THE THERAPEUTIC ROLE OF ERYTHROPOIETIN IN ANEMIA: FROM ERYTHROPOIESIS TO CLINICAL PRACTICE

Abstract

Anemia is a common hematological disorder marked by a drop in red blood cell mass or hemoglobin concentration, which reduces the amount of oxygen that reaches bodily tissues. It continues to be an important worldwide health issue that primarily affects children of young age and women of reproductive stage of life. Numerous factors, such as poor erythropoiesis, persistent infections, inflammatory disorders, and nutritional deficits, contribute to the syndrome. A glycoprotein hormone called erythropoietin (EPO) is secreted by the kidneys and a significant regulator of erythropoiesis. For maintaining sufficient amounts of red blood cells, EPO promotes the growth, development, and survival of red blood cell precursor cells in the bone marrow. The pathophysiology of many types of anemia, including chronic renal disease, inflammatory disorders, chemotherapy-induced anemia, and viral diseases like HIV, is greatly influenced by changes in erythropoietin production or activity. By increasing red blood cell production and lowering reliance on blood transfusions, the formation of recombinant erythropoietin and erythropoiesis-stimulating agents (ESAs) has revolutionized the treatment of anemia. However, as excessive erythropoiesis stimulation might result in consequences such hypertension, cardiovascular risks and thromboembolic events. Biosimilar ESAs and innovative therapy approach like hypoxia-inducible factor prolyl hydroxylase inhibitors, which stimulate endogenous erythropoietin production in a physiologically regulated way, are examples of recent therapeutic advancements. This review provide insight into the global burden of anemia, the mechanisms underlying erythropoiesis and erythropoietin regulation, the link between iron metabolism and RCBs production, and the therapeutic function of erythropoietin and its analogs. It also highlights emerging treatment approaches aimed at improving the safety and effectiveness of anemia management.