Efficacy of erythropoietin for wound healing: A systematic review of the literature

Abstract

Objectives To systematically review the available literature on the efficacy of erythropoietin for wound healing in human patients. Design The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A descriptive-analytical method was used to analyse and integrate review findings. Data sources A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: ‘efficacy’, ‘erythropoietin’ and ‘wound healing’. A secondary search of the grey literature was conducted in addition to checking the reference list of included studies and review papers. Results Seven distinct studies involving 150 patients met the inclusion criteria for the review. The included studies suggest that topical and subcutaneous application of erythropoietin improves the wound healing process via faster re-epithelialization and reducing wound area and depth. Conclusions There were a limited number of studies and a great degree of heterogeneity of evidence due to differences in the course of concomitant illness, wound aetiology, and the time and dosing regimens adopted. Further research adopting validated and consistent outcome measures is recommended to determine the efficacy and safety of erythropoietin for wound healing.

Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies

“…EPO, a glycosylated cytokine produced by peritubular cells in the kidneys as a treatment of anemia, has attracted increasing attention to be a potentially beneficial cytokine in wound healing. [211][212][213] Animal experiments identified that EPO could promote the release of growth factors such as VEGF, FGF, and insulin-like growth factor, 214 suppress the inflammatory responses and apoptosis, [215][216][217] stimulate angiogenesis, 218,219 promote the differentiation of myofibroblasts, 220 and orchestrate the remodeling of ECM. 221 To date, there are three RCTs 68,69,222 and one case series 223 that investigated the effect of EPO on diabetic ulcers either by topical or subcutaneous administration.…”

Erythropoietin Interacts with Specific S100 Proteins

“…The global EPO drugs market size has already reached 12 billion USD and is estimated to grow at a compound annual growth rate (CAGR) of 10%, according to the Market Data Forecast. Other EPO-based therapeutic applications are under development, including prevention of dementia, Alzheimer’s disease, Parkinson’s disease, schizophrenia, bipolar disorder, depression, ischemic stroke, traumatic brain injury, diabetes mellitus, acute and chronic lung diseases, various ocular diseases, severe COVID-19, as well as EPO use in the regenerative medicine [ 1 , 3 , 10 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. However, the clinical use of the EPO-based medicines is limited due to the pleiotropic nature of this cytokine, leading to serious adverse reactions, such as arterial hypertension, cerebral convulsion/hypertensive encephalopathy, thrombo-embolism, iron deficiency, development of pure red cell aplasia, and the possibility of cancer progression [ 8 , 22 , 23 ].…”