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Possibility of enhanced risk of retinal neovascularization in repeated blood donors: blood donation and retinal alteration

Authors Rastmanesh R

Published 6 September 2011 Volume 2011:4 Pages 647—656


Review by Single-blind

Peer reviewer comments 2

Reza Rastmanesh
Department of Clinical Nutrition and Dietetics, Shahid Beheshti University of Medical Sciences, National Nutrition and Food Technology Research Institute, Tehran, Iran

Abstract: Repeated blood donors manifest clinical, subclinical, and biochemical signs of iron deficiency anemia, have significantly higher erythropoietin and vascular endothelial growth factor (VEGF) concentrations, and decreased tissue oxygen saturation, oxygenated tissue hemoglobin, and regional cerebral oxygen saturation. Erythropoietin and VEGF are potent retinal angiogenic factors which may initiate and promote the retinal angiogenesis process independently or simultaneously. Increases in circulating levels of erythropoietin and VEGF are proportionate to the levels of hematocrit, hypoxemia, and tissue hypoxia. It is suggested that higher erythropoietin production following iron deficiency anemia-induced chronic hypoxemia/hypoxia may, hypothetically, enhance the risk of retinal angiogenesis and/or neovascularization, possibly by inducing hypoxia inducible factor-1 alpha, which consequently upregulates genes stimulating angiogenesis, resulting in formation of a new vasculature, possibly by modulation of signal transducer and activator of transcription 3 signaling in the retina. Implications of this hypothesis cover erythropoietin doping, chronic hypoxia, and hypoxemic situations, such as angiogenesis-related cardiac and pulmonary diseases.

Keywords: repeated blood donation, erythropoietin, retinal neovascularization, vascular endothelial growth factor, hypoxia

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