Erythropoietin induces excessive neointima formation: A study in a rat carotid artery model of vascular injury

Maram K. Reddy, Jaspreet K. Vasir, Ganapati V. Hegde, Shantaram S. Joshi, Vinod Labhasetwar

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


A therapeutic strategy that would mitigate the events leading to hyperplasia and facilitate re-endothelialization of an injured artery after balloon angioplasty could be effective for a long-term patency of the artery. It is hypothesized that erythropoietin (EPO), which has both anti-inflammatory and antiapoptotic properties, will prevent hyperplasia, and its ability to proliferate and mobilize endothelial progenitor cells will re-endothelialize the injured artery. To test this hypothesis, EPO (5000 IU/kg) in solution was injected intraperitoneally 6 hours before vascular injury and then on every alternate day for a week or as a single dose (5000 IU/kg) in a sustained release gel formulation 1 week before the vascular injury. Morphometric analysis revealed nearly continuous re-endothelialization of the injured artery in EPO solution-treated animals (90% vs less than 20% in saline control); however, the treatment also caused excessive neointima formation (intima/media ratio, 2.10 ± 0.09 vs 1.60 ± 0.02 saline control, n = 5, P <.001). The EPO gel also induced similar excessive neointima formation. Immunohistochemical analysis of the injured arteries from the animals treated with EPO solution demonstrated a significant angiogenic response in adventitia and media, thus explaining the formation of excessive neointima. Although the results are in contrast to expectation, they explain a greater degree of stenosis seen in hemodialysis access fistulas in patients who are on EPO therapy for anemic condition. The results also caution the use of EPO, particularly in patients who are at a risk of vascular injury or are suffering from an atherosclerotic condition.

Original languageEnglish (US)
Pages (from-to)237-247
Number of pages11
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Issue number3
StatePublished - Sep 2007


  • Balloon angioplasty
  • Endothelium
  • Hyperplasia
  • Restenosis
  • Vascular smooth muscle cells

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)


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