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J Am Soc Nephrol 15:2115-2124, 2004
© 2004 American Society of Nephrology


BASIC SCIENCE

Erythropoietin Protects the Kidney against the Injury and Dysfunction Caused by Ischemia-Reperfusion

Edward J. Sharples*, Nimesh Patel*, Paul Brown{dagger}, Keith Stewart{dagger}, Helder Mota-Philipe{ddagger}, Michael Sheaff§, Julius Kieswich*, David Allen*, Steven Harwood*, Martin Raftery*, Christoph Thiemermann* and Muhammad M. Yaqoob*

*Department of Experimental Medicine and Nephrology, Anthony Raine Laboratory and William Harvey Research Institute, St. Bartholomew’s and the Royal London School of Medicine, Queen Mary College, University of London, London, United Kingdom; {dagger}Department of Pathology, University Medical Buildings, Aberdeen, Scotland, United Kingdom; {ddagger}Laboratory of Pharmacology, University of Lisbon, Lisbon, Portugal; and §Department of Pathology, Royal London Hospital, London, United Kingdom

Correspondence to Dr. Edward J. Sharples, Department of Experimental Medicine and Nephrology, William Harvey Research Institute, John Vane Science Block, Charterhouse Square, London. Phone: 02007377480; Fax: 02073777003; E-mail: edsharps{at}doctors.org.uk

ABSTRACT. Erythropoietin (EPO) is upregulated by hypoxia and causes proliferation and differentiation of erythroid progenitors in the bone marrow through inhibition of apoptosis. EPO receptors are expressed in many tissues, including the kidney. Here it is shown that a single systemic administration of EPO either preischemia or just before reperfusion prevents ischemia-reperfusion injury in the rat kidney. Specifically, EPO (300 U/kg) reduced glomerular dysfunction and tubular injury (biochemical and histologic assessment) and prevented caspase-3, -8, and -9 activation in vivo and reduced apoptotic cell death. In human (HK-2) proximal tubule epithelial cells, EPO attenuated cell death in response to oxidative stress and serum starvation. EPO reduced DNA fragmentation and prevented caspase-3 activation, with upregulation of Bcl-XL and XIAP. The antiapoptotic effects of EPO were dependent on JAK2 signaling and the phosphorylation of Akt by phosphatidylinositol 3-kinase. These findings may have major implications in the treatment of acute renal tubular damage.




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