Anti-erythropoietin and anti-thrombopoietin antibodies induced after administration of recombinant human erythropoietin

Sug Kyun Shin; Seung Pil Pack; Jin Gyo Oh; Nam Kyu Kang; Myung Hee Chang; Yoon Hee Chung; Sung Jo Kim; Jong Wook Lee; Tae Hwe Heo

doi:10.1016/j.intimp.2011.10.014

Anti-erythropoietin and anti-thrombopoietin antibodies induced after administration of recombinant human erythropoietin

Sug Kyun Shin, Seung Pil Pack, Jin Gyo Oh, Nam Kyu Kang, Myung Hee Chang, Yoon Hee Chung, Sung Jo Kim, Jong Wook Lee, Tae Hwe Heo

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Recombinant human erythropoietin (rhEPO) has been successfully used for correcting renal anemia. However, recent studies have raised some concerns about the safety of rhEPO treatment due to its immunogenic side effect - pure red cell aplasia (PRCA). We now report a case of development of anti-EPO neutralizing antibodies (Abs) implicated in thrombocytopenia as well as erythrocytopenia. A 35-year-old man had a history of administering rhEPO (epoetin alfa, epoetin beta and darbepoetin alfa) for 2 years to treat renal anemia. The hematological parameters were collected. Anti-EPO, anti-platelet, and anti-thrombopoietin (TPO) Ab assays were performed to test the presence of autoreactive Abs. After performing antibody assays due to severe resistance to rhEPO treatment, a high titer of anti-EPO neutralizing Abs was detected. However, unexpectedly, this patient also showed thrombocytopenia rather than PRCA. We investigated the cause of the marked thrombocytopenia and found anti-TPO Abs in patient serum. To our best knowledge, this is the first report of the development of anti-TPO Abs during rhEPO treatment for anemia.

Original language	English
Pages (from-to)	2237-2241
Number of pages	5
Journal	International Immunopharmacology
Volume	11
Issue number	12
DOIs	https://doi.org/10.1016/j.intimp.2011.10.014
State	Published - Dec 2011

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology ( 2010-0002816 ). This study was supported by the Research Fund 2011 of The Catholic University of Korea . This research was supported by the Converging Research Center Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (No. 20090083290 ).We thank Eun-Jee Oh, (Department of Laboratory Medicine, the Catholic University of Korea) for MACE and Hyo Jeong Hong (College of Biomedical Science, Kangwon National University in Korea) for BaF-TPOR cells.

Keywords

Erythrocytopenia
Erythropoietin
Pure red cell aplasia
Thrombocytopenia
Thrombopoietin

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10.1016/j.intimp.2011.10.014

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@article{c402c252544f4593829996132edf2c7e,

title = "Anti-erythropoietin and anti-thrombopoietin antibodies induced after administration of recombinant human erythropoietin",

abstract = "Recombinant human erythropoietin (rhEPO) has been successfully used for correcting renal anemia. However, recent studies have raised some concerns about the safety of rhEPO treatment due to its immunogenic side effect - pure red cell aplasia (PRCA). We now report a case of development of anti-EPO neutralizing antibodies (Abs) implicated in thrombocytopenia as well as erythrocytopenia. A 35-year-old man had a history of administering rhEPO (epoetin alfa, epoetin beta and darbepoetin alfa) for 2 years to treat renal anemia. The hematological parameters were collected. Anti-EPO, anti-platelet, and anti-thrombopoietin (TPO) Ab assays were performed to test the presence of autoreactive Abs. After performing antibody assays due to severe resistance to rhEPO treatment, a high titer of anti-EPO neutralizing Abs was detected. However, unexpectedly, this patient also showed thrombocytopenia rather than PRCA. We investigated the cause of the marked thrombocytopenia and found anti-TPO Abs in patient serum. To our best knowledge, this is the first report of the development of anti-TPO Abs during rhEPO treatment for anemia.",

keywords = "Erythrocytopenia, Erythropoietin, Pure red cell aplasia, Thrombocytopenia, Thrombopoietin",

