• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.9-14
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• 2011

Recently, the population of patients who refuse transfusion has increased for both religious and non-religious reasons, even in life threatening emergency situations. Their refusal has highlighted the need to develop nonblood transfusion surgery techniques to decrease the risk from blood transfusions. A 57-year woman with an ulcerative lesion on the gingiva of the right upper molar area visited the department of oral and maxillofacial surgery in Dankook University Dental Hospital. After a preliminary evaluation, the patient was diagnosed with squamous cell carcinoma. As she refused blood transfusion during surgery for religious reasons, surgery was planned using recombinant human erythropoietin (rHuEPO) without a blood transfusion. The patient underwent a partial maxillectomy, supraomohyoid neck dissection, free radial forearm flap and split thickness skin graft under general anesthesia. rHuEPO and iron were used before and after surgery. The hemoglobin/hematocrit (Hb/Hct) level, iron (Fe) and total iron-binding capacity (TIBC) were assessed. The patient recovered completely without any blood transfusions. rHuEPO is a viable alternative for patients with religious objections to receiving blood transfusions.

• Biomolecules & Therapeutics
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• 제11권2호
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• pp.126-132
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• 2003

Efficacy and in vivo bioassay of recombinant human erythropoietin (rh-EPO, DWP413) was investigated. Efficacy studies on erythropoiesis were conducted in normal, cisplatin-induced anemic rats and acute hemorrhage - induced anemic rats. Animals were treated intravenously with DWP413 for 5 days, the changes in the number of red blood cells (RBC), hematocrit value (Hct), hemoglobin concentration (Hb) and reticulocyte were examined. In normal rats, at the doses of 50, 250, and 1250 IU/kg/day, in cisplatin-induced anemic rats, at the doses of 50, 100 and 200 IU/kg/day, RBC, Hb, Hct and reticulocyte were increased dose-depen-dently. And in acute hemorrhage-induced anemic rats, DWP413 (150, 450 and 1350 IU/kg/day) significantly increased RBC, Hb, Hct and reticulocytes. In histopathological findings of kidney, cisplatin alone treated rats expressed severe glomerulus and tubular damage. But in the DWP413 treated rats after cisplatin treatment, these were not remarkable compared to cisplatin alone treated rats. In vivo bioassay, DWP413 had 102.43% of bioactivity compared to erythropoietin BRP(Biological Reference Product, European Directorate for the Quality of Medicines). These results suggest that DWP413 might be useful for the therapy of anemia induce by renal failure and acute blood loss.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9131-9136
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• 2014

ELDF15, homologous with AT2 receptor-interaction protein 1 (ATIP1), may play an important role in cell differentiation, proliferation, and carcinogenesis. We aimed to understand the biological function of ELDF15 via construction and transfection of a recombinant expression vector containing antisense ELDF15. Recombinant expression vectors were successfully constructed and transfected into K562 cells. A stable transfectant, known as pXJ41-asELDF15, stably produced antisense ELDF15. Compared with K562 and K562-zeo cells, K562-pXJ41-asELDF15 cells showed inhibition of cell proliferation. RT-PCR analysis showed that the expression and protein level of ELDF15 decreased significantly in K562 cells transfected with pXJ41-asELDF15. Expression of hemoglobin increased in K562 cells transfected with pXJ41-asELDF15 by benzidine staining. increases NBT reduction activity in K562 cells transfected with pXJ41-asELDF15.Colony forming efficiency in two-layer soft agar was clearly inhibited as assessed by electron microscopy. These results suggest that ELDF15 plays a potential role in cell differentiation, proliferation and carcinogenesis.

