Regenerative Properties of Recombinant Human Erythropoietin in the Wound Healing

Authors

DOI:

https://doi.org/10.3889/oamjms.2021.5813

Keywords:

EPO, wound healing, VEGF, reepithelization, skin, erythropietin

Abstract

BACKGROUND: Erythropoietin (EPO) is the main stimulator of erythropoiesis, but EPO also has non-hematopoietic effects. The recent data show the positive effects of EPO on tissue regeneration.

AIM: This review aims to know highlights the pathophysiological mechanisms of EPO at different stages of tissue regeneration, and possible clinical applications in wound healing.

METHODS: A review of the literature considering reviews, clinical studies, original papers, and articles from electronic data has been used.

RESULTS: Analysis of animal studies and several clinical trials using EPO in context of wound healing revealed that EPO has a positive effect on all stages of regeneration process and may be a promising therapeutic strategy for the treatment of chronic wounds.

CONCLUSION: An improved understanding of the functions and regulatory mechanisms of EPO in the context of wound healing may lead to new considerations of this growth hormone for its regular clinical application in patients.

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References

Peng B, Kong G, Yang C, Ming Y. Erythropoietin and its derivatives: From tissue protection to immune regulation. Cell Death Dis. 2020;11:79. https://doi.org/10.1038/s41419-020-2276-8 DOI: https://doi.org/10.1038/s41419-020-2276-8

Suyono H, Sanjaya K, Susanti D. The role of antiapoptotic erythropoietin on ultraviolet B-induced photodamaged skin through inhibition of sunburn cells. Fol Med Indones. 2020;56(2):2114-7. https://doi.org/10.20473/fmi.v56i2.21229 DOI: https://doi.org/10.20473/fmi.v56i2.21229

French C. Erythropoietin in critical illness and trauma. Crit Care Clin. 2019;35(2):277-87. PMid:30784609 DOI: https://doi.org/10.1016/j.ccc.2018.11.015

Chamorro ME. Role of protein tyrosine phosphatase 1B (PTP1B) in the increased sensitivity of endothelial cells to a promigratory effect of erythropoietin in an inflammatory environment. Biol Chem. 2020;401(10):1167-80. https://doi.org/10.1515/hsz-2020-0136 PMid:32386183 DOI: https://doi.org/10.1515/hsz-2020-0136

Lee YM, Choi JH, Min WK, Han JK, Oh JW. Induction of functional erythropoietin and erythropoietin receptor gene expression by gamma-aminobutyric acid and piperine in kidney epithelial cells. Life Sci. 2018;215(15):207-15. https://doi.org/10.1016/j.lfs.2018.11.024 PMid:30439377 DOI: https://doi.org/10.1016/j.lfs.2018.11.024

Kimáková P, Solár P, Solárová Z, Komel R, Debeljak N. Erythropoietin and its angiogenic activity. Int J Mol Sci. 2017;18(7):1519. https://doi.org/10.3390/ijms1807151912 PMid:28703764 DOI: https://doi.org/10.3390/ijms18071519

Teramo KA, Klemetti MM, Widness JA. Robust increases in erythropoietin production by the hypoxic fetus is a response to protect the brain and other vital organs. Pediatr Res. 2018;84(6):807-12. https://doi.org/10.1038/s41390-018-0054-4 PMid:29895839 DOI: https://doi.org/10.1038/s41390-018-0054-4

Collino M, Thiemermann C, Cerami A, Brines M. Flipping the molecular switch for innate protection and repair of tissues: Long-lasting effects of a non-erythropoietic small peptide engineered from erythropoietin. Pharmacol Ther. 2015;151:32- 40. https://doi.org/10.1016/j.pharmthera.2015.02.005 PMid:25728128 DOI: https://doi.org/10.1016/j.pharmthera.2015.02.005

Hamed S, Ullmann Y, Egozi D, Keren A, Daod E, Anis O, et al. Topical erythropoietin treatment accelerates the healing of cutaneous burn wounds in diabetic pigs through an aquaporin- 3-dependent mechanism. Diabetes. 2017;66(8):2254-65. https://doi.org/10.2337/db16-1205 PMid:28546424 DOI: https://doi.org/10.2337/db16-1205

