Evidencias del potencial neuroprotector de la NeuroEPO en estudios preclínicos y ensayos clínicos; revisión sistemática
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Objetivo: evaluar el potencial neuroprotector de la NeuroEPO en desórdenes neurológicos.
Material y Métodos: Con la metodología PRISMA, se realizó una revisión
sistemática de artículos originales, en español e inglés, orientada por la
pregunta: ¿La NeuroEPO es un candidato terapéutico seguro y eficaz para la neuroprotección en desórdenes neurológicos? Se utilizaron las bases de datos LILACS, PubMed y el motor de búsqueda de Google Académico.
Resultados: Con la estrategia seguida, se incluyeron 20 artículos para
síntesis y revisión. Los estudios preclínicos se ejecutaron en biomodelos de
isquemia cerebral y de enfermedad de Alzheimer, mientras que los ensayos
clínicos se realizaron en pacientes con enfermedades neurodegenerativas. Se encontraron resultados de seguridad, tolerabilidad y eficacia de la NeuroEPO administrada por vía intranasal, con dosis, frecuencia de administración y duración de la intervención variables. En todos los estudios se observaron efectos neuroprotectores y en algunos se evidenciaron mecanismos moleculares que median estos efectos.
Conclusiones: La NeuroEPO ha resultado ser un producto seguro, sin efectos hematopoyéticos, y bien tolerado por vía intranasal, que aporta beneficios en situaciones de daño cerebral isquémico o degenerativo, por estimulación de mecanismos de neuroprotección endógena con acción antioxidante, antiinflamatoria y antiapoptótica. Los resultados respaldan la continuidad de estudios encaminados a enriquecer las evidencias científicas del potencial de la NeuroEPO para el tratamiento de desórdenes neurológicos.
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Referencias
Rizk, M. Z., G. I. Fouad, and H. F. Aly. "Neurological disorders: causes and treatment strategies." Int J Public Mental Health Neurosci 2018: 5.1 1-10.
WHO. World health statistics 2021 2021. Available from: https://www.who.int/publications/i/item/9789240027053.
Dirección de Registros Médicos y Estadísticas de Salud. Anuario estadístico de salud 2021. La Habana: Ministerio de Salud Pública [Internet]. 2022. Available from: https://temas.sld.cu/estadisticassalud/.
Suresh S, Rajvanshi PK, Noguchi CT. The many facets of erythropoietin physiologic and metabolic response. Frontiers in Physiology [Internet]. 2020; 10:[1534 p.]. Available from: https://www.frontiersin.org/articles/10.3389/fphys.2019.01534/full
Peng B, Kong G, Yang C, Ming Y. Erythropoietin and its derivatives: from tissue protection to immune regulation. Cell death & disease [Internet]. 2020; 11(2):[1-12 pp.]. Available from: https://www.nature.com/articles/s41419-020-2276-8.
Zhou, Z. W., Li, F., Zheng, Z. T., Li, Y. D., Chen, T. H., and Gao, W. W. Erythropoietin Egulates Mmune/inflammatory Eaction and Mproves Eurological Unction Utcomes in Raumatic Rain Njury. Brain Behav. 2017: 7 (11), E00827. doi:10.1002/brb3.827
Rama R, Garzón F, Rodríguez-Cruz Y, Maurice T, García-Rodríguez JC. Neuroprotective effect of Neuro-EPO in neurodegenerative diseases: "Alea jacta est." Neural Regen Res [Internet]. 2019 Sep 1 [cited 2022 Feb 4]; 14(9):1519. Available from: http://www.nrronline.org/
Rama R, Garzón F, Rodríguez-Cruz Y, Maurice T, García-Rodríguez JC. Neuroprotective effect of Neuro-EPO in neurodegenerative diseases: "Alea jacta est". Neural Regen Res. 2019 Sep;14(9):1519-1521. doi: 10.4103/1673-5374.255968. PMID: 31089047; PMCID: PMC6557108.
