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. 2020 Nov 24;8:584696. doi: 10.3389/fcell.2020.584696

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Copyright © 2020 Suresh, Lee and Noguchi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Effects of erythropoietin in the bone and the bone marrow compartment. 1. Endogenous EPO regulates bone marrow stromal cell differentiation to adipocytes and osteoblasts. 2. Increased EPO decreases bone marrow adipocytes. 3. EPO directly regulates osteoblast differentiation; the absence of EPO signaling in osteoblasts reduces their differentiation potential. Elevated EPO has a dose-dependent effect on osteoblasts, with low-dose EPO reducing differentiation and high-dose EPO increasing differentiation. 4. Absence of EPO signaling in mature osteoblasts reduces osteocytes, resulting in empty lacunae. 5. High EPO stimulates differentiation of preosteoclasts into osteoclasts. 6. EPO stimulates hematopoietic stem cells which, in turn, promotes both osteoblast and osteoclast differentiation.