• Biomolecules & Therapeutics
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• 제4권1호
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• pp.68-77
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• 1996

Efficacy and general pharmacology of recombinant human erythropoietin (rHu-EPO), were investigated. Efficacy studies were conducted in normal, cisplatin- and acute hemorrhage-induced anemic rats. Normal and anemic animals were treated intravenously with rHu-EPO for 5 days and the changes in the numbers of red blood cells (RBC), hemoglobin (Hb), hematocrit (Hct) and reticulocytes (Ret) were examined. In normal rats, rHu-EPO significantly increased RBC, Hb, Hct and Ret at doses of 50∼ 1250 IU/kg/day. Cisplatin-induced anemic rats showed significant increase of RBC, Hb, Hct and Ret in a dose-dependent manner after administration of rHu-EPO (50∼200 lU/kg/day). And in acute hemorrhage-induced anemic rats, rHu-EPO(4∼100 Iu/kg/day) accelerated recovery of anemia with significant increase in Ret. These changes disappeared gradually after cessation of the treatment. The general pharmacological effects of rHu-EPO were investigated in mice, rats, guinea-pigs, rabbits and cats. rHu-EPO had no influences on central nervous, cardiovascular, gastrointestinal and blood coagulation system. It also had no influence on the contraction of phrenic nerve-diaphragm preparation. rHu-EPO produced significant increase of urine volume at a dose of 7000 IU/kg. These results suggest that rHu-EPO might be useful for the therapy of anemia without serious side effect.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2001년도 추계학술발표대회
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• pp.754-757
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• 2001

Expression of the vhb gene encoding bacterial hemoglobin (VHb) from Vitreoscilla has been used to improve recombinant cell growth and enhance product formation under microaerobic conditions because of its ability to enhance oxygen use. We coexpressed GFP and VHb in Escherichia coli BL21 and W3110, and compared with GFP control which was not expressed VHb. We used nar oxygen-dependent inducible promoter for VHb expression. The GFP amounts in E. coli expressed VHb was about five fold higher than in the control Fluorescence intensity was increased about two fold.

• BMB Reports
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• 제31권6호
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• pp.590-594
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• 1998

X-ray crystallographic studies of the deoxy form of human adult hemoglobin (Hb A) have shown that ${\beta}99Asp$ is hydrogen bonded to both ${\alpha}42Tyr$ and ${\alpha}97Asn$ in the ${\alpha}_1{\beta}_2$ subunit interface, suggesting that the essential role of ${\beta}99Asp$ is to stabilize the deoxy-Hb by creating the intersubunit hydrogen bond. In particular, for Hb Kempsey (${\beta}99Asp{\rightarrow}Asn$), molecular dynamics simulation indicated that a new hydrogen bond involving ${\beta}99Asn$ can be induced by replacing ${\alpha}42Tyr$ with a strong hydrogen-bond acceptor such as Asp. Designed mutant recombinant (r) Hb (${\beta}99Asp{\rightarrow}Asn$, ${\alpha}42Tyr{\rightarrow}Asp$) have been produced in the Escherichia coli expression system and have shown that functional defects of Hb Kempsey could be compensated by the ${\alpha}42Tyr{\rightarrow}Asp$ substitution. However, as the ${\alpha}42 Tyr{\rightarrow}Asp$ mutation has never been reported before, it is still possible that the functional properties of r Hb (${\beta}99Asp{\rightarrow}Asn$, ${\alpha}42Tyr{\rightarrow}Asp$) may be due to the mutation itself. Thus, it is required to produce r Hb (${\alpha}42Tyr{\rightarrow}Asp$) and r Hb Kempsey (${\beta}99Asp{\rightarrow}AsnX$( as controls, and to compare their properties with those of r Hb (${\beta}99Asp{\rightarrow}Asn$, ${\alpha}42Tyr{\rightarrow}Asp$). r Hb (${\alpha}42Tyr{\rightarrow}Asp$) could not be purified because it is an unstable hemoglobin which forms Heinz bodies. r Hb Kempsey (${\beta}99Asp{\rightarrow}Asn$) exhibits very high oxygen affinity and greatly reduced cooperativity. Thus, r Hb (${\beta}99Asp{\rightarrow}Asn$) and r Hb (${\alpha}42Tyr{\rightarrow}Asp)$ compensate each other.

