Hemoglobin-based blood substitutes and the hazards of blood radicals |
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| Authors: | Abdu I Alayash |
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| Institution: | 1. Laboratory of Plasma Derivatives, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), National Institutes of Health Campus, Bldg. 29, Rm. 112, 8800 Rockville Pike, Bethesda, Maryland, 20892, USAalayash@cber.fda.gov |
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| Abstract: | Cell-free hemoglobins, chemically altered or genetically expressed in microbial host systems, have been developed as oxygen-carrying therapeutics. Sitedirected modifications are introduced and serve to stabilize the protein molecules in a tetrameric and/or a polymeric functional form. Animal studies, as well as recent clinical studies, have suggested these proteins probably deliver oxygen to tissues. However, concerns still persist regarding the interference of hemoglobin and its oxidation products with the vascular redox balance, potentially impeding its clinical usefulness. This article reviews our current understanding of heme-mediated toxicities and some of the emerging protective strategies used to overcome hemoglobin side reactions. |
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| Keywords: | Nitric oxide/nitric oxide synthase hemodialysis hypotension asymmetric dimethylarginine dimethylarginine dimethylamine hydrolase von Bezold-Jarisch reflex |
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