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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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Autores principales: Yugavathy, Nava, Abdullah, Bashar Mudhaffar, Lim, Soo Kun, Abdul Gafor, Abdul Halim Bin, Wong, Muh Geot, Bavanandan, Sunita, Wong, Hin Seng, Huri, Hasniza Zaman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453742/
https://www.ncbi.nlm.nih.gov/pubmed/37623232
http://dx.doi.org/10.3390/cimb45080413
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author Yugavathy, Nava
Abdullah, Bashar Mudhaffar
Lim, Soo Kun
Abdul Gafor, Abdul Halim Bin
Wong, Muh Geot
Bavanandan, Sunita
Wong, Hin Seng
Huri, Hasniza Zaman
author_facet Yugavathy, Nava
Abdullah, Bashar Mudhaffar
Lim, Soo Kun
Abdul Gafor, Abdul Halim Bin
Wong, Muh Geot
Bavanandan, Sunita
Wong, Hin Seng
Huri, Hasniza Zaman
author_sort Yugavathy, Nava
collection PubMed
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.
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spelling pubmed-104537422023-08-26 Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease Yugavathy, Nava Abdullah, Bashar Mudhaffar Lim, Soo Kun Abdul Gafor, Abdul Halim Bin Wong, Muh Geot Bavanandan, Sunita Wong, Hin Seng Huri, Hasniza Zaman Curr Issues Mol Biol Review 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. MDPI 2023-08-07 /pmc/articles/PMC10453742/ /pubmed/37623232 http://dx.doi.org/10.3390/cimb45080413 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Yugavathy, Nava
Abdullah, Bashar Mudhaffar
Lim, Soo Kun
Abdul Gafor, Abdul Halim Bin
Wong, Muh Geot
Bavanandan, Sunita
Wong, Hin Seng
Huri, Hasniza Zaman
Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453742/
https://www.ncbi.nlm.nih.gov/pubmed/37623232
http://dx.doi.org/10.3390/cimb45080413
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