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      Activation of the β‐common receptor by erythropoietin impairs acetylcholine‐mediated vasodilation in mouse mesenteric arterioles

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          Abstract

          Clinically, erythropoietin ( EPO) is known to increase systemic vascular resistance and arterial blood pressure. However, EPO stimulates the production of the potent vasodilator, nitric oxide ( NO), in culture endothelial cells. The mechanism by which EPO causes vasoconstriction despite stimulating NO production may be dependent on its ability to activate two receptor complexes, the homodimeric EPO ( EPOR 2) and the heterodimeric EPOR/ β‐common receptor ( β CR). The purpose of this study was to investigate the contribution of each receptor to the vasoactive properties of EPO. First‐order, mesenteric arteries were isolated from 16‐week‐old male C57 BL/6 mice, and arterial function was studied in pressure arteriographs. To determine the contribution of each receptor complex, EPO‐stimulating peptide ( ESP), which binds and activates the heterodimeric EPOR/ β CR complex, and EPO, which activates both receptors, were added to the arteriograph chamber 20 min prior to evaluation of endothelium‐dependent (acetylcholine, bradykinin, A23187) and endothelium‐independent (sodium nitroprusside) vasodilator responses. Only ACh‐induced vasodilation was impaired in arteries pretreated with EPO or ESP. EPO and ESP pretreatment abolished ACh‐induced vasodilation by 100% and 60%, respectively. EPO and ESP did not affect endothelium‐independent vasodilation by SNP. Additionally, a novel β CR inhibitory peptide ( β IP), which was computationally developed, prevented the impairment of acetylcholine‐induced vasodilation by EPO and ESP, further implicating the EPOR/ β CR complex. Last, pretreatment with either EPO or ESP did not affect vasoconstriction by phenylephrine and KCl. Taken together, these findings suggest that acute activation of the heterodimeric EPOR/ β CR in endothelial cells leads to a selective impairment of ACh‐mediated vasodilator response in mouse mesenteric resistance arteries.

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          Most cited references41

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          Correction of anemia with epoetin alfa in chronic kidney disease.

          Anemia, a common complication of chronic kidney disease, usually develops as a consequence of erythropoietin deficiency. Recombinant human erythropoietin (epoetin alfa) is indicated for the correction of anemia associated with this condition. However, the optimal level of hemoglobin correction is not defined. In this open-label trial, we studied 1432 patients with chronic kidney disease, 715 of whom were randomly assigned to receive a dose of epoetin alfa targeted to achieve a hemoglobin level of 13.5 g per deciliter and 717 of whom were assigned to receive a dose targeted to achieve a level of 11.3 g per deciliter. The median study duration was 16 months. The primary end point was a composite of death, myocardial infarction, hospitalization for congestive heart failure (without renal replacement therapy), and stroke. A total of 222 composite events occurred: 125 events in the high-hemoglobin group, as compared with 97 events in the low-hemoglobin group (hazard ratio, 1.34; 95% confidence interval, 1.03 to 1.74; P=0.03). There were 65 deaths (29.3%), 101 hospitalizations for congestive heart failure (45.5%), 25 myocardial infarctions (11.3%), and 23 strokes (10.4%). Seven patients (3.2%) were hospitalized for congestive heart failure and myocardial infarction combined, and one patient (0.5%) died after having a stroke. Improvements in the quality of life were similar in the two groups. More patients in the high-hemoglobin group had at least one serious adverse event. The use of a target hemoglobin level of 13.5 g per deciliter (as compared with 11.3 g per deciliter) was associated with increased risk and no incremental improvement in the quality of life. (ClinicalTrials.gov number, NCT00211120 [ClinicalTrials.gov].). Copyright 2006 Massachusetts Medical Society.
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            Normalization of hemoglobin level in patients with chronic kidney disease and anemia.

