The biology of erythropoietin in the central nervous system and its neurotrophic and neuroprotective potential

This review summarizes published as well as preliminary data on the biology of erythropoietin (Epo) in the developing and mature human central nervous system (CNS). Both Epo receptor (Epo-R) and Epo gene expression underlie d evelopmental changes and a brain-specific regulation. These features sugges t a different role of Epo in normal brain development than in neuroprotecti on and neuronal tissue repair after brain injury. Epo concentrations in the cerebrospinal fluid may have primary paracrine effects. While the transpor t of Epo across the intact blood brain barrier (BBB) is generally limited i n humans, systemically produced or administrated Epo may cross during BBB d ysfunction. Summarized data of the in vivo and in vitro effects of Epo in t he CNS show significant neuroprotective and neurotrophic effects of this mo lecule. These effects are mediated by several mechanisms, including the act ivation of a variety of genes and their consecutive protein production. The rapeutic strategies involving activation of the CNS Epo-R are discussed, in cluding the potential use of Epo mimetic peptides. Copyright (C) 2001 S. Ka rger AG,Basel.