Dr. Reza Nejat is an Iranian board-certified Anesthesiologist and Fellow of Critical Care Medicine. He earned his MD from Tehran University of Medical Sciences and completed his Anesthesiology residency at Iran University of Medical Sciences. He has practiced as an intensivist since 2014 after completing his fellowship at Sina Hospital. His research interests include sepsis, immunology, acute heart failure, and neuro-critical care, especially during the COVID-19 era. Dr. Nejat has authored five research papers and contributed to four medical books. He served as faculty at Shahid Beheshti University of Medical Sciences and was a hospital director. He is also a peer reviewer and editorial board member for several international journals.

Abstract Title: Neuroinflammation, Neuroimmunometabolism, and Erythropoietin

Introduction: Neuroinflammation is the pathobiologic basis of many deleterious brain injuries. It is evident that metabolic derangement in immune cells residing in the CNS contributes to this process. Erythropoietin has been found to be promising in improving the outcome of neuroinflammation and neuroimmunometabolic disorders.

Method: The recently published articles discussing neuroinflammation and brain immunometabolic disorders were studied.

Result and Discussion: Neuroinflammation, as an inflammatory reaction provoked in the central nervous system (CNS), is mediated by cytokines, chemokines, and reactive oxygen species released by neural cells, astrocytes, microglia, and penetrating leukocytes. The pathobiologic basis of the damages in a variety of insults endangering brain survival has been attributed to neuroinflammation. The cascade of this inflammatory reaction impacts the CNS in a time- and spatial-dependent manner. Short and mild forms of this response represent a rather homeostatic process resulting in neurodevelopment, neuroprotection, and neuroplasticity. Conversely, severe as well as chronic forms of neuroinflammatory responses lead to serious pathologies in the CNS. Consistently, astrocytes and microglia, with high metabolic demand, contribute to both homeostatic neuroprotection and dyshomeostatic neurotoxicity, which require proportional metabolic reprogramming.

Retaining physiologic energy metabolism and meticulously regulated metabolic reprogramming in immune cells endow the brain with the ability to regulate the neuroimmune responses.

Recently, regulating effects of erythropoietin through its receptor (EPOR) on neuroinflammation and neuroimmunometabolic balance have been studied in a large number of experiments.

Conclusion: Erythropoietin has been demonstrated to be promising in ameliorating neuroinflammation and subsiding neuroimmunometabolic derangements.

Keywords: Astrocytes, Erythropoietin, Metabolic disorder, Microglia, Neuroimmunometabolic disorder, Neuroinflammation.