LAUSR

Johann Wolfgang von Goethe (1749-1832) The International Network for Evaluating Outcomes of Neonates (iNeo) recently published the survival rate to discharge of a cohort of extremely preterm infants in high-income countries. The mean survival rate to discharge from a total of 88,327 preterm infants was 87% with a range of 78% to 93% [1]. Of note, around 50% of survivors, would develop neurodevelopmental impairment (NDI) [2]. The principal mechanisms for short-and-long-term brain damage are hypoxia, inflammation, oxidative and nitrosative stress, and programmed cell death. These pathogenic mechanisms are frequently triggered in utero but prolong their deleterious effects during postnatal life [2]. Thus, identifying reliable biomarkers capable of early predicting NDI would not only be of inestimable help to clinicians it also would open the gate for exploring new drugs or interventions to ameliorate the somber prognosis of these vulnerable patients. Erythropoietin (Epo), a glycoprotein hormone, is produced in response to low arterial partial pressure of oxygen perfusing oxygensensitive renal peritubular fibroblasts. Epo gene expression is triggered by the hypoxia-inducible transcription factors (HIF) when binding to the hypoxia responsive element after translocating into the cell nucleus. Of note, under hypoxic conditions HIFs trigger the expression of more than 70 genes involved in angiogenesis and oxygen supply, proliferation, anti-apoptosis, anti-inflammatory and