author = "Shin, {Sug Kyun} and Pack, {Seung Pil} and Oh, {Jin Gyo} and Kang, {Nam Kyu} and Chang, {Myung Hee} and Chung, {Yoon Hee} and Kim, {Sung Jo} and Lee, {Jong Wook} and Heo, {Tae Hwe}",

note = "Funding Information: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology ( 2010-0002816 ). This study was supported by the Research Fund 2011 of The Catholic University of Korea . This research was supported by the Converging Research Center Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (No. 20090083290 ).We thank Eun-Jee Oh, (Department of Laboratory Medicine, the Catholic University of Korea) for MACE and Hyo Jeong Hong (College of Biomedical Science, Kangwon National University in Korea) for BaF-TPOR cells.",

year = "2011",

month = dec,

doi = "10.1016/j.intimp.2011.10.014",

language = "English",

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journal = "International Immunopharmacology",

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AU - Shin, Sug Kyun

AU - Pack, Seung Pil

AU - Oh, Jin Gyo

AU - Kang, Nam Kyu

AU - Chang, Myung Hee

AU - Chung, Yoon Hee

AU - Kim, Sung Jo

AU - Lee, Jong Wook

AU - Heo, Tae Hwe

N1 - Funding Information: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology ( 2010-0002816 ). This study was supported by the Research Fund 2011 of The Catholic University of Korea . This research was supported by the Converging Research Center Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (No. 20090083290 ).We thank Eun-Jee Oh, (Department of Laboratory Medicine, the Catholic University of Korea) for MACE and Hyo Jeong Hong (College of Biomedical Science, Kangwon National University in Korea) for BaF-TPOR cells.

PY - 2011/12

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N2 - Recombinant human erythropoietin (rhEPO) has been successfully used for correcting renal anemia. However, recent studies have raised some concerns about the safety of rhEPO treatment due to its immunogenic side effect - pure red cell aplasia (PRCA). We now report a case of development of anti-EPO neutralizing antibodies (Abs) implicated in thrombocytopenia as well as erythrocytopenia. A 35-year-old man had a history of administering rhEPO (epoetin alfa, epoetin beta and darbepoetin alfa) for 2 years to treat renal anemia. The hematological parameters were collected. Anti-EPO, anti-platelet, and anti-thrombopoietin (TPO) Ab assays were performed to test the presence of autoreactive Abs. After performing antibody assays due to severe resistance to rhEPO treatment, a high titer of anti-EPO neutralizing Abs was detected. However, unexpectedly, this patient also showed thrombocytopenia rather than PRCA. We investigated the cause of the marked thrombocytopenia and found anti-TPO Abs in patient serum. To our best knowledge, this is the first report of the development of anti-TPO Abs during rhEPO treatment for anemia.

AB - Recombinant human erythropoietin (rhEPO) has been successfully used for correcting renal anemia. However, recent studies have raised some concerns about the safety of rhEPO treatment due to its immunogenic side effect - pure red cell aplasia (PRCA). We now report a case of development of anti-EPO neutralizing antibodies (Abs) implicated in thrombocytopenia as well as erythrocytopenia. A 35-year-old man had a history of administering rhEPO (epoetin alfa, epoetin beta and darbepoetin alfa) for 2 years to treat renal anemia. The hematological parameters were collected. Anti-EPO, anti-platelet, and anti-thrombopoietin (TPO) Ab assays were performed to test the presence of autoreactive Abs. After performing antibody assays due to severe resistance to rhEPO treatment, a high titer of anti-EPO neutralizing Abs was detected. However, unexpectedly, this patient also showed thrombocytopenia rather than PRCA. We investigated the cause of the marked thrombocytopenia and found anti-TPO Abs in patient serum. To our best knowledge, this is the first report of the development of anti-TPO Abs during rhEPO treatment for anemia.

KW - Erythrocytopenia

KW - Erythropoietin

KW - Pure red cell aplasia

KW - Thrombocytopenia

KW - Thrombopoietin

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JF - International Immunopharmacology

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ER -

Anti-erythropoietin and anti-thrombopoietin antibodies induced after administration of recombinant human erythropoietin

Abstract

Bibliographical note

Keywords

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