Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease
The study of anaemia is a well-developed discipline where the concepts of precision medicine have, in part, been researched extensively. This review discusses the treatment of erythropoietin (EPO) deficiency anaemia and resistance in cases of chronic kidney disease (CKD). Traditionally, erythropoiet...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Current Issues in Molecular Biology |
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| Online Access: | https://www.mdpi.com/1467-3045/45/8/413 |
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| author | Nava Yugavathy Bashar Mudhaffar Abdullah Soo Kun Lim Abdul Halim Bin Abdul Gafor Muh Geot Wong Sunita Bavanandan Hin Seng Wong Hasniza Zaman Huri |
| author_facet | Nava Yugavathy Bashar Mudhaffar Abdullah Soo Kun Lim Abdul Halim Bin Abdul Gafor Muh Geot Wong Sunita Bavanandan Hin Seng Wong Hasniza Zaman Huri |
| author_sort | Nava Yugavathy |
| collection | DOAJ |
| description | The study of anaemia is a well-developed discipline where the concepts of precision medicine have, in part, been researched extensively. This review discusses the treatment of erythropoietin (EPO) deficiency anaemia and resistance in cases of chronic kidney disease (CKD). Traditionally, erythropoietin-stimulating agents (ESAs) and iron supplementation have been used to manage anaemia in cases of CKD. However, these treatments pose potential risks, including cardiovascular and thromboembolic events. Newer treatments have emerged to address these risks, such as slow-release and low-dosage intravenous iron, oral iron supplementation, and erythropoietin–iron combination therapy. Another novel approach is the use of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs). This review highlights the need for precision medicine targeting the genetic components of EPO deficiency anaemia in CKD and discusses individual variability in genes such as the erythropoietin gene (EPO), the interleukin-β gene (IL-β), and the hypoxia-inducible factor gene (HIF). Pharmacogenetic testing aims to provide targeted therapies and interventions that are tailored to the specific characteristics of an individual, thus optimising treatment outcomes and minimising resistance and adverse effects. This article concludes by suggesting that receptor modification has the potential to revolutionise the treatment outcomes of patients with erythropoietin deficiency anaemia through the integration of the mentioned approach. |
| first_indexed | 2024-03-11T00:02:51Z |
| format | Article |
| id | doaj.art-e828a080398a4752b70124db3f96313e |
| institution | Directory Open Access Journal |
| issn | 1467-3037 1467-3045 |
| language | English |
| last_indexed | 2024-03-11T00:02:51Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Issues in Molecular Biology |
| spelling | doaj.art-e828a080398a4752b70124db3f96313e2023-11-19T00:41:52ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452023-08-014586550656310.3390/cimb45080413Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney DiseaseNava Yugavathy0Bashar Mudhaffar Abdullah1Soo Kun Lim2Abdul Halim Bin Abdul Gafor3Muh Geot Wong4Sunita Bavanandan5Hin Seng Wong6Hasniza Zaman Huri7Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, MalaysiaClinical Laboratory Technology Department, Al-Rafidain University College, Baghdad 46036, IraqDepartment of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaFaculty of Medicine, National University of Malaysia, Bangi 43600, MalaysiaDepartment of Renal Medicine, Royal North Shore Hospital, Sydney, NSW 2065, AustraliaDepartment of Nephrology, Hospital Kuala Lumpur, Kuala Lumpur 50586, MalaysiaDepartment of Nephrology, Hospital Selayang, Batu Caves 68100, MalaysiaDepartment of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, MalaysiaThe study of anaemia is a well-developed discipline where the concepts of precision medicine have, in part, been researched extensively. This review discusses the treatment of erythropoietin (EPO) deficiency anaemia and resistance in cases of chronic kidney disease (CKD). Traditionally, erythropoietin-stimulating agents (ESAs) and iron supplementation have been used to manage anaemia in cases of CKD. However, these treatments pose potential risks, including cardiovascular and thromboembolic events. Newer treatments have emerged to address these risks, such as slow-release and low-dosage intravenous iron, oral iron supplementation, and erythropoietin–iron combination therapy. Another novel approach is the use of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs). This review highlights the need for precision medicine targeting the genetic components of EPO deficiency anaemia in CKD and discusses individual variability in genes such as the erythropoietin gene (EPO), the interleukin-β gene (IL-β), and the hypoxia-inducible factor gene (HIF). Pharmacogenetic testing aims to provide targeted therapies and interventions that are tailored to the specific characteristics of an individual, thus optimising treatment outcomes and minimising resistance and adverse effects. This article concludes by suggesting that receptor modification has the potential to revolutionise the treatment outcomes of patients with erythropoietin deficiency anaemia through the integration of the mentioned approach.https://www.mdpi.com/1467-3045/45/8/413precision medicineerythropoietin deficiency anaemiaHIF-PHIpharmacogeneticsinflammation |
| spellingShingle | Nava Yugavathy Bashar Mudhaffar Abdullah Soo Kun Lim Abdul Halim Bin Abdul Gafor Muh Geot Wong Sunita Bavanandan Hin Seng Wong Hasniza Zaman Huri Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease Current Issues in Molecular Biology precision medicine erythropoietin deficiency anaemia HIF-PHI pharmacogenetics inflammation |
| title | Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease |
| title_full | Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease |
| title_fullStr | Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease |
| title_full_unstemmed | Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease |
| title_short | Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease |
| title_sort | precision medicine in erythropoietin deficiency and treatment resistance a novel approach to management of anaemia in chronic kidney disease |
| topic | precision medicine erythropoietin deficiency anaemia HIF-PHI pharmacogenetics inflammation |
| url | https://www.mdpi.com/1467-3045/45/8/413 |
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