Clinical Evolution of a Pleiotropic Cytokine

摘要: Recombinant human erythropoietin (epoetin alfa) has been used in clinical settings for more than a decade. Its indications have expanded considerably from its original use as hormone therapy the treatment of anemia adults with chronic kidney disease. Since introduction epoetin alfa, greater understanding pathophysiology and interactions erythropoietin, iron, erythropoiesis elucidated. Anemia is now independently associated increased mortality disease progression. Potential survival benefits correction various patient populations are leading to consideration earlier, aggressive mild moderate alfa. Moreover, this agent’s therapeutic may extend beyond currently accepted roles. Epoetin alfa undergoing evaluation promising results variety new settings, including congestive heart failure, ribavirin–interferon hepatitis C virus infection, critical illness. Preclinical studies also established recombinant equivalent be pleiotropic cytokine antiapoptotic activity neuroprotective actions central nervous system. The potential appears yet fully realized. Arch Intern Med. 2004;164:262-276