[Update on the role and mechanism of erythropoietin receptor in acute kidney injury and repair or fibrosis].

Sheng Li Xue Bao

Nantong-Leicester Joint Institute of Kidney Science, Department of Nephrology, Affiliated Hospital of Nantong University, Nantong 226001, China.

Published: February 2023

AI Article Synopsis

  • Acute kidney injury (AKI) is a serious condition that can lead to high morbidity and mortality, and can progress to chronic kidney disease, with renal ischemia-reperfusion (IR) as a major cause.
  • Changes in the expression of erythropoietin homodimer receptor (EPOR) and its heterodimer with β common receptor (EPOR/βcR) are significant in the development and repair of AKI, with EPOR aiding in fibrosis and EPOR/βcR promoting repair.
  • This review explores the roles and mechanisms of EPOR and EPOR/βcR, including their effects on apoptosis, inflammation, and repair processes after IR, highlighting the need for better understanding to improve treatment strategies

Article Abstract

Acute kidney injury (AKI) is a common critical disease clinically with high morbility and mortality and some survival patients also progress to chronic kidney disease. Renal ischemia-reperfusion (IR) is one of the main causes of AKI, in which, its repair and potential fibrosis, apoptosis, inflammation and phagocytosis play important roles. During the progression of IR-induced AKI, the expression of erythropoietin homodimer receptor (EPOR) and EPOR and β common receptor formed heterodimer receptor (EPOR/βcR) is changed dynamically. Moreover, (EPOR) and EPOR/βcR may synergistically participate in renoprotection at the stage of AKI and early repair, whereas at the late stage of AKI, the (EPOR) induces renal fibrosis and the EPOR/βcR facilitates repair and remodelling. The underlying mechanism, signaling pathways and the different effect turning point of (EPOR) and EPOR/βcR have not been well defined. It has been reported that EPO, according to its 3D structure, derived helix B surface peptide (HBSP) and cyclic HBSP (CHBP) only bind to EPOR/βcR. Synthesized HBSP, therefore, provides an effective tool to distinguish the different roles and mechanisms of both receptors, with the (EPOR) promoting fibrosis or the EPOR/βcR leading to repair/remodelling at the late stage of AKI. This review discusses the similarities and differences of (EPOR) and EPOR/βcR in their impacts on apoptosis, inflammation and phagocytosis in AKI, repair and fibrosis post IR, associated mechanisms, signaling pathways and outcomes.

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