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From the kidneys to the blood: How does erythropoietin affect our health?
Erythropoietin (EPO) is a glycoprotein cytokine secreted primarily by the kidneys and is essential for the production of red blood cells. When the body senses low oxygen levels, the kidneys increase secretion of this hormone to stimulate the production of red blood cells in the bone marrow and increase the oxygen-carrying capacity of the blood. Studies have shown that in the absence of oxygen, EPO production can surge nearly 1,000-fold to levels of 10,000 mU per milliliter of blood.
"The function of erythropoietin is not limited to the production of red blood cells. It also plays an important role in other physiological processes in the body."
Function and role of erythropoietin
The main function of EPO is to promote the production of red blood cells, which is a key link in the physiological process. When the kidneys detect a drop in oxygen levels in the body, they begin releasing more EPO, which causes red blood cell precursors to multiply rapidly in the bone marrow. In addition to stimulating the production of red blood cells, EPO can also activate the JAK2 signaling pathway by binding to the EPO receptors on the surface of red blood cell precursors, further promoting cell proliferation and survival.
Non-hematological effects of erythropoietin
Recent studies have shown that in addition to erythropoiesis, EPO may have other physiological effects, such as promoting angiogenesis and improving tissue survival. However, research results in this area are inconsistent and there are still many controversies. Some studies suggest that EPO's effects in tissues such as the heart and nerves may not be as pronounced as initially thought.
"In clinical trials, the direct protective effect of EPO on heart or nerve tissue has not been confirmed."
Synthesis and Regulation
EPO synthesis is mainly carried out by interstitial cells in the kidney, and in adults, EPO gene expression is regulated by the availability of oxygen and iron. When there is sufficient oxygen, the transcription factors that inhibit EPO production are reduced, while in hypoxic conditions, these inhibitory factors are reduced, promoting the production of EPO. This process demonstrates the body's ability to adapt in the face of changes in the external environment.
Medical Uses and Risks
With the advancement of science, recombinant erythropoietin (rhEPO) is used as a drug to treat various types of anemia, such as long-term renal anemia and chemotherapy-induced anemia. However, its use is associated with certain risks, including heart attack, stroke, and blood clots, especially when high hemoglobin levels are sought. The drug's package insert specifically states that raising hemoglobin above 11 g/dL may increase these risks.
"Overuse of erythropoietin may lead to patients facing higher health risks."
History and Development of Erythropoietin
The history of erythropoietin can be traced back to the early 20th century, when some scientists proposed a hormone that promotes the production of red blood cells based on rabbit experiments. As the research deepened, in 1989 the U.S. Food and Drug Administration approved Epogen as a drug to promote red blood cell production, and it quickly became a success in the medical community.
Doping and its use in sport
EPO was banned as a performance-enhancing drug in the 1990s, and subsequent testing methods have been continuously improved to combat its illegal use in professional sports. Many athletes have been punished for using EPO, reflecting its scandalous status in the sport.
As science and technology develop and our understanding of EPO deepens, can we better balance the use of this hormone in medicine and sports?
