Exploring erythropoiesis: aging through the lens of malaria and microgravity

Erythropoiesis, the production of red blood cells (RBCs), is a tightly regulated process essential for hematologic health. This system significantly shifts during aging, impacting RBC production and function. In this review, we examine erythropoiesis stages and highlight major age-related changes in stem cells, transcription factors, and key regulators such as erythropoietin and iron. We then explore mechanisms driving the high prevalence of anemia in the elderly - chronic disease, sepsis, and unexplained anemia - while discussing current therapies and gaps in management. Finally, we introduce two underexplored models for studying aging RBCs: malaria and microgravity. Plasmodium infection and spaceflight mirror key features of age-related erythropoietic dysfunction and RBC morphological alterations, offering insights into mechanisms of anemia in the elderly.