Neuroprotective properties of epoetin alfa. Nephrol Dial Transplant 17, Suppl 1: 8–12

Erythropoietin and its receptor function as primary mediators of the normal physiological response to hypoxia. Erythropoietin is recognized for its central role in erythropoiesis, but studies in which recombin-ant human erythropoietin (epoetin alfa) is injected directly into ischaemic rodent brain show that ery-thropoietin also mediates neuroprotection. Abundant expression of the erythropoietin receptor has been observed at brain capillaries, which could provide a route for circulating erythropoietin to enter the brain. In confirmation of this hypothesis, systemic adminis-tration of epoetin alfa before or up to 6 h after focal brain ischaemia reduced injury by 50–75%. Epoetin alfa also limited the extent of concussive brain injury, the immune damage in experimental autoimmune encephalomyelitis and excitotoxicity induced by kai-nate. Thus, systemically administered epoetin alfa in animal models has neuroprotective effects, demon-strating its potential use after brain injury, trauma and multiple sclerosis. It is evident that erythropoietin has biological activities in addition to increasing red cell mass. Given the excellent safety profile of epoetin alfa, clinical trials evaluating systemically administered epoetin alfa as a general neuroprotective treatment are warranted