Theme |
Erythropoietin Up-To-Date |
Title |
Renal anemia and immune system |
Author |
Kazushi Nakao |
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry |
Author |
Haruo Ichikawa |
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry |
Author |
Jun Wada |
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry |
Author |
Hirofumi Makino |
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry |
[ Summary ] |
Much work has been done to elucidate the pathogenesis of anemia in chronic inflammatory states. It has become apparent that inflammatory cytokines, such as IL-1, tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) probably are associated with the suppression of erythropoiesis. It has also been reported that some uremic toxins and inflammatory cytokines seem to suppress erythropoiesis in patients with end stage renal disease (ESRD). Furthermore, our investigation identified that erythropoiesis in patients with ESRD underlying rHuEPO therapy was significantly suppressed at the initial step of hematopoiesis. Further investigation of primitive hematopoietic stem/progenitors may help reveal the mechanisms of not only renal anemia but also hypo-responsiveness to rHuEPO. |