title: Hemoglobin-based blood substitutes and the hazards of blood radicals.
abstract: Cell-free hemoglobins, chemically altered or genetically expressed in microbial host systems, have been developed as oxygen-carrying therapeutics. Site-directed 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.
authors.affiliation: Laboratory of Plasma Derivatives, Center for Biologics Evaluation and Research, Food and Drug Administration, National Institutes of Health Campus, Bethesda, Maryland 20892, USA. alayash@cber.fda.gov
authors.forename: A I
authors.initials: AI
authors.lastname: Alayash
mesh_terms: D000818:Animals; D001802:Blood Substitutes; D005609:Free Radicals; D006454:Hemoglobins / Q000009:adverse effects*; D006801:Humans; D009569:Nitric Oxide / Q000378:metabolism; D010084:Oxidation-Reduction; D011994:Recombinant Proteins / Q000009:adverse effects; D012996:Solutions
chemical_list: D001802:Blood Substitutes; D005609:Free Radicals; D006454:Hemoglobins; D011994:Recombinant Proteins; D012996:Solutions; D009569:Nitric Oxide