Recombinant human erythropoietin reduces plasminogen activator inhibitor and ameliorates pro-inflammatory responses following trauma

Besides its hematopoietic effects, erythropoietin [EPO] by mobilization of iron and modulation of some inflammatory cytokines has antioxidant and anti-inflammatory properties. The purpose of this study was to evaluate these effects of erythropoietin and its impact on organ function in traumatized patients. Twenty-six ICU-admitted traumatized patients within 24 hrs after trauma were randomly assigned to the EPO [received EPO, 300 units/Kg/day] and Control [not received EPO] groups. The inflammatory biomarkers including Tumor Necrosis Factor alpha [TNF-alpha], Interleukin 1 [IL-1], Plasminogen Activator Inhibitor 1 [PAI-1] and Nitrotyrosine were recorded at the admission, 3, 6 and 9 days thereafter. Acute Physiology and Chronic Health Evaluation [APACHE II] and Sequential Organ Failure Assessment [SOFA] scores were also recorded. Results: Among 12 patients [EPO group] TNF-alpha level at the day of 9 [P=0.046], and within EPO group at the days of 3 [P=0.026 ameliorate], 6 [P=0.016], and 9 [P=0.052] were significantly lowered. Level of IL-1 and PAI-1 decreased significantly at days of 3, 6 and 9 post intervention. Also there were significant differences between two groups in the SOFA score during three measured time intervals [the first, third and seventh days]. From the results of this study it seems that injection of erythrocyte stimulating agent is well tolerated and inhibits the inflammatory response and oxidative stress following trauma