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Mechanisms in Hematology: Erythropoiesis
Regulation of Erythropoiesis
Erythropoietin (EPO), a 35 kD glycoprotein, is
the primary humoral regulator of erythropoiesis ~
promoting both proliferation and survival of
erythroid precursors. Approximately 90% of EPO is
synthesized in renal peritubular interstitial cells that
respond to an Or-sensing mechanism. As in other
cells, the oxygen sensor in renal cells probably is a
ferrous iron prolyl hydroxylase that requires
molecular O2 as a cosubstrate. It hydroxylates
specific proline residue(s) in the hypoxia inducible
factor (HIF), a transcription factor that targets a
number of erythropoietic genes, including
erythropoietin, transferrin, the transferrin receptor
(TR), and the vascular-endothelial growth factor
(VEGF). When HIF binds to the hypoxia-response
element (HRE) on the EPO gene, enhanced
transcription results in increased EPO synthesis. In
response to a hypoxic stimulus, recruitment of
additional EPO-producing peritubular cells
supplements the cells that constitutively synthesize
EPO; when the hypoxic stimulus is removed, the
recruited cells return to their non-secretory state.
- TR
glycolysis angiogenesis
VEGF
oxygen s
sensor HIF
hypoxia
EPO WOO
gene
ONION,
EPO
Control of erythropoietin synthesis