Erythropoietin: a neuroprotective agent in cerebral hypoxia, neurodegeneration, and epilepsy

Curr Pharm Des. 2013;19(38):6791-801. doi: 10.2174/1381612811319380011.

Abstract

Neuronal damage secondary to brain injuries such as cerebral hypoxia, seizures as well as neurodegenerative process, may include pro-inflammatory changes. The activation of a common mechanism related to survival or cell death, mediated by the stabilization and trans-activation of Hypoxia-Inducible Factor 1 (HIF-1), has been observed in these conditions. HIF-1 may induce over expression of P-glycoprotein, the product multidrug-resistance gene (MDR-1), both on blood-brain barrier as well as on the cerebral damaged cells, producing the refractoriness to therapeutic strategies for neuroprotection. However, in these same cells, HIF-1 can also induce the expression of erythropoietin receptor (Epo-R). Irrespective of its known properties on hematopoiesis, it was proposed that erythropoietin can trigger neuroprotective mechanisms mediated by Epo-R activation. Brain hypoxia, epilepsy, neurodegeneration and inflammation, can share the induction of Epo-R and several other growth factor receptors as well as signal transductions pathways after HIF-1 transactivation. Perhaps, the use of the intranasal route for the exogenous administration of Epo, (or other biological compounds) could help neuroprotection as well as to repair the brain areas damaged.

Publication types

  • Review

MeSH terms

  • Animals
  • Epilepsy / drug therapy*
  • Epilepsy / physiopathology
  • Erythropoietin / therapeutic use*
  • Glutamic Acid / physiology
  • Humans
  • Hypoxia, Brain / drug therapy*
  • Hypoxia, Brain / physiopathology
  • Hypoxia-Inducible Factor 1 / physiology
  • Neurodegenerative Diseases / drug therapy*
  • Neurodegenerative Diseases / physiopathology
  • Neuroprotective Agents / therapeutic use*
  • Receptors, Erythropoietin / physiology

Substances

  • Hypoxia-Inducible Factor 1
  • Neuroprotective Agents
  • Receptors, Erythropoietin
  • Erythropoietin
  • Glutamic Acid