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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 66 (1988), S. 241-245 
    ISSN: 1432-1440
    Keywords: Erythropoietin ; Stability ; Radioimmunoassay ; Polycythemic mouse bioassay ; Recombinant DNA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Radioimmunoassays for erythropoietin are limited so far to a few specialized laboratories and this requires transport and storage of samples. We therefore tested the stability of immunoreactive erythropoietin in serum and plasma samples obtained from a uremic and a nonuremic anemic patient. No significant change in the concentration of immunoreactive erythropoietin was found in either serum or plasma samples for up to 14 days of storage. This type of stability was observed no matter whether the samples were stored at room temperature, 4° C, or −20° C. There was no difference between the estimates of erythropoietin in serum and heparinized plasma. Validity of the radioimmunoassay used in this study was demonstrated by parallelism of dilution curves of test specimens and the 2nd International Reference Preparation for erythropoietin and by a close correlation between the immunoreactivity and the bioactivity of the hormone, as assessed in the same samples by the exhypoxic polycythemic mouse bioassay. In conclusion the data obtained clearly indicate that the necessity of storage and transport of clinical samples does not limit the practicability of the radioimmunoassay for erythropoietin.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Hypoxia ; Ischemia ; Acute phase proteins ; Cardiac arrest ; Infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inflammation and hypoxia are frequently associated, but their interaction is poorly understood. In vitro studies have shown that hypoxia stimulates the genes of acute phase proteins (APP) and cytokines known to induce APP. We decided to determine kinetics and potential determinants of an acute phase response after cardiac arrest and to assess whether isolated moderate hypoxia can induce APP in humans in vivo. Design: Prospective, observational study in patients and human experiment. Setting: Tertiary care university hospital. Patients and participants: 22 patients after primarily successful cardiopulmonary resuscitation (CPR) and 7 healthy volunteers. Interventions: None in patients; exposure of volunteers to simulated altitude (460 torr/6 h). Results: Following CPR, type-1 APP (C-reactive protein, α1-acidglycoprotein, serum amyloid A) and type-2 APP (haptoglobin, α1-antitrypsin) increased consistently within 1–2 days and the ’negative' APP transferrin was downregulated. This APP response occurred irrespective of the cause of arrest, the estimated time of anoxia, clinical course or patient outcome and was not different in patients with and without infectious complications. Exposure of healthy volunteers to less severe but more prolonged hypoxia did not induce APP, although a time dependent increase of serum erythropoietin (EPO) was measurable under these conditions, indicating the activation of oxygen dependent gene expression. Conclusions: (i) A marked acute phase response occurs regularly after cardiac arrest, but within the complexity of this situation the severity of hypoxia is not a predominant determinant of this response. (ii) Despite in vitro evidence for similarities in the oxygen dependent regulation of APP and EPO production, the oxygen sensitivity of these proteins in vivo is different. (iii) Measurements of APP are not revealing regarding infectious complications in the early phase after CPR.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 149 (1990), S. 459-464 
    ISSN: 1432-1076
    Keywords: Newborn ; Erythropoiesis ; Anaemia ; Congenital heart disease ; Renal failure ; Arterial oxygen content
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum immunoreactive erythropoietin (siEPO) was determined in cord serum from neonates (n=97, gestational age 36–43 weeks), in healthy children from birth to adolescence (n=260) and in children with haematological (n=30), renal (n=10) and congenital heart diseases (n=70). In healthy children siEPO levels decreased after birth (geometric mean cord siEPO 35.6 mU/ml with 95% range of 17–56 mU/ml in eutrophic, nondistressed fetuses) and reached lowest values during the first 2 months (geometric mean siEPO 11.5 mU/ml). Thereafter siEPO levels increased slightly and were constant between 2 months and adolescence. The geometric mean siEPO for healthy children after birth was 18.8 mU/ml with 95% range of 7–47 mU/ml. These estimates were not significantly different from normal adult values. In newborns with fetal distress (n=15) cord siEPO was significantly elevated (geometric mean 63.0 mU/ml;P〈0.001). In children with haematological disease, siEPO and Hb concentration were inversely correlated (log siEPO (mU/ml)=4.1−0.20×Hb (g/dl);r=−0.62;P〈0.0005). This relationship was significantly different in children with chronic renal failure (log siEPO (mU/ml)=0.67+0.035×Hb (g/dl);r=0.50;P=0.1). In children with heart disease the geometric mean siEPO was 19.2 mU/ml with 95% range 8–65 mU/ml for cyanotic (SaO2〈94%) and 17.7 mU/ml with 95% range of 12–36 mU/ml for acyanotic patients. In this group siEPO values were inversely correlated to the arterial oxygen content (log siEPO (mU/ml) =1.61−2.04×oxygen content (l/l);r=−0.28;P〈0.02).
