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Review
. 2010 Apr;22(2):139-45.
doi: 10.1097/MOP.0b013e328336eb57.

Erythropoietin for infants with hypoxic-ischemic encephalopathy

Ronald J McPherson  1 , Sandra E Juul
Affiliations
Review

Erythropoietin for infants with hypoxic-ischemic encephalopathy

Ronald J McPherson et al. Curr Opin Pediatr. 2010 Apr.

Abstract

Purpose of review: Perinatal asphyxia, intraventricular hemorrhage and stroke are common causes of neonatal brain injury, with hypoxia-ischemia as the final common pathway of injury. Erythropoietin (Epo) has potential to lessen neurologic sequelae due to hypoxia-ischemia. The purpose of this review is to highlight new clinical trials and experimental evidence that expand our understanding of Epo as a potential treatment for perinatal brain injury.

Recent findings: Several trials of Epo treatment are reviewed: two phase I/II trials of high-dose Epo given to preterm infants established pharmacokinetic and safety profiles, and a trial of Epo treatment for term infants with moderate hypoxic-ischemic encephalopathy found reduced disability. Potential risks and benefits of high-dose Epo are discussed. New evidence related to Epo receptor expression, signal transduction pathways, and mechanisms of neuroprotection are reviewed.

Summary: Cautious optimism is warranted regarding the use of high-dose Epo as a treatment option for neonatal brain injury. To date, Epo has been well tolerated to use in neonatal populations and now studies of neuroprotective efficacy are underway.

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Figures

Figure 1
Figure 1
A comparison of human and rat blood Epo concentrations. Data from [13] and [14]
Figure 2
Figure 2
Mechanisms of Epo neuroprotection.
See this image and copyright information in PMC

References

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    1. McPherson RJ, Juul SE. Recent trends in erythropoietin-mediated neuroprotection. Int J Dev Neurosci. 2008;26:103–111. The historical evidence for Epo-mediated neuroprotection, and the rationale for using Epo to treat perinatal asphyxia are reviewed. - PMC - PubMed
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