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Colon cancer-related anemia (CCRA) is mainly caused by systemic inflammation, intestinal bleeding, iron deficiency and chemotherapy-induced myelosuppression in colon cancer. However, the best therapeutic schedule and related mechanism on CCRA were still uncertain. Studies on blood enrichment and anti-tumor effects of combined Danggui Buxue Decoction (DBD), Fe and rhEPO based on CCRA and gut microbiota modulation were conducted in this paper. Here, CCRA model was successfully induced by subcutaneous inoculation of CT-26 and i.p. oxaliplatin, rhEPO + DBD high dosage + Fe (EDF) and rhEPO + DBD high dosage (ED) groups had the best blood enrichment effect. Attractively, EDF group also showed antitumor activity. The sequencing results of gut microbiota showed that compared to P group, the relative abundances of Lachnospiraceae and opportunistic pathogen (Odoribacter) in ED and EDF groups were decreased. Interestingly, EDF also decreased the relative abundances of cancer-related bacteria (Helicobacter, Lactococcus, Alloprevotella) and imbalance-inducing bacteria (Escherichia-Shigella and Parabacteroides) and increased the relative abundances of butyrate-producing bacteria (Ruminococcaceae_UCG-014), however, ED showed the opposite effects to EDF, this might be the reason of the smaller tumor volume in EDF group. Our findings proposed the best treatment combination of DBD, rhEPO and Fe in CCRA and provided theoretical basis and literature reference for CCRA-induced intestinal flora disorder and the regulatory mechanism of EDF.
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Objective To observe changes of the expression of Bcl‐2 and endothelial nitric oxide synthase (eNOS) in lung tissue ,which was used the indifferent treatment doses of recombinant human erythropoietin (rhEPO) of newborn SD model of a new type of bronchial pulmonary dysplasia .To explore its effect on the protection of the new type of bronchial pulmonary dysplasia (BPD) ,and find out the appropriate drug delivery time and dosage .Methods We used the things lipopolysaccharide (LPS) and continuous high oxygen preparation to make the new model of the BPD .We made random normal newborn mice 18 as normal air group ,and then 90 newborn baby mice model of random points normal saline group (group A) ,rhEPO800 group (group B);rhEPO 1000 group (group C) ,rhEPO1200 group (group D) ,rhEPO1400 group (group E) ,in experiment 1 ,7 ,and 14 days ,we were ran‐domly selected 6 executed only lung tissue under liquid nitrogen .Using RT‐PCR and Western blot method to detect the Bcl‐2 and eNOS protein and mRNA expression in lung tissue .Results Compared with the normal air group ,the expression of protein and mRNA of Bcl‐2 in group A was decreased ,while the expression of eNOS was increased .Compared with group B ,C ,D ,E ,with the increase of rhEPO concentration ,the expression of Bcl‐2 protein and mRNA in group A gradually increased ,while the expression of eNOS gradually decreased ,and the expression of the group E was the most obvious ,and the difference was statistically significant (P<0 .05) .Conclusion It is prompted that rhEPO has some treatment function to the new BPD ,while the dose of 1 400 IU/kg of 14 days have the best function .
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We conducted a multicenter clinical trial to evaluate the efficacy and safety of recombinant human erythropoietin(Espogen(R), LG Chemical Ltd.) in the anemic patients of chronic renal failure undergoing dialysis. The patients were end-stage renal disease who were undergoing hemodialysis or peritonea1 dialysis for 3 months or longer and they had less than 8g/dL of hemoglobin and more than 100ng/mL of serum ferritin. Hemodialysis patients were administered 150unit/kg/week of recombinant human erythropoietin as initial dose, and peritoneal dialysis patients 50unitAg, twice per week. We examined hemoglobin value every other week and adjusted the dose in order to maintain hemoglobin level as 10-llg/dL. We enrolled 64 patients and analysed 54 cases in the final. 96.3% (52/54) of patients showed increase by more than 1.0g/dL and the others in- crease by more than 0.5g/dL. Baseline hemoglobin, hematocrit were 7.11+/-0.85g/dL, 21.3+/-2.6% and final level were 10.42+/-1.31g/dL, 31.9+/-3.5%(p=0.0001), respectively. Reticulocyte was increased after 2 weeks of administration from 0.90+/-0.74% to 2.45+/-0.84% The adverse effects included hypertension, headache, increased potassium and phosphate level so required regular monitoring. Therefore we showed that Es-pogen was effective in correcting the anemia of chronic renal failure and didn't have any particular adverse effects.
