促红细胞生成素(EPO)为165个氨基酸残基组成的糖蛋白,主要由胎肝和成人肾皮质的成纤维细胞生成。EPO的表达受到多种转录因子和表观遗传学调控。EPO与其受体结合后主要通过激活Jak2/stat5通路,进而激活 Pim、c-Myc、OncostatinM、Bcl-2、Bcl-xL、SOCS 和 D-type cyclin 等基因,在红细胞生成过程中起到抗细胞凋亡和促进细胞增殖等重要作用。使用促红细胞生成剂上调血红蛋白含量,进而改善贫血患者的能量水平和生活质量具有重要意义,但长期使用存在一些副作用。本文对EPO表达调控机制及其在贫血治疗中的应用进行论述。
Erythropoietin (EPO) is a glycoprotein composed of 165 amino acid residue that is mainly produced in the fetal liver and adult kidney cortex fibroblast. The binding of EPO and its receptor can activate Jak2/stat5 pathway. Several important Stat5 target genes, such as Pim, c-Myc, OncostatinM, Bcl-xL SOCS or D-type cyclins are required for functional erythropoiesis. The expression of EPO is regulated by a variety of transcription factors and epigenetic regulation. Erythropoiesis-stimulating agents (ESA) can increase hemoglobin levels, and thus improve the energy level and quality of life in patients with anemia, but the long-term use of ESA also has some side effects. In this paper, the EPO expression regulation mechanism and its application in the treatment of anemia of chronic disease is discussed.