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 718 (1994), S. 0 
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2013
    Keywords: Isolated perfused kidney ; Radioimmunoassay ; Hypoxia ; Renal oxygen sensing ; cAMP ; cGMP ; Calmodulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study we have investigated the role of oxygen delivery and of classic second messengers on erythropoietin production by the isolated perfused rat kidney. We found that the rat kidney was capable of de novo synthesis of erythropoietin. The erythropoietin production rate was inversely related to the oxygen pressure in the perfusate and increased from 0.17 to 1.85 U erythropoietin h−1 g kidney−1 when arterial PO2 was lowered from 500 mmHg to 30 mmHg. Addition of forskolin (10 μM) and 8-bromo-cGMP (100 μM) to the perfusate elicited significant effects on the renal vascular resistance, but had no significant effect on erythropoietin production. Hypoxia-induced erythropoietin formation, however, was blocked by calmidazolium (1 μM) and W-7 (10 μM), two structurally different putative calmodulin antagonists. Calmidazolium and W-7 had no effect on other functional parameters of the isolated perfused rat kidney such as flow rate, glomerular filtration rate or sodium reabsorption. Our findings suggest that the oxygen-sensing mechanism that controls renal erythropoietin production is primarily located in the kidney itself. A calcium/calmodulin-dependent cellular reaction could be involved in the signal transduction process.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 423 (1993), S. 356-364 
    ISSN: 1432-2013
    Keywords: Erythropoietin ; Hepatocytes ; Rat ; In vitro ; Hypoxia ; Signalling ; mRNA ; RNase protection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since in juvenile rats the liver is the predominant site of erythropoietin (EPO) gene expression, we have used primary cultures of juvenile rat hepatocytes to establish an in vitro system for investigation of oxygen-dependent EPO formation. When isolated hepatocytes were incubated at reduced oxygen tensions for 18–48 h, we found increased secretion of EPO protein and elevated levels of EPO mRNA, as determined by RNase protection. This increase was maximal at 3% O2, where EPO mRNA levels after 18 h were approximately 15fold higher than at 20% O2. The increase in EPO mRNA at low oxygen tensions was specific insofar as [3H]uridine incorporation, as a measure of total RNA synthesis, was reduced by approximately 50% at 3% O2, and it appeared to involve gene transcription since it was abolished in the presence of actinomycin D (35 μM). Significant increases in EPO mRNA were also observed in cells kept at 20% oxygen in the presence of cobalt chloride (50 μM) and nickel chloride (400 μM), but EPO mRNA levels achieved under these conditions were less than 7% of those in cells incubated at 3% oxygen. No increase in EPO mRNA levels was observed in cultures incubated at 20% O2 in the presence of cyclic dibutyrylAMP (10 μM-3 mM), cyclic 8-bromoGMP (10 μM1 mM), cyclohexyladenosine (1 μM), 5′-N-ethylcarboxamidoadenosine (1 μM) and phorbol 12-myristate 13acetate (3 nM). In the presence of 10% carbon monoxide, used to block haem proteins in their oxy conformation, EPO mRNA levels in hepatocytes incubated at low oxygen tensions were reduced to 63%. Taken together, these findings indicate that oxygen-dependent control of the EPO gene in hepatocytes operates via intrinsic cellular oxygen-sensing mechanisms. Their signal transduction does not seem to occur via classical “second-messenger” pathways. A haem protein may be involved in oxygen sensing, but no conclusive evidence was obtained as to whether it is essential.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 69 (1991), S. 567-575 
    ISSN: 1432-1440
    Keywords: Erythropoietin ; Kidney ; Anemia ; Oxygen ; Proximal tubule ; Endothelium ; Fibroblasts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The kidney is the main site of erythropoietin (EPO) formation. Oxygen sensing in the kidney itself plays a major role in the control of EPO synthesis. By in situ hybridization it has been established that the EPO-producing cells are situated in the interstitium of the cortical labyrinth, but they have not been precisely identified. Morphological findings provide new insights into the location and mechanism of oxygen sensing in the kidney. In addition to causing an increase in the number of cells containing EPO messenger RNA, anemia provokes structural changes exclusively in the cortical labyrinth. Specifically, the fibroblasts become enlarged and show increased activity of 5′-nucleotidase, and the S1 segment of the proximal tubule shows similar alterations as in various models of hypoxia. Thus, structures that are situated in the close vicinity of the EPO-producing cells appear to be sensitive to decreased oxygen delivery.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 68 (1994), S. 117-124 
    ISSN: 1432-0584
