促红细胞生成素在心血管疾病中的作用研究进展

促红细胞生成素是一种由肾脏分泌的相对分子量为34 000的糖蛋白。以往认为促红细胞生成素在体内的主要作用是与红系祖细胞表面的特异性促红细胞生成素受体结合,从而刺激其增殖分化,其在临床上的应用也局限于纠正慢性贫血。新近认为促红细胞生成素属于细胞因子超家族。除肾脏外,许多器官和组织如大脑、肝脏、子宫、血管内皮细胞、平滑肌细胞和心肌细胞等都可产生促红细胞生成素和表达促红细胞生成素受体。促红细胞生成素与促红细胞生成素受体结合后激活某些信号转导途径,发挥抑制细胞凋亡、促新生血管生成等多种与造血无关的组织和细胞保护作用。研究发现,心力衰竭患者接受促红细胞生成素治疗后心功能明显改善。在缺血再灌注损伤的实验动物模型中也发现,促红细胞生成素治疗组梗死面积明显减小。综上所述,促红细胞生成素在临床上除了简单的纠正贫血以外还可用于多种心血管疾病的辅助治疗。现对促红细胞生成素在心血管系统的多种作用及机制进行综述。

A Review of Effects of Erythropoietin in Cardiovascular Diseases

Erythropoietin is a 34 kD glycoprotein synthesized primarily by the kidney.It is well known that erythropoietin can correct anemia as it regulates proliferation and differentiation of erythroid cells.Aside from the kidney,other organs and tissue such as the brain,liver,uterus,endothelium,smooth muscle cell and cardiac muscle cell can also synthesize erythropoietin and express the erythropoietin receptor.The combination of erythropoietin and the erythropoietin receptor produces anti-apoptotic and pro-angiogenesis effects by activating a signal pathway,which is not involved in hemopoiesis.Recent studies have found an enhancement of cardiac function in heart failure patients receiving erythropoietin treatment.Experiments carried out in animal models of ischemia/reperfusion injury have shown a significant reduction in infarct size following erythropoietin treatment.Taken together,these findings suggest that erythropoietin may be clinically useful as an adjunct in the treatment of cardiovascular conditions.This review focuses on the effects of erythropoietin in the cardiovascular system.