Physiology
EPO is a glycoprotein (protein-sugar conjugate) that has been shown to regulate synthesis of red blood cells in the bone marrow. When released from the kidneys it directs it activity in the bone marrow and helps stimulate the differentiation of stem cells into red blood cells. It is a normal body chemical which control hemoglobin synthesis and red blood cell concentration. Human EPO is a medium sized molecule (30,400-dalton) and contains 165 amino acids which are coupled to a few carbohydrate and sialic acid residues. There are several sub classes of EPO in the body- they only differ in the carbohydrate content.
At birth, EPO is manufactured in the liver but shortly afterwards the kidneys become the primary source of EPO. The regulation of EPO is based on concentration of oxygen in the blood crossing the kidneys. When the kidneys sense a low oxygen concentration in blood, EPO synthesis is increased. Human Epogen was isolated from urine nearly 40 years ago. Since then we have developed recombinant DNA methods to produce EPO in the laboratory. The drug is made by Amgen and widely available globally
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