Fernández Romero T, Clapés Hernández S, Pérez Hernández CL, Barreto López JJ, Fernández Peña G. Hypoglycemic effect of NeuroEPO in rats with and without diabetes mellitus. Rev haban cienc méd. 2022; 21(1):E4617. Available in: http://www.revhabanera.sld.cu/index.php/rhab/article/view/4617
Fernández Romero T, Clapés Hernández S, Pérez Hernández CL, Núñez López N, Suárez Román G, Fernández Peña G. Protective effect of NeuroEPO on the reproduction of diabetic rats. Rev haban cienc méd. 2022; 21(4):E4797. Available from: http://www.revhabanera.sld.cu/index.php/rhab/article/view/4797
Sosa Testé, I., García Rodríguez, J. C., García Salman, J. D., Santana, J., Subirós Martínez, N., González Triana, C. Intranasal administration of recombinant human erythropoietin exerts neuroprotective effects on post-ischemic brain injury in Mongolian gerbils. Pharmacologyonline, 2006: 1, 100-112.
Sosa, I., Cruz, J., Santana, J., Mengana, Y., García-Salman, J. D., Muñoz, A., ... & Garcia, J. C. Paso de la molécula de eritropoyetina humana recombinante con bajo contenido de ácido siálico al Sistema nervioso central por la vía intranasal en los modelos del meriones unguiculatus y el primate no humano Macaca fascicularis. Revista de Salud Animal. 2008; 30(1), 39-44.
Núñez-Figueredo Y, Bueno V, Carrillo C, Jiménez N, Valdés O, Muñoz-Cernada A, et al. Neuroprotective effect of a nasal formulation of erythropoietin with low sialic acid content. Rev Cuba Farm. 2009; 43:1–13
Rodríguez Cruz Y, Mengana Támos Y, Muñoz Cernuda A, Subirós Martines N, González-Quevedo A, Sosa Testé I, et al. Treatment with nasal Neuro-EPO improves the neurological, cognitive, and histological state in a gerbil model of focal ischemia. ScientificWorldJournal [Internet]. 2010 Nov 16 PMC5763740]; 10:[2288-300 pp.]. Available from: https://www.hindawi.com/journals/tswj/2010/141453/.
Lagarto A, Bueno V, Guerra I, Valdés O, Couret M, López R, et al. Absence of hematological side effects in acute and subacute nasal dosing of erythropoietin with a low content of sialic acid. Exp Toxicol Pathol [Internet]. 2011 Sep [cited 2022 Feb 4]; 63(6):563–7. Available from: https://pubmed.ncbi.nlm.nih.gov/20488687/
Gao Y, Mengana Y, Cruz YR, Muñoz A, Testé IS, García JD, et al. Different expression patterns of Ngb and EPOR in the cerebral cortex and hippocampus revealed distinctive therapeutic effects of intranasal delivery of Neuro-EPO for ischemic insults to the gerbil brain. J Histochem Cytochem [Internet]. 2011 Feb PMC3201137 authorship and/or publication of this article.]; 59(2):[214-27 pp.]. Available from: https://journals.sagepub.com/doi/full/10.1369/0022155410390323.
Teste IS, Tamos YM, Cruz YR, Cernada AM, Rodríguez JC, Martínez NS, et al. Dose effect evaluation and therapeutic window of the neuro-EPO nasal application for the treatment of the focal ischemia model in the Mongolian gerbil. ScientificWorldJournal [Internet]. 2012 PMC3366217]; 2012:[607498 p.]. Available from: https://www.hindawi.com/journals/tswj/2012/607498/.
Maurice T, Mustafa MH, Desrumaux C, Keller E, Naert G, de la CG-BM, et al. Intranasal formulation of erythropoietin (EPO) showed potent protective activity against amyloid toxicity in the Aβ₂₅₋₃₅ non-transgenic mouse model of Alzheimer's disease. J Psychopharmacol [Internet]. 2013 Nov; 27(11):[1044-57 pp.]. Available from: https://journals.sagepub.com/doi/abs/10.1177/0269881113494939.
