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Erythropoietin (EPO) is a hormone that helps treat Anemia, kidney diseases. It helps improve Muscular performance, aids with bone regeneration.

Introduction: What is Erythropoietin?

Erythropoietin is also known as EPO, hematopoietin or hemopoietin is a glycoprotein hormone which controls erythropoiesis or red blood cell production. It is a protein signaling molecule for red blood cell (erythrocyte) precursors in the bone marrow.

Erythropoietin (EPO) levels in the blood are quite low in the absence of anemia, but in the condition of hypoxic stress, EPO production may increase up to 1000-fold.  Tissue hypoxia is the only physiological mechanism for increasing erythropoietin production (R).

Erythropoietin controls the proliferation, differentiation, and survival of red blood cell precursors (R).

Erythropoietin (EPO) is produced by the kidney in the adult and by the liver in the fetus, also by the brain in very little quantities (R).

Production of EPO

Loss of red blood cells in a normal individual due to bleeding or hemolysis reduce the delivery of oxygen to the tissues. When cells in the kidney and liver find this low oxygen level in tissues, they produce EPO (R).


Health Benefits of Erythropoietin


1) Erythropoietin is an Anti-inflammatory

In a randomized controlled trial, 94 patients with necrotizing enterocolitis were treated with recombinant EPO, results showed that EPO was able to reduce the levels of inflammatory response of TNF-α and IL-6 (R).

EPO increases the production of some cytokines (Th2 cytokinesIL-2, IL-4, and IL-10) by activated T cells. It could directly reduce the regulation of pro-inflammatory T cell responses and it cannot affect the T cell activation status (R).

Inflammation is said to play a key role in meconium aspiration syndrome (MAS). Recombinant human EPO is associated with improved BAL (bronchoalveolar lavage) fluid and serum cytokine levels. Pretreatment might also reduce the risk of developing MAS (R).

2) Erythropoietin Helps Treat Anemia


The approved clinical uses of EPO are the anemias associated with end-stage kidney disease, cancer chemotherapeutic agents and patients with HIV infection (R).

A prospective observational case series study in Chronic kidney failure (CKD) patients with anemia suggested the use of erythropoietin along with iron as an effective and beneficial treatment especially in patients with low hemoglobin (R).

EPO treatment reduced the number of blood transfusions in preterm infants with anemia (R).

For the treatment of anemia in patients receiving cytotoxic chemotherapy, administered EPO shortens the period of symptomatic anemia (R).

3) Erythropoietin Enhances Muscular Performance


EPO as blood doping improved the athletes’ long-duration muscular performances much more than expected by increasing red blood cells which carry the oxygen to tissues (R).

Experimental evidence and clinical experience show that erythropoietin has a positive effect on skeletal and cardiac muscle. Mice lacking EPO or its receptor suffer from incomplete development of heart and have a reduced number of proliferating cardiac muscle cells (R).

4) Erythropoietin Protects the Brain

EPO is a promising neuroprotective agent and is currently in the Phase III clinical trials for the treatment of traumatic brain injury. It has a bimodal effect on cell death, glial reactivity, and oxidative stress (R).

5) Erythropoietin Could Prevent Eye Damage


Studies showed that treatment with EPO protects the retina after trauma. Either intraocular delivery of EPO or treatment with non-erythropoietic forms of EPO may be more effective (R).

6) Erythropoietin for Bone Regeneration

Studies in animals showed that EPO has significant effects on bone formation and angiogenesis (development of new blood vessels) and has the capacity to promote the repair of bone defects (R).

7) Erythropoietin for Wound Healing

A Phase II clinical study states that low doses of EPO promoted wound healing of ulcers in diabetics (R).

In a Double-blind, randomized, placebo-controlled trial EPO mouthwash when given to patients with Oral mucositis (OM) and undergoing autologous hematopoietic stem cell transplantation reduced the incidence and duration of OM (R).


The use of recombinant human erythropoietin as a performance-enhancing agent is dangerous particularly in the less fit athlete (R).

Elevation of red cell mass by recombinant human EPO  is associated with the reduction in plasma level and also hypertension is induced in some patients (R).


  • EPO receptor activation induces the stimulation of JAK2, which leads to tyrosine phosphorylation of several proteins including EPO receptor itself (R).
  • EPO receptor binding leads to intracellular activation of Ras/MAPK and other pathways, which have a role in cell proliferation (R).

Increasing Erythropoietin

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