| Objective: To study the changes of the expression of erythropoietin receptor(EPOR) mRNA of pre- and post-renal transplantation in bone marrow of patients with renal anemia and its correlation with renal function and state of anemia so as to explore the pathogenesis of renal anemia and improve the therapy of renal anemia and post-transplant erythropoiesis(PTE).Methods: 58 cases of uremia admitted in our hospital and underwent renal transplantation from September 2000 to December 2001 were observed at different stages of pre- and post-transplantation. Based on the recovering condition of renal function, cases were divided into the following groups, Group IGF(immediate graft function) of 49 cases, Group SGF(slow graft function) of 5, Group DGF(delayed graft function) of 4. 5 cases in Group IGF suffered from PTE in 3 months after transplantation and hence formed Group PTE. 15 healthy persons formed the control group. The expression of EPOR mRNA in bone marrow of all the subjects extracted before transplantation and at days 10, 30 and 90 after transplantation was detected by RT-PCR technique. Serum creatinine(SCr), blood urea nitrogen(BUN), hemoglobin(Hb) and haematocrit(Hct) were also detected respectively to study their correlation with the expression of EPOR mRNA.Results: 1. After transplantation, renal function of Group IGF recovered quickly and stably for its SCr and BUN reached normal level at day 10(p>0.05) while that of Group SGF comparatively slowly and its SCr and BUN reached normal level at day 30. Renal function of Group DGF recovered the most slowly and its SCr and BUN didn't turn nomal until day 90, but were higher than those of Group IGF and SGF. The recovery of Group PTE was the fastest. 2. Hb and Hct of pre-transplantation were significantly lower than normalinlevel(p<0.01) and increased gradually after transplantation. The slowest increasing speed occurred in Group DGF for no significant difference was found at day 30 compared with pre-transplantation(p>0.05) and Hb and Hct were much lower than other groups at day 90. Hb and Hct of Group IGF and SGF increased faster and those of Group PTE increased the fastest. They even became significantly higher than normal level at day 90(p<0.05). 3. The expression of EPOR mRNA in bone marrow was significantly lower than normal level before transplantation(p<0.01) and increased gradually after transplantation. It increased the fastest in Group PTE just as renal function and Hb did and reached normal level at day 30, then became siginificantly higher at day 90(p<0.01). The increasing speed of Group DGF was the slowest, for the expression of EPOR mRNA didn't reach normal level until day 90, but was much lower than other groups. The increasing speed of Group IGF and SGF was between that of PTE and DGF. 4. The expression of EPOR mRNA was found to be significantly negatively correlated with SCr(r=-0.78, p<0.05), whereas significantly positively correlated with Hb(r=0.91, p<0.01).Conclusions: 1. The decreased expression of EPOR mRNA in renal anemia suggests that EPOR plays a crucial role in the pathogenesis of renal anemia. 2. In patients whose renal function recovers after transplantation, the expression of EPOR mRNA increases gradually as well as Hb. It is significantly negatively correlated with SCr, but significantly positively correlated with Hb, which suggests renal function has effect on the expression of EPOR mRNA and recovery of Hb depends on the normal expression of EPOR mRNA. 3. In this article, an assumption of EPOR abnormality in renal anemia is put forward. 4. The intervention of the expression of EPOR might result in new therapeutic methods for renal anemia and PTE. Further studies on EPOR will be of important theoretical significance and a bright future of application. |
PDF Full Text Request