Rodríguez Cruz Y, Strehaiano M, Rodríguez Obaya T, García Rodríguez JC, Maurice T. An Intranasal Formulation of Erythropoietin (Neuro-EPO) Prevents Memory Deficits and Amyloid Toxicity in the APPSwe Transgenic Mouse Model of Alzheimer's Disease. J Alzheimers Dis [Internet]. 2017; 55(1):[231-48 pp.]. Available from:https://content.iospress.com/articles/journal-of-alzheimers-disease/jad160500.
Arzón F, Rodríguez Y, Arcía J, Rama R. Neuroprotective Effects of neuroEPO Using an In Vitro Model of Stroke. Behavioral Sciences. 2018; 8(2):26. Available from: https://doi.org/10.3390/bs8020026
Garzon, F., Coimbra, D., Parcerisas, A., Rodriguez, Y., García, J. C., Soriano, E., & Rama, R. NeuroEPO preserves neurons from glutamate-induced excitotoxicity. Journal of Alzheimer's Disease, 2018: 65(4), 1469-1483.
Suárez Borrás K, Fernández Peña G, Rodríguez Cruz Y, Puldón Seguí G. Intranasal administration of NeuroEPO does not affect the structure of respiratory mucosa in Wistar rats. Rev haban cienc méd [Internet]. 2022;21(4):E4849. Available from: http://www.revhabanera.sld.cu/index.php/rhab/article/view/4849
Suárez-Bórras K, Fernández-Peña G, Puldón-Seguí G, Rodríguez-Cruz Y, Pérez-Hernández CL. Effect of intranasal administration of NeuroEPO in the histological structure of the olfactory mucosa of Wistar rats. Rev haban cienc méd [Internet]. 2022; 21(5):E5061. Available from: http://www.revhabanera.sld.cu/index.php/rhab/article/view/5061
Santos-Morales O, Díaz-Machado A, Jiménez-Rodríguez D, Pomares-Iturralde Y, Festary-Casanovas T, González-Delgado CA, et al. Nasal administration of the neuroprotective candidate NeuroEPO to healthy volunteers: a randomized, parallel, open-label safety study. BMC Neurol [Internet]. 2017 Jul 4 PMC5496637]; 17(1):[129 p.]. Available from: https://link.springer.com/article/10.1186/s12883-017-0908-0.
Pedroso I, Garcia M, Casabona E, Morales L, Bringas ML, Pérez L, et al. Protective Activity of Erythropoyetine in the Cognition of Patients with Parkinson's Disease. Behav Sci (Basel) [Internet]. 2018 May PMC5981245]; 8(5):[51 p.]. Available from: https://www.mdpi.com/2076-328X/8/5/51.
García-Llano M, Pedroso-Ibáñez I, Morales-Chacón L, Rodríguez-Obaya T, Pérez-Ruiz L, Sosa-Testé I, et al. Short-term Tolerance of Nasally-administered NeuroEPO in Patients with Parkinson Disease. MEDICC Rev [Internet]. 2021 Jan; 23(1):[49-54 pp.]. Available from: https://mediccreview.org/short-term-tolerance-of-nasally-administered-neuroepo-in-patients-with-parkinson-disease/.