Assuntos
Humanos , Anemia , Diálise , Eritropoetina , Ferritinas , Cefaleia , Hematócrito , Hipertensão , Falência Renal Crônica , Diálise Peritoneal , Potássio , Diálise Renal , ReticulócitosRESUMO
Objective:To observe the change of endogenous erythropoietin(EPO) in patients undergoing elective major surgeries and the impact of recombinant human erythropoietin(rhEPO) on blood viscosity of animalsunder normal physiologic al conditions. In addition, the effect of rhEPO on postoperative anemia in cardiac surgery patients was evaluated. Methods:Ten patients scheduled for elective major procedures were studied. Included criteria were no preoperative anemia, moderate intraoperative blood loss and no postoperative transfusion. Serum EPO levers were measured prior to operation, immediately after the operation, as well as on postoperative days(PODs) 1, 2, 4, 6, 8. The change of Hct was measured too. (EPO group) Six adult rabbits received 300IU/kg of rhEPO weekly for two weeks. Specimens of Hb, Hct, RBC, serum ALT, serum potassium and blood viscosity were obtained before, during and after administration of rhEPO. Six patients with postoperative anemia (Hb＜100g/L) who underwent cardiac surgeries received 300IU/kg of rhEPO weekly for two weeks. The changes of Hb,Hct were compared(rhEpO group). Results: In EPO group serum EPO concentration increased immediately after the operation, reached a peak level during 24-48h postoperatively and remained significantly elevated above the operative value until POD 8. Hct significantly declined after the operation and was still significantly lower than the preoperative value on POD 8.On the 12th day after applying rhEPO, Hb, Hct and RBC of the rabbits were increased significantly, (P＜0.01 ) but serum ALT, potassium and blood viscosity did not changed significantly. In rhEPO group, Hb, Hct increased significantly on the 14 days after applying rhEPO. Conclusion: It is effective and safe to treat postoperative anemia with a high dose of rhEPO in patients undergoing cardiac procedures. The administration of rhEPO corrects postoperative anemia quickly, then precludes many complications related to decrease oxygen delivery capacity.
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PURPOSE: Very low birth weight infants frequently suffer severe anemia. This study was designed to evaluate the effectiveness of rhEPO for prevention of anemia of prematurity and for reduction of the need for transfusion in very low birth weight infants. METHODS: Eighty very low birth weight infants(<1.5 kg) whose gestational age was under 33 weeks were enrolled at 9 university hospital in Korea. This study was conducted as a double-blind randomized, dose-controlled study. In high dose EPO group, 500 IU/kg of rhEPO was subcutaneously administered every other day for 17 times. In low dose EPO group, 250 IU/kg of rhEPO was subcutaneously administered every other day for 17 times. In control group, placebo was administered in the same manner. The effectiveness of rhEPO was evaluated for multiple parameters. RESULTS: 1) Infants receiving high dose rhEPO showed a significant increase in hemoglobin and hematocrit by 3 weeks(P<0.05). 2) Infants receiving high & low dose rhEPO showed an increase in reticulocyte count by 1 week(P<0.05). 3) There were no significant changes in platelet, WBC count, and ANC in each group. 4) Serum concentration of erythropoietin, iron, TIBC and ferritin were highly variable in study patients.5) Incidence of anemia k transfusion in high dose rhEPO group was lower than low dose and control group(P<0.05). 6) Number of patients who did not receive transfusion and whose hematocrit did not fall below 30% in high dose rhEPO group was significantly higher than in low dose and control group(P<0.01). CONCLUSION: High dose recombinant human erythropoietin(rhEPO) treatment for anemia of prematurity may minimize the decrease in hemoglobin and hematocrit, rapidly increase reticulocyte count and reduce the need for transfusion.