Human recombinant erythropoietin (HRE) is a hormone which is administered when a patient is not producing enough erythropoietin on his or her own. This hormone is typically produced and activated in the kidneys, and may be used in patients who are in kidney failure. It can also be used to treat people with anemia, and in cases where patients need to build up their hematocrit but cannot receive a blood transfusion.
In healthy people, erythropoietin (EPO) responds to low oxygen levels in the body by regulating the production of more red blood cells. If the production of red blood cells is disturbed, people can develop anemia and an assortment of complications. Human recombinant erythropoietin is used to supplement the body's production of the hormone to increase the number of red blood cells, allowing the patient to reach a healthier hematocrit reading and to avoid complications associated with a low red blood cell count.
In people on dialysis because of kidney failure, the hematocrit can fall because not enough erythropoietin is being made. In these patients, HRE compensates for the kidney issues. People with anemia, especially drug-induced anemia such as that associated with some AIDS medications, can also use this hormone. Human recombinant erythropoietin has also been used in “blood doping” in sports, with athletes taking the drug to increase red blood cells with the goal of improving performance.
Pharmaceutical companies make HRE with recombinant technology, in which genes are inserted to create a custom organism. In this particular case, mammalian cells are modified with recombination so that they will produce human erythropoietin which can be administered to patients. The same technology is used to produce a variety of other human hormones. These hormones are as effective in the body as hormones of human or animal origin, but they are easier and safer to produce.
There are side effects associated with human recombinant erythropoietin, especially in patients who use it for a long time. It can increase the risk of heavy clotting and adverse cardiovascular events, and it can also lead to iron deficiency and high blood pressure. In some young athletes, unexpected death has been linked to EPO usage, which is one of the reasons sports authorities are concerned about blood doping. Recombinant EPO is chemically slightly different from the made in the body version, and this can be used on blood tests to determine whether or not an athlete is doping.