may be assumed, when these parameters change in a nonphysiologic way. Hematologists should be familiar with blood doping practices as they may play an important role in evaluating blood profiles of athletes with respect to manipulations, as contrasted with the established diagnosis of clinical disorders and genetic variations.
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