Erythropoietin

The book contains a series of up-to-date review articles on the physiology and pathophysiology of the control of the production of red cells by the hormone erythropoietin. In addition, the results are reported of initial clinical trials using recombinant human erythropoietin (rhuEpo) in the treatment of the anemia of renal failure. The introductory chapter briefly recalls the history of erythropoietin research. The following section on the chemistry and physiology covers details of the structure of the hormone, assay methods, the identification of renal and extrarenal sites of the production of erythropoietin by in situ hybridization and the hypoxic stimulation of its production. A special chapter is devoted to the regulation of erythropoiesis in the neonatal period. There follows a section on pathophysiology, which includes respiratory, renal and malignant diseases in humans. In the final section the pharmacology of rhuEpo is considered. The strategy of the cloning and in vitro expression of the erythropoietin gene is described. Four chapters summarize clinical observations of the effects of rhuEpo in the correction of the anemia of renal failure, including the rise in hematocrit, blood viscosity and possibly hypertension, and the increased physical work capacity of the patients. The monograph will prove useful not only to investigators working in the basic fields of physiology, pharmacology and endocrinology, but also to practising physicians, especially hematologists and nephrologists, who are interested in erythropoietin for diagnostic or therapeutic purposes.

Recent developments in recombinant DNA technology have led to the large-scale production of human erythropoietin and to the demonstration that it is effective in the treatment of renal and possibly some other anaemias. This has lent a new impetus to studies of the pathophysiology and pharmacology of the hormone which is reflected in this report of the proceedings of a meeting held in Liibeck in June 1988. In 15 papers, all from European centres, the broad topics covered are erythropoietin's physiology and chemistry, the patho- physiology of erythropoiesis and the use of erythropoietin in the treatment of anaemia. Several of the papers include up-to-date reviews of the literature. The field is now expanding rapidly, and this volume, though not comprehensive, usefully points up many areas of recent understanding as well as others of continuing un- certainty. Overall, it contains material likely to be of interest to biochemists and experimental haematologists as well as to phar- macologists, clinical haematologists and nephrologists.