High-dose erythropoietin alters platelet reactivity and bleeding time in rodents in contrast to the neuroprotective variant carbamyl-erythropoietin (CEPO)

Thromb Haemost. 2008 Apr;99(4):720-8. doi: 10.1160/TH07-03-0208.

Abstract

The haematopoietic hormone erythropoietin (EPO) has neuroprotective properties and is currently being explored for treatment of stroke and other neurological disorders. Short-term, high-dose treatment with EPO seems to improve neurological function of stroke patients but may be associated with increased thrombotic risk, whereas alternative non-erythropoietic neuroprotective derivatives of EPO, such as carbamylated EPO (CEPO), may be devoid of such side-effects. We investigated the effects of short-term, high-dose treatment with EPO and CEPO on platelet function and haemostasis in healthy mice and rats. Animals received three daily doses of EPO or CEPO (50 microg/kg), and blood was compared with respect to alterations in haematology and platelet reactivity. In rats, treatment with EPO increased the haematocrit to >50% and the mean platelet volume by 37%, while CEPO had no effect on these parameters. Platelets from EPO-treated rats showed an increased sensitivity to thrombin receptor agonist peptides and elevated plasma levels of soluble P-selectin (sP-selectin) were found in treated mice. Further indicators of platelet hyperreactivity in EPO, but not CEPO-treated animals, were significantly increased aggregatory responses to collagen in whole blood and platelet-rich plasma (PRP). The increased platelet reactivity was paralleled by a decreased bleeding time after tail transection in rats. Samples from EPO-treated rats showed an attenuated response to ADP in whole blood aggregometry and thrombelastography (TEG) platelet mapping but not in apyrase-treated PRP, suggesting involvement of ADP receptor desensitization. These findings suggest that while EPO affects various aspects of platelet function, CEPO is devoid of such effects.

Publication types

  • Comparative Study

MeSH terms

  • Adenosine Diphosphate / pharmacology
  • Animals
  • Bleeding Time
  • Blood Proteins / metabolism
  • Collagen / pharmacology
  • Dose-Response Relationship, Drug
  • Erythropoietin / administration & dosage
  • Erythropoietin / analogs & derivatives*
  • Erythropoietin / pharmacology*
  • Male
  • Mice
  • Neuroprotective Agents / administration & dosage
  • Neuroprotective Agents / pharmacology*
  • P-Selectin / blood
  • Platelet Activation / drug effects*
  • Platelet Aggregation / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Proteinase-Activated / agonists
  • Recombinant Proteins

Substances

  • Blood Proteins
  • Neuroprotective Agents
  • P-Selectin
  • Receptors, Proteinase-Activated
  • Recombinant Proteins
  • carbamylated erythropoietin
  • protease-activated receptor 3, mouse
  • protease-activated receptor 4, mouse
  • Erythropoietin
  • Adenosine Diphosphate
  • Collagen