    Keywords: Erythropoietin ; Erythropoiesis Surgery ; Hip arthroplasty ; Revision hip arthroplasty ; Blood loss ; Acute-phase proteins C-reactive protein ; Fibrinogen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To examine the influence of intra- and post-operative blood loss and operative trauma on erythropoietin (EPO) production we studied patients undergoing endoprothetic surgery of the hip. Immunoreactive plasma EPO was determined in ten patients (seven male, three female, aged 39–68 years), undergoing surgery for hip arthroplasty (n=8) or revision hip arthroplasty (n=2). EPO levels had already been determined during preoperative autologous deposit, thus allowing direct comparison between EPO response to blood loss alone and the response to blood loss and operative trauma. Perioperative blood loss amounted to 1720 (480–8100) ml (median, range). The hemoglobin concentration decreased from 12.4 (10.6–14.0) g/dl (median, range) before the operation to 10.0 (9.3–12.3) g/dl 2 h after the operation. Thereafter, the hemoglobin concentration increased slowly due to transfusion and erythropoiesis and was not significantly different (p〈0.05) from the preoperative value on the seventh postoperative day. The EPO concentration was preoperatively 26 (11–28) mU/ml and increased 2 h after the end of the operation, reaching a peak of 64 (45–104) mU/ml at 24 h. This peak was followed by a plateau at lower, but still elevated levels. The EPO concentration remained significantly elevated above the preoperative value on the seventh postoperative day. Plasma EPO concentrations showed an adequate response to postoperative anemia compared with the time course after autologous donation. In the early postoperative phase, they do not seem to be appreciably influenced by the neuroendocrine response to trauma, by mediators of inflammation, or by the postoperative catabolic state. The slightly elevated EPO concentration in the late postoperative phase indicates that factors other than anemia may contribute to EPO production at this time.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 64 (1992), S. 281-285 
    ISSN: 1432-0584
    Keywords: Autologous blood donation ; Donation intervals ; Erythropoietin ; Erythropoiesis ; Iron metabolism ; Vitamin B12 ; Folic acid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Plasma immunoreactive erythropoietin (EPO) concentrations were studied in ten patients (7 men, 3 women) predonating autologous blood for hip arthroplasty. Donations were scheduled on day 1, 3, 7, 14 (and 21 if four units could not be donated previously). A predonation hemoglobin concentration of 11 g/dl was required. The donations led to a decline of the hemoglobin concentration from 14.1±1.0 g/dl (X±SD) prior to donation to 11.0±0.9 g/dl on day 15. EPO concentration prior to donation was 17.6±2.6 mU/ml. Each phlebotomy was followed by a rise in EPO levels that reached a peak concentration within 1 day. The highest concentration (35.8±15.0 mU/ml) was measured on day 16. The peak concentration was followed by a plateau at lower, although still elevated levels after the first and second donation, and by a slow, continuous decline after the third and fourth donation. This particular time course is similar to that during weekly donations [15]. The time integral of the EPO concentration during the first 3 weeks, however, was greater in the present study. This increased availability of EPO early during donation may lead to a more efficient stimulation of erythropoiesis.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Cellular and molecular life sciences 46 (1990), S. 1197-1201 
    ISSN: 1420-9071
    Keywords: Hypoxia ; oxygen sensing ; erythropoietin ; isolated kidneys
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary The glycoprotein hormone erythropoietin (EPO) counteracts tissue hypoxia by increasing the systemic oxygen-carrying capacity. It induces augmentation of red blood cell mass by stimulating the formation and differentiation of erythroid precursor cells in the bone marrow. EPO production is increased under various forms of diminished oxygen supply such as anemic or hypoxic hypoxia. In the adult organism, the kidneys are the major source of EPO. The precise nature of the cells responsible for renal EPO production, however, has not yet been elucidated. Most likely, peritubular cortical cells, e.g. interstitial or endothelial cells, are involved in the elaboration of the hormone. From the observation that isolated perfused rat kidneys produce EPO in an oxygen-dependent fashion we conclude that the ‘oxygen sensor’ that controls hypoxia-induced EPO synthesis is located in the kidney itself. Within the kidneys, the local venous oxygen tension which reflects the ratio of oxygen supply to oxygen consumption is measured and transformed into a signal that regulates the formation of EPO. However, the mechanism by which a decrease of oxygen delivery to the kidneys is linked to an enhanced EPO gene expression is not yet known. Two possible mechanisms of regulation are discussed: First, renal hypoxia could lead to enhanced formation of metabolic mediators, for example prostaglandins or adenosine, which might stimulate EPO gene transcription by increasing cellular levels of second messenger molecules. Second, some kind of molecular ‘oxygen receptor’ such as a heme protein, that controls EPO formation by an oxygen-dependent conformational change, could mediate signal transduction.
    Type of Medium: Electronic Resource
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