Noninvasive in vivo monitoring of methemoglobin formation and reduction with broadband diffuse optical spectroscopy.

We present noninvasive, quantitative in vivo measurements of methemoglobin formation and reduction in a rabbit model using broadband diffuse optical spectroscopy (DOS). Broadband DOS combines multifrequency frequency-domain photon migration (FDPM) with time-independent near infrared (NIR) spectroscopy to quantitatively measure bulk tissue absorption and scattering spectra between 600 nm and 1,000 nm. Tissue concentrations (denoted by brackets) of methemoglobin ([MetHb]), deoxyhemoglobin ([Hb-R]), and oxyhemoglobin ([HbO2]) were determined from absorption spectra acquired in "real time" during nitrite infusions in nine pathogen-free New Zealand White rabbits. As little as 30 nM [MetHb] changes were detected for levels of [MetHb] that ranged from 0.80 to 5.72 microM, representing 2.2 to 14.9% of the total hemoglobin content (%MetHb). These values agreed well with on-site ex vivo cooximetry data (r2= 0.902, P < 0.0001, n = 4). The reduction of MetHb to functional hemoglobins was also carried out with intravenous injections of methylene blue (MB). As little as 10 nM changes in [MB] were detectable at levels of up to 150 nM in tissue. Our results demonstrate, for the first time, the ability of broadband DOS to noninvasively quantify real-time changes in [MetHb] and four additional chromophore concentrations ([Hb-R], [HbO2], [H2O], and [MB]) despite significant overlapping spectral features. These techniques are expected to be useful in evaluating dynamics of drug delivery and therapeutic efficacy in blood chemistry, human, and preclinical animal models.     

Hemoglobin vesicles containing methemoglobin and L-tyrosine to suppress methemoglobin formation in vitro and in vivo

Hemoglobin (Hb) vesicles have been developed as cellular-type Hb-based O(2) carriers in which a purified and concentrated Hb solution is encapsulated with a phospholipid bilayer membrane. Ferrous Hb molecules within an Hb vesicle were converted to ferric metHb by reacting with reactive oxygen species such as hydrogen peroxide (H(2)O(2)) generated in the living body or during the autoxidation of oxyHb in the Hb vesicle, and this leads to the loss of O(2) binding ability. The prevention of metHb formation by H(2)O(2) in the Hb vesicle is required to prolong the in vivo O(2) carrying ability. We found that a mixed solution of metHb and L-tyrosine (L-Tyr) showed an effective H(2)O(2) elimination ability by utilizing the reverse peroxidase activity of metHb with L-Tyr as an electron donor. The time taken for the conversion of half of oxyHb to metHb (T(50)) was 420 min for the Hb vesicles containing 4 g/dL (620 microM) metHb and 8.5 mM L-Tyr ((metHb/L-Tyr) Hb vesicles), whereas the time of conversion for the conventional Hb vesicles was 25 min by stepwise injection of H(2)O(2) (310 microM) in 10 min intervals. Furthermore, in the (metHb/L-Tyr) Hb vesicles, the metHb percentage did not reach 50% even after 48 h under a pO(2) of 40 Torr at 37 degrees C, whereas T(50) of the conventional Hb vesicles was 13 h under the same conditions. Moreover, the T(50) values of the conventional Hb vesicles and the (metHb/L-Tyr) Hb vesicles were 14 and 44 h, respectively, after injection into rats (20 mL/kg), confirming the remarkable inhibitory effect of metHb formation in vivo in the (metHb/L-Tyr) Hb vesicles.     

Hexose monophosphate shunt-stimulated reduction of methemoglobin by divicine

Reduced divicine (2,6-diamino-4,5-dihydroxypyrimidine), an aglycone implicated in the pathogenesis of favism, reduces methemoglobin efficiently in intact erythrocytes and in hemolysates. Oxidized divicine produces the same effect when glucose or an NADPH-generating system is added to intact erythrocytes or to hemolysates. Although NADPH, NADH, and GSH have no direct methemoglobin-reducing activity in vitro, they convert oxidized divicine to the reduced hydroquinone species, which is responsible for the electron transfer to methemoglobin. Reduction of methemoglobin is optimally observed under nitrogen since, in the presence of oxygen, reduced divicine undergoes autoxidation. Several lines of evidence rule out the reduction of methemoglobin by divicine through an enzyme-catalyzed process, although it is certainly sustained by the hexose monophosphate shunt activity of erythrocytes through the generation of both NADPH and GSH. Thus, the strong enhancing effect that glucose produces on the divicine-dependent methemoglobin reduction within intact normal erythrocytes is completely absent in erythrocytes from glucose-6-phosphate dehydrogenase-deficient subjects. This distinctive behavior might account for the enhanced methemoglobin levels that are found both in vitro in glucose-6-phosphate dehydrogenase-deficient erythrocytes exposed to divicine and in vivo as a typical feature of the acute hemolytic crisis of favic patients.     

