, Volume 37, Issue 9, pp 1403-1405

Erythropoietic neuroprotection: Holy Grail or potential to fail?

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In this issue of Intensive Care Medicine, Simon et al. [1] report that pretreatment with a carbamylated erythropoietin fusion protein (cEPO-FC) is as effective as recombinant human EPO (rhEPO) in ameliorating spinal cord injury in a well-established porcine model of acute spinal cord ischemia and reperfusion. This new fusion protein contains two rhEPO molecules connected by the Fc region of human IgG1. Subsequent carbamylation of the EPO molecule is thought to improve the cytoprotective effects, while reducing side effects including hypertension and thrombosis [2].

EPO and EPO variants

Since the human EPO gene was cloned in 1985, several variants of the EPO molecule have been developed to improve its pharmacokinetic and pharmacodynamic characteristics and to separate its hemopoietic and neuroprotective properties [3]. Epoietin alpha and beta are rhEPOs and have minimal differences in their structure. A variety of EPO derivatives, including cEPO-FC, which target the erythropoietin recepto

This editorial refers to the article available at doi:10.1007/s00134-011-2303-4.