Vega MLB, Shengnan L, Leon YR, Rodriguez AM, Fernandez EC, Llano MG, et al. NeuroEPO improves cognition in Parkinson's disease. Preliminary report. medRxiv [Internet]. 2022 Mar 28 [cited 2022 Apr 17];2022.02.24.22271444. Available from: https://www.medrxiv.org/content/10.1101/2022.02.24.22271444v2
Bringas Vega ML, Pedroso Ibáñez I, Razzaq FA, Zhang M, Morales Chacón L, Ren P, Galan Garcia L, Gan P, Virues Alba T, Lopez Naranjo C, Jahanshahi M, Bosch-Bayard J and Valdes-Sosa PA. The effect of neuroepo on cognition in Parkinson's disease patients is mediated by electroencephalogram source activity. Front. Neurosci. 2022: 16:841428. doi: 10.3389/fnins.2022.841428
Rodriguez‐Labrada, R., Ortega‐Sanchez, R., Hernandez Casana, P., Santos Morales, O., Padrón‐Estupiñan, M. D. C., et al. Erythropoietin in Spinocerebellar ataxia Type 2: Feasibility and Proof‐of‐Principle Issues from a Randomized Controlled Study. Movement Disorders, 2022: 37(7), 1516-1525. Available from: https://doi.org/10.1002/mds.29045
Amable, N. U., Pérez, S. S., Brito, D. L., Peñalver, A. I., Guía, G., Impacto del tratamiento con NeuroEPO en la evaluación neuropsicológica de pacientes con Alzheimer. Revista Iberoamericana de Neuropsicología. 2023: 6(1) 52.
Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. International Journal of Molecular Sciences. 2020; 21(20):7609. https://doi.org/10.3390/ijms21207609
Lamptey RNL, Chaulagain B, Trivedi R, Gothwal A, Layek B, Singh J. A Review of the Common Neurodegenerative Disorders: Current Therapeutic Approaches and the Potential Role of Nanotherapeutics. International Journal of Molecular Sciences. 2022; 23(3):1851. https://doi.org/10.3390/ijms23031851
Rodríguez-Labrada, Roberto, Medrano-Montero, Jacqueline and Velázquez-Pérez, Luis. Hereditary Ataxias in Cuba: Results and Impact of a Comprehensive, Multidisciplinary Project. MEDICC Review. 2019: 21(4). 39-45. Available from: https://www.scielosp.org/article/medicc/2019.v21n4/39-45/#
García-Artalejo, J. A., Mancera-Arteu, M., Sanz-Nebot, V., Rodríguez, T., & Giménez, E. Characterizing a novel hyposialylated erythropoietin by intact glycoprotein and glycan analysis. Journal of Pharmaceutical and Biomedical Analysis, 2022: 213, 114686. https://doi.org/10.1016/j.jpba.2022.114686
He L, Cohen EB, Edwards APB, Xavier-Ferrucio J, Bugge K, Federman RS, Absher D, Myers RM, Kragelund BB, Krause DS, DiMaio D. Transmembrane Protein Aptamer Induces Cooperative Signaling by the EPO Receptor and the Cytokine Receptor β-Common Subunit. iScience. 2019 Jul 26;17:167-181. DOI: 10.1016/J.ISCI.2019.06.027. Epub 2019 Jun 21. PMID: 31279934; PMCID: PMC6614117.
Tóthová Z, Šemeláková M, Solárová Z, Tomc J, Debeljak N, Solár P. The Role of PI3K/AKT and MAPK Signaling Pathways in Erythropoietin Signalization. International Journal of Molecular Sciences. 2021; 22(14):7682. https://doi.org/10.3390/ijms22147682
Silva, I., Alípio, C., Pinto, R., & Mateus, V. Potential anti-inflammatory effect of erythropoietin in non-clinical studies in vivo: A systematic review. Biomedicine & Pharmacotherapy. 2021; 139, 111558.
Mao, R., Zong, N., Hu, Y., Chen, Y., & Xu, Y. Neuronal death mechanisms and therapeutic strategy in ischemic stroke. Neuroscience Bulletin. 2022; 38(10), 1229-1247.
Teleanu, D. M., Niculescu, A. G., Lungu, I. I., Radu, C. I., Vladâcenco, O., Roza, E., ... & Teleanu, R. I. An overview of oxidative stress, neuroinflammation, and neurodegenerative diseases. International journal of molecular sciences. 2022; 23(11), 5938.
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