Glad to you were able to tell us your story
You wrote - "Anyway. As my blood cells were just dissolving, I was encouraged to have e-poetin. Before I became too ill to make a decision, I had already decided that if it was not genetically engineered that I would not have it, as it contains some blood and this is against my christian conscience."
One point of clarification - Recombinant EPO is in fact genetically engineered. The products available here in the United States do in fact contain a very small amount of albumin, which is derived from proteins extracted from blood plasma and therefore are a matter of personal decision for the Jehovah's Witness population.
I believe the European EPO does not contain albumin making it a purely genetically engineered product.
EPO (Erythropoietin)
Erythropoietin (EPO) is a glycopeptid hormone which controls the formation of red blood cells (erythrocytes) in the stem cells of the bone marrow depending on oxygen requirements. EPO is produced chiefly in the kidney tissue.
EPO is composed of amino acids. At four places in the protein chain there are links with different glycosidic residues. Because of the variety of these sugar residues there are different EPO forms, whose physiological effects are comparable although their physical and chemical characteristics are somewhat different.
The genetically engineered recombinant human erythropoietin (in the presented literature abbreviated as: rHuEPO, r-HuEPO, rhu-EPO, rhEPO or rEPO) is identical with natural EPO as far as the amino acid structure is concerned. However, there are slight differences in the sugar chains. These differences also have an effect on the physical and chemical behaviour of the molecule. For example, there are differences in the electrical charges of the various EPO forms.
SOME EPO HISTORY
1977 Purified EPO is isolated from human urine for the first time
1985 EPO gene is cloned.
1987 Recombinant EPO is first available in Europe.
1987-1990 A number of deaths of competitive Dutch and Belgian cyclists is linked to EPO use.
1988 The Federation Internationale de Ski (Fis) classifies EPO as a doping substance.
1989 Recombinant EPO is approved by the FDA for manufacture.
1990 EPO is banned by the IOC.
1993-1994 The IAAF introduces blood sampling during eight World Cup Meetings.
1997 The Union Cycliste Internationale (UCI) and the Federation Internationale de Ski (Fis) accept random blood testing before competition and fix maximum haematocrit and haemoglobin values. However, these blood values are not controlled to prove the athlete guilty of doping but to protect his or her health against possible damage caused by elevated haematocrit and haemoglobin values.
1998 The discovery of EPO in a Festina team car during the Tour de France leads to a doping scandal, which is covered extensively in the press.
1999 Work to develop a reliable EPO test in time for Sydney 2000 is intensified.
THE EFFECTS OF EPO
EPO stimulates the maturation of reticulocytes to erythrocytes in the stem cells of the bone marrow. The increase in the number of erythrocytes leads to an increase in the amount of storable oxygen per blood volume portion and, in connection with this, to the improvement of oxygen transport capacity and an increase in endurance performance. A similar effect is achieved through altitude training. (See e.g. BREIDBACH, ch. 1; Gambrell/Lombardo, ch. 1; Schnauzer, ch. 1; Rendic, ch. 2.)
In which cases is rhEPO normally used in medicine?
As EPO is produced by the kidneys, people suffering from chronic renal failure are anaemic. While patients with total renal failure were treated with blood transfusions and erythrocyte concentrates until the end of the eighties, they have been treated with rhEPO since the approval of this medicament in 1989. In a lot of cases anaemias of a different genesis can also be improved by rhEPO. The fact that rhEPO therapy induces an additional stimulation of erythropoesis, even in the case of a completely intact endogenous EPO production,
is utilized with autologous blood donors. As an alternative to erythrocyte transfusion, high rhEPO doses are also effective as an antianaemic in the case of chronic polyarthritis, AIDS, tumors and surgery. A still unclear side effect of therapeutic rhEPO administration is increased blood pressure. (See e.g. BREIDBACH, ch. 1; ECKARDT, ch. 1 ; FANDREV/JElKMANN, ch. 1; JElKMANN, ch. 1 ; MANDIN, ch. 2)
How is rhEPO administered?
In haemodialysis patients rhEPO is normally administered intravenously. However, rhEPO can also be injected subcutanously. (See GAMBRELL/LMBARDO, ch. 1.)
What are the risks of rhEPO administration?
RhEPO is a well-tolerated medicament, which has almost no adverse effects. However, if rhEPO is administered in an excessively high dosage and in an uncontrolled way, the result is an increase in blood viscosity and thus a high risk of coronary and cerebral vascular occlusions.
The risks associated with the intake of too much rhEPO even increase when training is done at altitude or in the case of dehydration. (See e.g. BREIDBACH. ch. 1 ; GAMBRELL/LOMBARDO, ch. 1 ; SCHANZER, ch. 1; SHASKEY/GREEN, ch. 1; STRICKER, ch. 1.)