eritropoëtine

eritropoëtine, also known as erythropoietin (EPO), is a glycoprotein hormone that regulates red blood cell production. In humans, the kidneys produce most circulating erythropoietin, while the liver contributes during fetal development. Erythropoietin is released in response to tissue hypoxia and acts on erythroid progenitor cells in the bone marrow by binding to the erythropoietin receptor, activating signaling pathways such as JAK2/STAT5 that promote the proliferation and maturation of red blood cells.

Recombinant forms of erythropoietin, collectively known as erythropoiesis-stimulating agents (ESAs), are used clinically to treat anemia. Indications include chronic kidney disease, anemia related to chemotherapy for cancer, and certain HIV therapies. They may also be used to reduce the need for red blood cell transfusions in surgical patients. Treatment targets and dosing vary, and therapy typically requires monitoring of hemoglobin and iron status to avoid overcorrection, which can raise cardiovascular risk.

Adverse effects and safety concerns include hypertension, thromboembolic events, and, rarely, antibodies that neutralize endogenous erythropoietin leading to pure red cell aplasia. Risks are heightened at higher hemoglobin targets or with rapid correction. Erythropoietin misuse has been reported as a performance-enhancing drug in sport and is regulated by major sporting bodies and health authorities.

History and development: the hormone was identified in the mid-20th century, with the first recombinant ESAs approved for clinical use in the 1980s. See also erythropoietin receptor; anemia; blood doping.