EPO

Question 1

What kind of drug is Alipogene Tiparvovec (Glybera)? What is it used for?

Answer 1

It is a gene-therapy cure. It is used for Lipoprotein lipase deficiency.

Question 2

What is Epoetin also known as? What is it?

Answer 2

Procrit, Epogen, EPO. It is an rDNA derived version of the human hormone, erythropoietin.

Question 3

What is Erythropoietin?

Answer 3

Hormone that stimulates the formation of RBCs.

Question 4

What is EPO used to treat?

Answer 4

Anemia.

Question 5

How long does it take until the brain dies due to oxygen deprivation?

Answer 5

About 6 minutes.

Question 6

What does anemia do to Vo2 max?

Answer 6

It lowers it. Even regular activities could max out someone’s physical abilities.

Question 7

What is Hematocrit?

Answer 7

The percent of the blood volume occupied by RBCs (AKA erythrocytes).

Question 8

What is Anemia?

Answer 8

A diseased state caused by reduced blood hemoglobin concentration (there are several types).

Question 9

What are the symptoms of Anemia (5)?

Answer 9

1. Fatigue. 2. Breathlessness. 3. Paleness. 4. Increased cardiac output (sweating, palpitations). 5. Other, specific to type of Anemia.

Question 10

What are some causes of Anemia?

Answer 10

Genetic disorders, autoimmunity, premature birth, iron deficiency, vitamin B12 deficiency, chemotherapy, renal disease.

Question 11

Where are red blood cells produced?

Answer 11

Stem cells present in bone marrow.

Question 12

How does erythropoietin affect RBC production?

Answer 12

It signals the erythropoietin recepter (EpoR) which stimulates cell proliferation and differentiation in the erythroblast lineage (creating RBCs).

Question 13

What is EpoR’s mechanism of action?

Answer 13

It activates the JAK/STAT signal transduction pathway. Stat dimers activate transcription of key genes in the erythroblast lineage.

Question 14

Where is erythropoietin produced? What happens when this place is negatively affected?

Answer 14

By special O2-sensing cells in the kidney. Reduced EPO production by diseased kidneys is one cause of Anemia.

Question 15

How does EPO circulate?

Answer 15

As an endocrine hormone.

Question 16

What can trigger erythropoietin production?

Answer 16

Low atmosphere levels and blood loss that reduces blood O2 density.

Question 17

How does chemotherapy induce Anemia? What can help treat it?

Answer 17

By poisoning cell lineages. EPO can help treat it.

Question 18

How does renal disease induce Anemia? What can help treat it?

Answer 18

It decreases natural EPO. Exogenous EPO can help treat it.

Question 19

What is Epoetin Alpha (Procrit, Epogen)? How is this drug administered?

Answer 19

Recombinant erythropoietin. It is administered by IV or subcutaneous injection.

Question 20

What is Darbepoetin Alpha (Aranesp)?

Answer 20

Sequence-modified, highly glycosylated EPO with increased half-life.

Question 21

What is Peginesatide (Omontys)?

Answer 21

A chemically modified peptide that mimics erythropoietin.

Question 22

What is Methoxy Polyethylene glycol-epoetin beta (Micera, CERA)?

Answer 22

A conjugate of EPO to polyethylene glycol. Gives a 20-fold longer half-life. It continuously activates the erythropoietin recepter.

Question 23

How does blood doping work?

Answer 23

By increasing VO2 max by increasing the carrying capacity of the blood (usually by increasing Hematocrit).

Question 24

How was blood doping originally done?

Answer 24

Via blood transfusions.

Question 25

What is Homologous doping?

Answer 25

Uses blood from a matched donor.

Question 26

What is Autologous doping?

Answer 26

Uses a persons own blood that was previously stored.

Question 27

How much can recombinant EPO increase VO2 max?

Answer 27

By around 12 percent.

Question 28

How much can recombinant EPO increase time to exhaustion at 80% VO2 max?

Answer 28

By about 50%.

Question 29

What is Vadadustat?

Answer 29

A drug that inhibits HIF prolyl-hydroxylase. Leading to increased HIF 2 alpha production which leads to erythropoietin production under normal conditions.