Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach in management of Anemia of Chronic Kidney Disease

Nava Yugavathy
ORCID logo ,
Bashar Mudhaffar Abdullah
,
Soo Kun Lim
ORCID logo ,
Abdul Halim Bin Abdul Gafor
ORCID logo ,
Muh Geot Wong
,
Sunita Bavanandan
,
Hin Seng Wong
ORCID logo ,
Hasniza Zaman Huri
* ORCID logo
Version 1 : Received: 27 June 2023 / Approved: 27 June 2023 / Online: 28 June 2023 (02:49:05 CEST)

A peer-reviewed article of this Preprint also exists.

Yugavathy, N.; Abdullah, B.M.; Lim, S.K.; Abdul Gafor, A.H.B.; Wong, M.G.; Bavanandan, S.; Wong, H.S.; Huri, H.Z. Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease. Curr. Issues Mol. Biol. 2023, 45, 6550-6563. Yugavathy, N.; Abdullah, B.M.; Lim, S.K.; Abdul Gafor, A.H.B.; Wong, M.G.; Bavanandan, S.; Wong, H.S.; Huri, H.Z. Precision Medicine in Erythropoietin Deficiency and Treatment Resistance: A Novel Approach to Management of Anaemia in Chronic Kidney Disease. Curr. Issues Mol. Biol. 2023, 45, 6550-6563.

Abstract

Anemia is a well-developed discipline where the concepts of precision medicine have, in part and being studied extensively. This review discusses the treatment of EPO-deficient anemia and resistance in Chronic Kidney Disease (CKD). Traditionally, erythropoietin-stimulating agents (ESA) and iron supplementation have been used to manage anemia in CKD. However, these treatments have 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, and erythropoietin-iron combination therapy. Another novel approach is using hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHI). This review highlights the need for precision medicine targeting genetic components of EPO-deficient anemia in CKD and discusses individual variability of genes such as the erythropoietin gene (EPO), Interleukin-β gene (IL-β), and hypoxia-inducible factor gene (HIF). Pharmacogenomics testing aims to provide targeted therapies and interventions that are tailored to the specific characteristics of an individual, optimizing treatment outcomes and minimizing resistance and adverse effects. The article concludes by suggesting the potential of receptor modification to revolutionize treatment outcome of erythropoietin deficiency anemia through integration of the mentioned approach.

Keywords

precision medicine; erythropoietin-deficiency anemia; HIF-PHI; pharmacogenetics; inflammation; genotyping

Subject

Medicine and Pharmacology, Other

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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