红细胞生成素在慢性肾病一体化治疗中的研究进展

Erythropoietin in the integrative treatment of chronic kidney disease:research advances

红细胞生成素(EPO)传统意义上是一种调控红系祖细胞增殖、分化和成熟的造血细胞生长因子。慢性肾病(CKD)患者使用重组人红细胞生成素(rh EPO)是肾性贫血治疗领域的里程碑。在纠正贫血的临床治疗中发现,EPO对减轻肾功能损害和降低心血管疾病(CVD)的发生率等方面具有潜在益处。通过对EPO生物学效应和CKD病理生理学特征的分析发现,EPO可以发挥细胞保护及免疫调节等多种作用,直接或间接地延缓CKD进展,降低患者死亡率。本文主要探讨EPO对心肾功能的保护机制。

Erythropoietin（EPO） is traditionally d escribed as a hematopoietic cytokine or growth hormone regulating proliferation,differentiation,and survival of erythroid progenitors. The use of EPO in patients with chronic kidney disease（CKD）was a milestone achievement in the treatment of anemia. A growing number of clinical trials aimed at anemia management have assessed the potential benefits of EPO in reducing the loss of kidney function and also the incidence of cardicvascular disease（CVD）in CKD patients. Analysis of the biological effects of EPO and pathophysiology of CKD in these studies suggests that treatment with EPO exerts cellular protection,immune regulation by pleiotropic actions on several targets and directly or indirectly slows the progression of CKD and reduces CVD-related mortality. The aim of this article is to discuss these possible protection mechanisms and provides a comprehensive overview of EPO.