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Erythropoiesis and chronic kidney disease-related anemia: From physiology to new therapeutic advancements.

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Cernaro, Valeria Coppolino, Giuseppe Visconti, Luca Rivoli, Laura Lacquaniti, Antonio Buemi, Antoine [UCL] Buemi, Michele

Erythropoiesis is triggered by hypoxia and is strictly regulated by hormones, growth factors, cytokines, and vitamins to ensure an adequate oxygen delivery to all body cells. Abnormalities in one or more of these factors may induce different kinds of anemia requiring different treatments. A key player in red blood cell production is erythropoietin. It is a glycoprotein hormone, mainly produced by the kidneys, that promotes erythroid progenitor cell survival and differentiation in the bone marrow and regulates iron metabolism. A deficit in erythropoietin synthesis is the main cause of the normochromic normocytic anemia frequently observed in patients with progressive chronic kidney disease. The present review summarizes the most recent findings about each step of the erythropoietic process, going from the renal oxygen sensing system to the cascade of events induced by erythropoietin through its own receptor in the bone marrow. The paper also describes the new class of drugs designed to stabilize the hypoxia-inducible factor by inhibiting prolyl hydroxylase, with a discussion about their metabolism, disposition, efficacy, and safety. According to many trials, these drugs seem able to simulate tissue hypoxia and then stimulate erythropoiesis in patients affected by renal impairment. In conclusion, the in-depth investigation of all events involved in erythropoiesis is crucial to understand anemia pathophysiology and to identify new therapeutic strategies, in an attempt to overcome the potential side effects of the commonly used erythropoiesis-stimulating agents.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès libre
Publication date 2019
Language Anglais
Journal information "Medicinal research reviews" - Vol. 39, no. 2, p. 427-460 (2019)
Peer reviewed yes
Publisher Wiley ((United States) New York, NY)
issn 0198-6325
e-issn 1098-1128
Publication status Publié
Affiliations UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation
UCL - (SLuc) Service de chirurgie et transplantation abdominale
Keywords HIF stabilizers ; erythropoiesis-stimulating agents (ESA) ; erythropoietin ; hypoxia-inducible factor (HIF) ; pleiotropic effects
Links
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Bibliographic reference Cernaro, Valeria ; Coppolino, Giuseppe ; Visconti, Luca ; Rivoli, Laura ; Lacquaniti, Antonio ; et. al. Erythropoiesis and chronic kidney disease-related anemia: From physiology to new therapeutic advancements.. In: Medicinal research reviews, Vol. 39, no. 2, p. 427-460 (2019)
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