Siebert N, Xu W, Grambow E, Zechner D, Vollmar B. Erythropoietin improves skin wound healing and activates the TGF-β signaling pathway. Lab Invest. 2011;91(12):1753-65. https://doi.org/10.1038/labinvest.2011.125 PMid:21894148 DOI: https://doi.org/10.1038/labinvest.2011.125

Javadmoosavi S Y, Parsamanesh N, Afshar M, Zardast M, Ghaderi R. Comparison of the effects of systemic and subcutaneous injection of recombinant human erythropoietin on the tissue-healing process in BALB/c Mice. J Surg Trauma. 2020;8(1):16-22. https://doi.org/10.32592/jsurgery.2020.8.1.102 DOI: https://doi.org/10.32592/jsurgery.2020.8.1.102

Sayan H, Ozacmak VH, Guven A, Aktas RG, Ozacmak ID. Erythropoietin stimulates wound healing and angiogenesis in mice. J Invest Surg. 2006;19(3):163-73. https://doi.org/10.1080 / 08941930600674694 PMid:16809226 DOI: https://doi.org/10.1080/08941930600674694

Bader A, Ebert S, Giri S, Kremer M, Liu S, Nerlich A, et al. Skin regeneration with conical and hair follicle structure of deep second-degree scalding injuries via combined expression of the EPO receptor and beta common receptor by local subcutaneous injection of nanosized rhEPO. Int J Nanomed. 2012;7:1227-37. https://doi.org/10.2147/ijn.s28186 PMid:22419870 DOI: https://doi.org/10.2147/IJN.S28186

Erbayraktar Z, Erbayraktar S, Yilmaz O, Cerami A, Coleman T, Brines M. Nonerythropoietic tissue protective compounds are highly effective facilitators of wound healing. Mol Med. 2009;15(7- 8):235-41. https://doi.org/10.2119/molmed.2009.00051 PMid:19593407 DOI: https://doi.org/10.2119/molmed.2009.00051

Bodó E, Kromminga A, Funk W, Laugsch M, Duske U, Jelkmann W, et al. Human hair follicles are an extrarenal source and a nonhematopoietic target of erythropoietin. FASEB J. 2007;21(12):3346-54. https://doi.org/10.1096/fj.07-8628com PMid:17540710 DOI: https://doi.org/10.1096/fj.07-8628com

Paus R, Bodó E, Kromminga A, Jelkmann W. Erythropoietin and the skin: A role for epidermal oxygen sensing? Bioessays. 2009;31(3):344-8. https://doi.org/10.1002/bies.200800192 PMid:19260015 DOI: https://doi.org/10.1002/bies.200800192

Buemi M, Galeano M, Sturiale A, Ientile R, Crisafulli C, Parisi A, et al. Recombinant human erythropoietin stimulates angiogenesis and healing of ischemic skin wounds. Shock. 2004;22(2):169- 73. https://doi.org/10.1097/01.shk.0000133591.47776.bd PMid:15257091 DOI: https://doi.org/10.1097/01.shk.0000133591.47776.bd

Galeano M, Altavilla D, Cucinotta D, Russo GT, Calò M, Bitto A, et al. Recombinant human erythropoietin stimulates angiogenesis and wound healing in the genetically diabetic mouse. Diabetes. 2004;53(9):2509-17. https://doi.org/10.2337/diabetes.53.9.2509 PMid:15331568 DOI: https://doi.org/10.2337/diabetes.53.9.2509

Hamed S, Ullmann Y, Egozi D, Daod E, Hellou E, Ashkar M, et al. Fibronectin potentiates topical erythropoietin-induced wound repair in diabetic mice. J Invest Dermatol. 2011;131(6):1365-75. https://doi.org/10.1038/jid.2011.15 PMid:21326299 DOI: https://doi.org/10.1038/jid.2011.15

Imam RA, Rizk AA. Efficacy of erythropoietin-pretreated mesenchymal stem cells in murine burn wound healing: Possible in vivo transdifferentiation into keratinocytes. Folia Morphol (Warsz). 2019;78(4):798-808. https://doi.org/10.5603/fm.a2019.0038 PMid:30949996 DOI: https://doi.org/10.5603/FM.a2019.0038

Holderfield MT, Hughes CC. Crosstalk between vascular endothelial growth factor, notch, and transforming growth factor-beta in vascular morphogenesis. Circ Res. 2008;102(6):637-52. https://doi.org/10.1161/circresaha.107.167171 PMid:18369162 DOI: https://doi.org/10.1161/CIRCRESAHA.107.167171