• Clinical and Experimental Pediatrics
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• 제59권2호
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Biomolecules & Therapeutics
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• 제6권2호
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• pp.182-190
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• 1998

DA-3585 is a recombinant human erythropoietin produced by Dong-A pharmaceutical Co. Ltd. using recombinant DNA technique. Recently, recombinant human erythropoietin (rHu-EPO) has been used to treat various types of anemia. In this study, we examined acute and subacute toxicity of DA-3585 in rats. DA-3585 was intravenously administered to rats at dose levels of 0, 6,250, 12,500 and 25,000 lU/kg for single dose toxicity study and at dose levels of 0,100,500 and 2,500IU/kg daily for 4 week-repeated dose toxicity study. In the single dose toxicity study, there were no death, clinical signs and changes in body weight gain related to the treatment. Necropsy revealed no evidence of toxicity related to DA-3585, In the repeated dose toxicity study, all the rats survived throughout the study. There were no treatment-related changes in clinical signs, food and water intake, and body weight. Hematological examination showed increases in the number of erythrocytes, hemoglobin concentration, hematocrit value and mean corpuscular volume, and decrease in the number of platelet in 500 and 2,500 lU/kg dosed groups. Extramedullary hematopoiesis in the spleen and erythroid hyperplasia in the bone marrow were noted as treatment-related histological changes. Toxicologically significant changes were not observed in blood biochemistry, urinalysis, organ weights and in any other examinations. The treatment-related changes observed in this study were hematological or histological changes associated with pharmacological effects of DA-3585. On the basis of the results of this study, LD5n value of DA-3585 was above 25,000 lU/kg and the no-observed-adverse-effect-level was estimated to be 100 lU/kg.

• Biomolecules & Therapeutics
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• 제6권3호
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• pp.312-316
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• 1998

Efficacy and in vivo bioassay of recombinant human erythropoietin (rho-EPO), was investigated. Efficacy studies were conducted in normal, and cisplatin-induced anemic rats. Normal and anemic animals were treated intravenously with rhu-EPO for 5 days, and the changes in the number of red blood cells (RBC), hemoglobin concentration (Hb), hematocrit value (Hct) and percentage reticulocyte value (Ret, reticulocyte/RBC) were examined. In normal rats, rho-EPO significantly increased RBC, Hb, Hct and Ret at the doses of 50∼ 1,250 lU/kg/day in a dose-dependent fashion. Cisplatin-induced anemic rats showed significant increase of RBC, Hb, Hct and Ret after administration of rho-EPO (50-200 lU/kg/day) in a dose-dependent manner. These changes of hematological parameters disappeared gradually after cessation of the treatment. The in vivo bioassay results in polycythemic mice showed that rho-EPO had 90% of bioactivity compared to NIBSC standard rhu-EPO. These results suggest that rho-EPO might be useful for the therapy of anemia originated from renal failure and chemotherapy-induced anemia.

• Parasites, Hosts and Diseases
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• 제44권3호
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• pp.187-196
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• 2006

The mammalian trematode Paragonimus westermani is a typical digenetic parasite, which can cause paragonimiasis in humans. Host tissues and blood cells are important sources of nutrients for development, growth and reproduction of P. westermani. In this study, a cDNA clone encoding a 47 kDa hemoglobinase of P. westermani was characterized by sequencing analysis, and its localization was investigated immunohistochemically. The phylogenetic tree prepared based on the hemoglobinase gene showed high homology with hemoglobinases of Fasciola hepatica and Schistosoma spp. Moreover, recombinant P. westermani hemoglobinase degradaded human hemoglobin at acidic pH (from 3.0 to 5.5) and its activity was almost completely inhibited by E-64, a cysteine proteinase inhibitor. Immunohistochemical studies showed that P. westermani hemoglobinase was localized in the epithelium of the adult worm intestine implying that the protein has a specific function. These observations suggest that hemoglobinase may act as a digestive enzyme for acquisition of nutrients from host hemoglobin. Further investigations may provide insights into hemoglobin catabolism in P. westermani.