Effects of ascorbate on methemoglobin reduction in intact red cells

An endpoint of 75% HbO₂/25% methemoglobin (MetHb) was approached in red cells incubated with a greater than physiologic concentration of ascorbate (10 mm). The presence of glucose (5 mm) with ascorbate shifted the endpoint to 90% HbO₂/10% MetHb while lactate (2 mm) plus pyruvate (0.1 mm) had no effect. These endpoints were approached regardless of the $\text{HbO}{}_2\text{MetHb}$ ratio at zero time. No hemoglobin degradation was observed. When red cells containing 100% MetHb at zero time were used, analysis of the initial rate of HbO₂ formation in the presence of various substrates showed synergistic interaction between ascorbate (10 mm) and glucose, additive activity with ascorbate and lactate, and less than additive activity with glucose and lactate. Incubation of red cells with a phsyiologic concentration of ascorbate (0.1 mm) resulted in no significant HbO₂ formation in the absence of other additions. When red cells were incubated with glucose and/or lactate plus pyruvate, an endpoint of about 99% HbO₂/1% MetHb was approached regardless of the HbO₂/MetHb ratio at zero time or the presence or absence of physiologic ascorbate. Physiologic ascorbate slightly but consistently increased the rate of HbO₂ formation in red cells incubated with glucose but not with lactate. HbO₂ formation was not increased by ascorbate in red cells which contained more than about 90% HbO₂ at zero time. The results indicate that excess ascorbate functions stoichiometrically driving cellular chemistry to a steady state between HbO₂ and MetHb formation whereas physiologic ascorbate functions catalytically allowing electron transport from glucose to MetHb via the hexose monophosphate shunt.     

Enzymatic methemoglobin reduction - effect of organic phosphate.

The enzymatic reduction of aquomethemoglobin A, A₁C, fluoro-methemoglobin A (high spin) and cyanomethemoglobin A (low spin) by NADH-methemoglobin reductase was studied in the presence and absence of IHP and NaCl. It is shown that at alkaline pH, IHP accelerates the rate of reduction of high spin methemoglobins only. This effect is specific for IHP and cannot be produced by NaCl, although NaCl does exert similar effect as IHP at acid pH. Blocking of the NH₂- termini of β-chains (Hb A₁C) does not alter the effect of IHP on methemoglobin reduction.     

Catalytic action of selenium in the reduction of methemoglobin by glutathione

Selenite, selenate and selenocystine catalyzed the reduction of methemoglobin (metHb) by glutathione (GSH), while selenomethionine did not. Maximal reduction of metHb was observed with 10^?5 M selenite and 2 mM GSH, at pH 7.4. Selenite also catalyzed the reduction of metHb with cysteine or 2-mercaptoethylamine in place of GSH. Heavy metals and arsenite completely prevented the effect of selenite. These findings suggest that certain seleno-compounds catalyze the reduction of metHb by thiol compounds.     

Indirect electrochemical reduction of methemoglobin: design of the process

Methemoglobin can be reduced on a platinum cathode using flavin mononucleotide as an oxido-reduction mediator. The process requires the utilization of a filter-press cell with compartments separated by a semi-permeable membrane. Analysis of the various constraints imposed by the process itself and by the nature of the molecules involved shows that the electrolysis cell must operate at a low temperature, in strictly anaerobic conditions, in series with a storage tank, and with fluid circulation rates lower than approximately 0.8 m/s. A process has been designed that takes into account these imperatives and enables volumes of solution of the order of 200 cm(3) to be processed. It enables optimization of the flow rates used as well as of the methemoglobin/flavin ratio and is the forerunner of an industrial reactor.     

Effect of organic phosphates on methemoglobin reduction by ascorbic acid.

The rate of methemoglobin reduction by ascorbic acid was accelerated in the presence of ATP,2,3-diphosphoglycerate (2,3-DPG), and inositol hexaphosphate (IHP). The acceleration was as much as three times, four times, and ten times in the presence of ATP, 2.3-DPG, and IHP at pH 7.0, respectively. The changes of the concentrations of methemoglobin and ascorbic acid during the methemoglobin reduction were determined, and the reaction was found to proceed stoichiometrically in the presence of IHP. The reduction rate of methemoglobin by ascorbic acid was compared at different concentrations of organic phosphates (ATP,2,3-DPG, and IHP) at various pH values (6.3, 7.0, 7.7). From the changes in the reduction rate under different concentrations of organic phosphates, the dissociation constants of ATP, 2,3-DPG, and IHP to methemoglobin could be determined and were estimated to be 3.3 X 10(-4) M, 2 X 10(-3) M, and 8 X 10(-6) M at pH 7.0, respectively. On the basis of these results, the acceleration mechanism of methemoglobin reduction by ascorbic acid due to the presence of organic phosphates was described. The physiological role of 2,3-DPG in human red cells was discussed in relation to the reduction of methemoglobin by ascorbic acid.