Corwin HL, Gettinger A, Fabian TC, May A, Pearl RG, Heard S, et al. Efficacy and safety of epoetin alfa in critically ill patients. N Engl J Med. 2007;357(10):965-76. https://doi.org/10.1056/nejmoa071533 PMid:17804841 DOI: https://doi.org/10.1056/NEJMoa071533

Brines M, Patel NS, Villa P, Brines C, Mennini T, De Paola M, et al. Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin. Proc Natl Acad Sci U S A. 2008;105(31):10925-30. https://doi.org/10.1073/pnas.0805594105 PMid:18676614 DOI: https://doi.org/10.1073/pnas.0805594105

Bor-Kucukatay M, Yalcin O, Meiselman HJ, Baskurt OK. Erythropoietin-induced rheological changes of rat erythrocytes. Br J Haematol. 2000;110(1):82-8. https://doi.org/10.1046/j.1365-2141.2000.02150.x PMid:10930982 DOI: https://doi.org/10.1046/j.1365-2141.2000.02150.x

Kwaan HC, Wang J. Hyperviscosity in polycythemia vera and other red cell abnormalities. Semin Thromb Hemost. 2003;29(5):451-8. https://doi.org/10.1055/s-2003-44552 PMid:14631544 DOI: https://doi.org/10.1055/s-2003-44552

Chatzikyrkou C, Bahlmann FH, Sushakova N, Scurt FG, Menne J, Nawroth P, et al. Low-dose erythropoietin promotes wound-healing of ulcers in diabetics: Evidence from a phase-IIa clinical study. Diabetes Metab. 2016;42(6):466-70. http://dx.doi.org/10.1016/j.diabet.2016.05.010 PMid:27324461 DOI: https://doi.org/10.1016/j.diabet.2016.05.010

Günter CI, Machens HG, Ilg FP, Hapfelmeier A, Jelkmann W, Egert-Schwender S, et al. A randomized controlled trial: Regenerative effects, efficacy and safety of erythropoietin in burn and scalding injuries. Front Pharmacol. 2018;9:951. https://doi.org/10.3389/fphar.2018.00951 PMid:30429786 DOI: https://doi.org/10.3389/fphar.2018.00951

Hamed S, Belokopytov M, Ullmann Y, Safadi M, Stark Y, Shoufani A, et al. Interim results of the remede d’Or study: A multicenter, single-blind, randomized, controlled trial to assess the safety and efficacy of an innovative topical formulation of erythropoietin for treating diabetic foot ulcers. Adv Wound Care (New Rochelle). 2019;8(10):514-21. https://doi.org/10.1089/wound.2018.0808 PMid:31832270 DOI: https://doi.org/10.1089/wound.2018.0808

Ferri C, Giuggioli D, Sebastiani M, Colaci M. Treatment of severe scleroderma skin ulcers with recombinant human erythropoietin. Clin Exp Dermatol. 2007;32(3):287-90. https://doi.org/10.1111/j.1365-2230.2007.02363.x PMid:17397351 DOI: https://doi.org/10.1111/j.1365-2230.2007.02363.x

Günter CI, Kern L, Giri S, Machens HG, Bader A. First results on three patients treated with topical recombinant human erythropoietin (rhEPO) to improve wound healing in diabetic foot ulcers. J Transplant Stem Cell Biol. 2015;2(1):2-5. https://doi.org/10.13188 / 2374-9326.1000007 DOI: https://doi.org/10.13188/2374-9326.1000007

Keast DH, Fraser C. Treatment of chronic skin ulcers in individuals with anemia of chronic disease using recombinant human erythropoietin (EPO): A review of four cases. Ostomy Wound Manage. 2004;50(10):64-70. PMid:15509883

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Published

2021-04-04

How to Cite

1.
Toleubayev M, Dmitriyeva M, Kozhakhmetov S, Igissinov N, Turebayev M, Omarbekov A, Adaibayev K, Shakenov A, Izimbergenov M. Regenerative Properties of Recombinant Human Erythropoietin in the Wound Healing. Open Access Maced J Med Sci [Internet]. 2021 Apr. 4 [cited 2024 Nov. 20];9(F):113-7. Available from: https://oamjms.eu/index.php/mjms/article/view/5813

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