Abstract:
Erythropoietin (EPO) is a cytokine hormone commonly associated with its role as regulator of erythropoiesis. Over the last years, interest in EPO has increased after the discovery of its anti-apoptotic and neuroprotective effects in the CNS, making it a potential therapeutic agent for various neurological diseases. Here, we analysed the impact of EPO on neuritogenesis and cell survival in a cell culture model of adult retinal ganglion cells (RGCs), by postlesional in vitro conditioning following crush of the optic nerve, or by intravitreal application in vivo, and compared the results to those of the neuroprotective Ad.Bcl-XL-adenovirus, which has recently been suggested to stimulate regeneration (Kretz et al., 2004). To elucidate its mode of action, we focused on presumed intracellular downstream mechanisms of EPO; the Jak/STAT-3 pathway, the activation of p44/42 MAP-kinase, and the induction of PI3-kinase/Akt, and nuclear target gene up-regulation including the anti-apoptotic proto-oncogene Bcl-XL.
We could demonstrate that a single application of EPO to cultured RGCs, or repeated EPO injections in vivo, in postlesional settings, increased both numbers and length of newly generated neurites 2.5-fold/n and 10-fold/l, for the in vitro setting, and 2,16-fold/n and 5,7-fold/l for the in vivo setting, respectively, compared to lesioned untreated controls. In contrast to Bcl-XL, which revealed neuroprotective function only in vivo, but not in vitro, EPO mediated sustained anti-apoptotic effects, thus promoting survival and neurite extention of cultured severed RGCs.
Investigations of downstream signalling pathways suggest EPO-mediated Bcl-XL induction, as shown by western blot analysis. Pharmacological inhibition of Jak-2/STAT-3 caused a block of EPO-induced neurite regeneration in cultured RGCs. Accordingly, cytokine treated neurons strongly up-regulate phosphorylated STAT-3, while no effect was observed for STAT-1 and STAT-5, suggesting that STAT-3 induction contributes to EPO-related neuritogenesis. We also assayed the role of classical survival- and regeneration promoting cascades including PI3K and MAPK-pathways, respectively. Based on growth response and protein expression analyses, these well-known protective cascades seem also involved in EPO-mediated neuroregeneration, with phosphorylated p44/42 MAPK being up-regulated after cytokine application, and suppression of neurogenesis after inhibition of PI3-kinase.
We have demonstrated that EPO holds an important potential for survival and regeneration of severly injured adult CNS neurons, when administered delayed after injury, possibly by STAT-3 dependent Bcl-XL induction. However, according to non-linear, but complex network interactions of transduction cascades, other signalling pathways, such as PI3-kinase and MAP-kinase-cascades, may also be involved.