Moran Eye Center Researchers Show Potential Risk of Using Erythropoietin to Treat Eye Disease

The important role of the hormone erythropoietin (EPO), which works to increase red blood cell production, in treating anemia has been known for decades.

But as clinical trials examine EPO as a potential treatment for a host of other conditions, John A. Moran Eye Center physician investigator Mary Elizabeth Hartnett’s National Institutes of Health-funded lab has discovered crucial information about its role in the eye.

Using unique mouse models that modulate EPO receptor activation, researchers determined increased activation primed the choroid to develop abnormal blood vessel growth in response to stresses and has relevance to neovascular age-related macular degeneration (AMD). The findings may have negative implications for using EPO to treat patients with AMD, the leading cause of blindness in adults over 60.

Hartnett’s research, Erythropoietin Signaling Increases Choroidal Macrophages and Cytokine Expression, and Exacerbates Choroidal Neovascularization, was published on Feb. 1, 2018 in Scientific Reports.

“This study provides some insight into the pathophysiology of neovascular AMD,” said Hartnett. “Reports of elevated EPO with age may make eyes more receptive to vision loss from invading blood vessels in neovascular AMD. It also reminds us of the importance of assessing safety in human clinical trials testing exogenous EPO for other conditions.”

Clinical trials have tested or are testing forms of EPO as a neuroprotective factor in conditions including autoimmune optic neuritis, retinopathy of prematurity, and traumatic optic neuropathy. It has been proposed to be protective in diabetic rentinopathy, macular edema, and AMD.

Beyond AMD, Hartnett points out the findings shed further light on the potentially harmful effects of sports-doping using EPO.

The study was conducted by Moran investigators Colin Bretz, PhD, Haibo Wang, MD, PhD, Eric Kuntz, and Aaron B. Simmons, PhD, in addition to Hartnett. Vladimir Divoky, PhD, from Palacky University in the Czech Republic, and University of Utah Division of Hematology Prof. Josef Prchal, MD, were also key collaborators on the research.