Erythropoietin in traumatic brain injury: the "golden bullet" on the horizon?

The study by Liao and colleagues investigated the cellular and molecular events of erythropoietin (EPO)-mediated neuroprotection in traumatic brain injury (TBI).[1] Using the “classic” Feeney cortical contusion model, the authors performed an experimental study on 130 Wistar rats, designed to elucidate in more detail the established antiapoptotic effects of recombinant human EPO (rhEPO). Animals were randomly assigned to either a treatment group with rhEPO, applied by intraperitoneal injection once a day for seven days after TBI, or a vehicle-injection control group managed under identical conditions. Outcome parameters consisted of quantification of neuronal cell death by TUNEL histochemistry and assessment of gene (RT-PCR) and protein (Western blot) expression of the pro-apoptotic molecule Bax. The data revealed that the treatment with rhEPO led to a decrease of TUNEL-positive neurons, associated with attenuated Bax mRNA and protein expression after TBI, compared to the vehicle control group. The authors concluded that EPO represents an effective neuroprotective treatment in experimental TBI by reducing Bax expression and associated apoptotic neuronal cell death. These findings confirm a previous report from the same group[2] and shed some further light onto the EPO-mediated regulation of the molecular events leading to neuronal cell death and secondary brain injury.