            Whether correction of anemia in patients with stage 3 or 4 chronic kidney disease improves cardiovascular outcomes is not established. We randomly assigned 603 patients with an estimated glomerular filtration rate (GFR) of 15.0 to 35.0 ml per minute per 1.73 m2 of body-surface area and mild-to-moderate anemia (hemoglobin level, 11.0 to 12.5 g per deciliter) to a target hemoglobin value in the normal range (13.0 to 15.0 g per deciliter, group 1) or the subnormal range (10.5 to 11.5 g per deciliter, group 2). Subcutaneous erythropoietin (epoetin beta) was initiated at randomization (group 1) or only after the hemoglobin level fell below 10.5 g per deciliter (group 2). The primary end point was a composite of eight cardiovascular events; secondary end points included left ventricular mass index, quality-of-life scores, and the progression of chronic kidney disease. During the 3-year study, complete correction of anemia did not affect the likelihood of a first cardiovascular event (58 events in group 1 vs. 47 events in group 2; hazard ratio, 0.78; 95% confidence interval, 0.53 to 1.14; P=0.20). Left ventricular mass index remained stable in both groups. The mean estimated GFR was 24.9 ml per minute in group 1 and 24.2 ml per minute in group 2 at baseline and decreased by 3.6 and 3.1 ml per minute per year, respectively (P=0.40). Dialysis was required in more patients in group 1 than in group 2 (127 vs. 111, P=0.03). General health and physical function improved significantly (P=0.003 and P<0.001, respectively, in group 1, as compared with group 2). There was no significant difference in the combined incidence of adverse events between the two groups, but hypertensive episodes and headaches were more prevalent in group 1. In patients with chronic kidney disease, early complete correction of anemia does not reduce the risk of cardiovascular events. (ClinicalTrials.gov number, NCT00321919 [ClinicalTrials.gov].). Copyright 2006 Massachusetts Medical Society.
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              Derivatives of erythropoietin that are tissue protective but not erythropoietic.

              Erythropoietin (EPO) is both hematopoietic and tissue protective, putatively through interaction with different receptors. We generated receptor subtype-selective ligands allowing the separation of EPO's bioactivities at the cellular level and in animals. Carbamylated EPO (CEPO) or certain EPO mutants did not bind to the classical EPO receptor (EPOR) and did not show any hematopoietic activity in human cell signaling assays or upon chronic dosing in different animal species. Nevertheless, CEPO and various nonhematopoietic mutants were cytoprotective in vitro and conferred neuroprotection against stroke, spinal cord compression, diabetic neuropathy, and experimental autoimmune encephalomyelitis at a potency and efficacy comparable to EPO.
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                Author and article information

                Contributors
                segalms@medicine.ufl.edu
                Journal
                Physiol Rep
                Physiol Rep
                10.1002/(ISSN)2051-817X
                PHY2
                physreports
                Physiological Reports
                John Wiley and Sons Inc. (Hoboken )
                2051-817X
                25 June 2018
                June 2018
                : 6
                : 12 ( doiID: 10.1002/phy2.2018.6.issue-12 )
                : e13751
                Affiliations
                [ 1 ] Division of Nephrology Hypertension, and Transplantation College of Medicine University of Florida Gainesville Florida
                [ 2 ] Department of Physiology and Functional Genomics College of Medicine University of Florida Gainesville Florida
                [ 3 ] Cloud Pharmaceuticals Inc. 6 Davis Dr Research Triangle Park North Carolina
                [ 4 ] Department of Obstetrics and Gynecology College of Medicine University of Florida Gainesville Florida
                [ 5 ] North Florida/South Georgia Veterans Health System Gainesville Florida
                [ 6 ]Present address: The Cambridge Crystallographic Data Centre 174 Frelinghuysen Road Piscataway New Jersey 08854
                Author notes
                [*] [* ] Correspondence

                Mark S. Segal, Division of Nephrology, Hypertension, and Transplantation, College of Medicine, University of Florida, CG‐98, 1600 Archer Road, Gainesville, FL 32610.

                Tel: 352 273 8820

                Fax: 352 392 5465

                E‐mail: segalms@ 123456medicine.ufl.edu

                Article
                PHY213751
                10.14814/phy2.13751
                6016622
                21884e43-8b46-436f-a266-c058eb8c859e
                © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 January 2018
                : 26 May 2018
                : 29 May 2018
                Page count
                Figures: 6, Tables: 0, Pages: 9, Words: 5070
                Funding
                Funded by: NIH/NIGMS
                Award ID: P50 GM111152 (MSS)
                Award ID: NIH K08 HL130945
                Funded by: University of Florida
                Categories
                Blood Pressure
                Cardiovascular Conditions, Disorders and Treatments
                Vasculature
                Original Research
                Original Research
                Custom metadata
                2.0
                phy213751
                June 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.1.1 mode:remove_FC converted:25.06.2018

                cd131,erythropoietin,hypertension,β‐common receptor
                cd131, erythropoietin, hypertension, β‐common receptor

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