Darbepoetin Administration in Term and Preterm Neonates

Patel, Shrena; Ohls, Robin K.

doi:10.1016/j.clp.2015.04.016

Cited by 24 publications

(9 citation statements)

References 28 publications

(44 reference statements)

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“…Given its significantly longer halflife, [32][33][34] darbepoetin may be the more attractive and practical choice of ESA for preterm infants. We speculate that ESAs may serve as a beneficial therapy for preterm infants, not only in acute hospitalization where the risk of anemia exists but also as possible neuroprotective agents to improve long-term neurodevelopmental outcomes.…”

Section: Figurementioning

confidence: 99%

Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin

Ohls

Cannon²,

Phillips

et al. 2016

Pediatrics

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Section: Figurementioning

confidence: 99%

Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin

Ohls

Cannon²,

Phillips

et al. 2016

Pediatrics

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“…The causes are multifactorial and include an immature haemopoietic system, physiological breakdown of fetal haemoglobin, iatrogenic blood loss, chronic inflammation and nutritional deficiencies . Despite advances in preventive measures such as minimising the frequency and volume of blood sampling, delayed umbilical cord clamping and use of erythropoiesis‐stimulating agents, the transfusion of allogenic red blood cells remains the mainstay therapeutic intervention for AOP.…”

mentioning

confidence: 99%

Blood transfusion for anaemia of prematurity: Current practice in Australia and New Zealand

Saito-Benz

Sandle

Jackson

et al. 2018

J Paediatrics Child Health

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Aim To characterise the current transfusion practice among clinicians in Australasian neonatal units and factors that influence their decision‐making. Methods Members of the Australia and New Zealand Neonatal Network (ANZNN) and practitioners at their local institutions were invited to participate in a 15‐question web‐based survey between 1 June and 31 July 2016. The survey was designed to assess (i) haemoglobin‐based transfusion thresholds; (ii) presence of local guidelines; (iii) preference for a restrictive or liberal transfusion policy; (iv) perceived benefits and risks of transfusion; and (v) use of clinical adjuncts to assist decision‐making. Results Overall, 130 participants responded to at least one question. Haemoglobin transfusion thresholds for anaemia of prematurity (AOP) varied significantly from <60 to <120 g/L. Of 103 participants, 36 (35%) reported that they do not have access to local transfusion guidelines. The majority utilise multiple clinical and haematological parameters to guide their decision‐making, and approximately half (45/84, 54%) believe that tissue hypoxia detected by near‐infrared spectroscopy (NIRS) may better inform transfusion thresholds. Of 102 participants, 51 (50%) support a restrictive rather than liberal transfusion policy. The most commonly reported perceived risks of transfusion for AOP were suppression of endogenous erythropoiesis and increased rates of necrotising enterocolitis. Conclusions There is a significant variation in transfusion practice in Australasian neonatal units. Quality and safety initiatives may assist with improved consistency of transfusion practice across the ANZNN. However, further research is required to better define optimal transfusion thresholds, quantify potential risks of transfusion and determine clinical utility of newer adjuncts such as NIRS.

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“…Aranesp crosses the BBB [47] and showed neuroprotective activity, but the increment of hematopoiesis became a sensitive factor to reject it as a neurotherapeutic. [48][49][50] Aranesp has two extra N-glycosylation sites compared to rhEPO, with a possible maximum number of 22 isoforms. [46,51] Therefore, we estimate that Mut 45_47 or Mut 104 or Mut 151_153 would pass the BBB since they only have one extra Nglycosylation site compared to rhEPO reaching a maximum number of 18 isoforms.…”

Section: Discussionmentioning

confidence: 99%

Novel erythropoietin‐based therapeutic candidates with extra N‐glycan sites that block hematopoiesis but preserve neuroplasticity

Bürgi

Aparicio

Dorella

et al. 2021

Biotechnology Journal

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Neurological disorders affect millions of people causing behavior-cognitive disabilities.Nowadays they have no effective treatment. Human erythropoietin (hEPO) has been clinically used because of its neurotrophic and cytoprotective properties. However, the erythropoietic activity (EA) should be considered as a side effect. Some analogs like non-sialylated EPO, carbamylated EPO, or EPO peptides have been developed showing different weaknesses: erythropoiesis preservation, low stability, potential immunogenicity, or fast clearance. Herein, we used a novel strategy that blocks the EA but preserves hEPO neurobiological actions. N-glycoengineering was accomplished to add a new glycosylation site within the hEPO sequence responsible for its EA. hEPOderivatives were produced by CHO.K1 cells, affinity-purified and functionally analyzed studying their in vitro and in vivo EA, their in vitro neuronal plasticity in hippocampal neurons and their neuroprotective action by rescuing hippocampal neurons from apoptosis. Muteins Mut 45_47 (K45 > N45 + N47 > T47), Mut 104 (S104 > N104), and Mut 151_153 (G151 > N151 + K153 > T153) lost their EA but preserved their neuroprotection activity and enhanced neuroplasticity more efficiently than hEPO. Interestingly, Mut 45_47 resulted in a promising candidate to explore as neurotherapeutic considering not only its biopotency but also its pharmacokinetic potential due to the hyperglycosylation.

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Darbepoetin Administration in Term and Preterm Neonates

Cited by 24 publications

References 28 publications

Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin

Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin

Blood transfusion for anaemia of prematurity: Current practice in Australia and New Zealand

Novel erythropoietin‐based therapeutic candidates with extra N‐glycan sites that block hematopoiesis but preserve neuroplasticity

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