Background: It has been reported that human recombinant erythropoietin (rHuEPO) modulates the sensitivity of the cardiovascular system to vasoconstrictors. We investigated whether rHuEPO has modulative effects on the endothelin-1 (ET-1)-induced elevation of cytosolic free calcium concentration ([Ca<sup>2+</sup>]<sub>i</sub>) and mitogen-activated protein (MAP) kinase activation in vascular smooth muscle cells (VSMC). Methods: [Ca<sup>2+</sup>]<sub>i</sub> was measured by fura-2/AM, and MAP kinase activation was analyzed by Western blotting. Results: Exposure of VSMC to rHuEPO prior to stimulation with ET-1 enhanced both basal and ET-1-induced elevation of [Ca<sup>2+</sup>]<sub>i</sub> in a dose-dependent manner in the presence of extracellular Ca<sup>2+</sup>. The synergistic effect was also retained in the absence of extracellular Ca<sup>2+</sup> after exposure to rHuEPO. However, the effect was diminished in the presence of extracellular Ca<sup>2+</sup> combined with the intracellular Ca<sup>2+</sup> release inhibitor TMB-8, PKC inhibitor, or PKC depletion. Exposure to rHuEPO also had a synergistic effect on the activation of MAP kinase induced by ET-1; however, this effect was diminished in the presence of the Ca<sup>2+</sup> chelator BAPTA-AM. Conclusion: The results suggest that rHuEPO has synergistic effects on ET-1-induced [Ca<sup>2+</sup>]<sub>i</sub> mobilization, particularly on intracellular Ca<sup>2+</sup> release, and MAP kinase activation in VSMC.
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