Out of Thin Air: The Evolving Enigma of Erythropoietin and Neocytolysis
Authors: Bernard A. Harris, Paul E. Epstein
Journal: Annals of Internal Medicine (2001)

Editorials17 April 2001Out of Thin Air: The Evolving Enigma of Erythropoietin and NeocytolysisBernard A. Harris Jr., MD and Paul E. Epstein, MDBernard A. Harris Jr., MDDr. Harris: The Harris Foundation, Inc.; Houston, TX 77289-0907Dr. Epstein: University of Pennsylvania; Radnor, PA 19087Search for more papers by this author and Paul E. Epstein, MDDr. Harris: The Harris Foundation, Inc.; Houston, TX 77289-0907Dr. Epstein: University of Pennsylvania; Radnor, PA 19087Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-8-200104170-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, Rice and colleagues (1) explore the mechanisms underlying a rapid decrease in red cell mass that occurs during descent from high altitude to sea level, a process known as neocytolysis. The sequence of events that they describe is instructive not only for its physiologic implications but also for its demonstration of how keen observation in one setting can be translated into useful knowledge in another. While it seems logical at first to think of altitude on mountains as analogous to altitude in a spacecraft, in reality the environments could not be more dissimilar. Mountainous altitude is characterized ...References1. Rice L, Ruiz W, Driscoll T, Whitley C, Tapia R, Hachey D, Gonzales G, Alfrey C. Neocytolysis on descent from altitude: a newly recognized mechanism for the control of red cell mass. Ann Intern Med. 2001;134:652-6. LinkGoogle Scholar2. Udden M, Driscoll T, Pickett M, Leach-Huntoon C, Alfrey C. Decreased production of red blood cells in human subjects exposed to microgravity. J Lab Clin Med. 1995;125:442-9. [PMID: 7706898] MedlineGoogle Scholar3. Alfrey C, Udden M, Leach-Huntoon C, Driscoll T, Pickett M. Control of red blood cell mass in spaceflight. J Appl Physiol. 1996;81:98-104. [PMID: 8828651] CrossrefMedlineGoogle Scholar4. Alfrey C, Rice L, Moulds J. Hematologic changes in space. In: White, ed. Gravity, Biology and Medicine: Insights through Space Research. Paris: Gordon & Breach [In press]. Google Scholar5. Audran M, Gareau R, Matecki S, Durand F, Chenard C, Sicart M, et al . Effects of erythropoietin administration in training athletes and possible indirect detection in doping control. Med Sci Sports Exerc. 1999;31:639-45. [PMID: 10331881] CrossrefMedlineGoogle Scholar6. Ashenden M, Gore C, Dobson G, Hahn A. “Live high, train low” does not change the total hemoglobin mass of male endurance athletes sleeping at a simulated altitude of 3000 m for 23 nights. Eur J Appl Physiol. 1999;80:479-84. CrossrefGoogle Scholar7. Daghman N, Elder G, Savage G, Winter P, Maxwell A, Lappin T. Erythropoietin production: evidence for multiple oxygen sensing pathways. Ann Hematol. 1999;78:275-8. [PMID: 10422630] CrossrefMedlineGoogle Scholar8. Jones S, D'Andrea A, Haines L, Wong G. Human erythropoietin receptor: cloning, expression, and biologic characterization. Blood. 1990;76:31-5. [PMID: 2163696] CrossrefMedlineGoogle Scholar9. Witthuhn B, Quelle F, Silvennoinen O, Yi T, Tang B, Miura O, et al . JAK2 associates with the erythropoietin receptor and is tyrosine phosphorylated and activated following stimulation with erythropoietin. Cell. 1993;74:227-36. [PMID: 8343951] CrossrefMedlineGoogle Scholar10. Koury M, Bondurant M. Erythropoietin retards DNA breakdown and prevents programmed death in erythroid progenitor cells. Science. 1990;248:378-81. [PMID: 2326648] CrossrefMedlineGoogle Scholar11. Lawson A, Bao H, Wickrema A, Jacobs-Helber S, Sawyer S. Phosphatase inhibition promotes antiapoptotic but not proliferative signaling pathways in erythropoietin-dependent HCD57 cells. Blood. 2000;96:2084-92. [PMID: 10979952] CrossrefMedlineGoogle Scholar12. Johnson P, Driscoll T, LeBlanc A. Blood volume changes.. In: Johnston RS, Dietlein LF, eds. Biomedical Results from Skylab (NASA SP-337). Washington, DC: NASA Headquarters; 1977. Google Scholar13. Leach C, et al . Hematology and biomedical findings of Spacelab 1 flight.. In: Zanjani E, Tavassoli M, Ascensao J, eds. Regulation of Erythropoiesis. New York: PMA Publishing Corp; 1988:15-53. Google Scholar Author, Article, and Disclosure InformationAuthors: Bernard A. HarrisJr., MD; Paul E. Epstein, MDAffiliations: Dr. Harris: The Harris Foundation, Inc.; Houston, TX 77289-0907Dr. Epstein: University of Pennsylvania; Radnor, PA 19087Corresponding Author: Bernard A. Harris, Jr., MD, The Harris Foundation, Inc., PO Box 890907, Houston, TX 77289-0907; e-mail, [email protected]org.Current Author Addresses: Dr. Harris: The Harris Foundation, Inc., PO Box 890907, Houston, TX 77289-0907.Dr. Epstein: Penn Medicine at Radnor, 250 King of Prussia Road, Radnor, PA 19087. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNeocytolysis on Descent from Altitude: A Newly Recognized Mechanism for the Control of Red Cell Mass Lawrence Rice , Wilson Ruiz , Theda Driscoll , Carl E. Whitley , Rosario Tapia , David L. Hachey , Gustavo F. Gonzales , and Clarence P. Alfrey Metrics Cited byNeocytolysis: How to Get Rid of the Extra Erythrocytes Formed by Stress Erythropoiesis Upon Descent From High AltitudeRegulation of erythropoiesis after normoxic return from chronic sustained and intermittent hypoxiaChanges of Red Blood Cell Surface Markers in a Blood Doping Model of NeocytolysisBiochemistry, Physiology, and Complications of Blood Doping: Facts and SpeculationAnemia and Erythropoietin in Space FlightsThe Negative Regulation of Red Cell Mass by Neocytolysis: Physiologic and Pathophysiologic Manifestations 17 April 2001Volume 134, Issue 8Page: 710-712KeywordsAnemiaBlood cellsBlood vesselsChronic obstructive pulmonary diseaseErythropoietinMembrane proteinsOxygenPlasma volumePopulation statisticsReticulocytes ePublished: 17 April 2001 Issue Published: 17 April 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...