title: Decreased damage from transient focal cerebral ischemia by transfusion of zero-link hemoglobin polymers in mouse.
abstract: OBJECTIVE
  Transfusion of large polymers of hemoglobin avoids the peripheral extravasation and hypertension associated with crosslinked tetrameric hemoglobin transfusion and may be more effective in rescuing brain from focal ischemia. Effects of transfusion of high-oxygen-affinity hemoglobin polymers of different weight ranges were determined.
  
  
  METHODS
  Hypervolemic exchange transfusion was performed during 2 hours of middle cerebral artery occlusion in mice.
  
  
  RESULTS
  Compared to transfusion with a 5% albumin solution or no transfusion, infarct volume was reduced 40% by transfusion of a 6% solution containing hemoglobin polymers in the nominal range 500 to 14 000 kDa. Infarct volume was not significantly reduced by transfusion of a lower concentration of 2% to 3% of this size range of polymers, 6% hemoglobin solutions without removal of polymers <500 kDa or >14000 kDa, or crosslinked hemoglobin tetramers with normal oxygen affinity. Exchange transfusion with the 6% solution of the 500 to 14 000 kDa hemoglobin polymers did not improve the distribution of cerebral blood flow during focal ischemia and, in mice without ischemia, did not affect flow to brain or other major organs.
  
  
  CONCLUSIONS
  An intermediate size range of polymerized bovine hemoglobin possessing high oxygen affinity appears optimal for rescuing mouse brain from transient focal cerebral ischemia. A minimum concentration of a 6% solution is required, the rescue is superior to that obtained with crosslinked tetrameric hemoglobin possessing normal oxygen affinity, and tissue salvage is not associated with increased blood flow. This polymer solution avoids the adverse effects of severe renal and splanchnic vasoconstriction seen with crosslinked tetrameric hemoglobin.
authors.affiliation: Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 1404, Baltimore, MD 21287, USA.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Mito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nemoto
authors.forename: Herman
authors.initials: H
authors.lastname: Kwansa
authors.forename: Kenji
authors.initials: K
authors.lastname: Sampei
authors.forename: Murtuza
authors.initials: M
authors.lastname: Habeeb
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Murphy
authors.forename: Enrico
authors.initials: E
authors.lastname: Bucci
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Koehler
mesh_terms: D000818:Animals; D016913:Blood Component Transfusion / Q000379:methods; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000502:physiology; D020520:Brain Infarction / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D002417:Cattle; D002536:Cerebral Arteries / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D006454:Hemoglobins / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008970:Molecular Weight; D018696:Neuroprotective Agents / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D010100:Oxygen / Q000378:metabolism; D011108:Polymers / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D013152:Splanchnic Circulation / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology
chemical_list: D006454:Hemoglobins; D018696:Neuroprotective Agents; D011108:Polymers; D010100:Oxygen