Hemoglobin Catabolism in Human Macrophages and Inflammation
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: a Review
Journal of Clinical Medicine Review The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review Felix Scholkmann 1,2,*, Tanja Restin 2, Marco Ferrari 3 and Valentina Quaresima 3 1 Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland 2 Newborn Research Zurich, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; [email protected] 3 Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; [email protected] (M.F.); [email protected] (V.Q.) * Correspondence: [email protected]; Tel.: +41-4-4255-9326 Abstract: Following the outbreak of a novel coronavirus (SARS-CoV-2) associated with pneumonia in China (Corona Virus Disease 2019, COVID-19) at the end of 2019, the world is currently facing a global pandemic of infections with SARS-CoV-2 and cases of COVID-19. Since severely ill patients often show elevated methemoglobin (MetHb) and carboxyhemoglobin (COHb) concentrations in their blood as a marker of disease severity, we aimed to summarize the currently available published study results (case reports and cross-sectional studies) on MetHb and COHb concentrations in the blood of COVID-19 patients. To this end, a systematic literature research was performed. For the case of MetHb, seven publications were identified (five case reports and two cross-sectional studies), and for the case of COHb, three studies were found (two cross-sectional studies and one case report). The findings reported in the publications show that an increase in MetHb and COHb can happen in COVID-19 patients, especially in critically ill ones, and that MetHb and COHb can increase to dangerously high levels during the course of the disease in some patients. -
Approach to Anemia
APPROACH TO ANEMIA Mahsa Mohebtash, MD Medstar Union Memorial Hospital Definition of Anemia • Reduced red blood mass • RBC measurements: RBC mass, Hgb, Hct or RBC count • Hgb, Hct and RBC count typically decrease in parallel except in severe microcytosis (like thalassemia) Normal Range of Hgb/Hct • NL range: many different values: • 2 SD below mean: < Hgb13.5 or Hct 41 in men and Hgb 12 or Hct of 36 in women • WHO: Hgb: <13 in men, <12 in women • Revised WHO/NCI: Hgb <14 in men, <12 in women • Scrpps-Kaiser based on race and age: based on 5th percentiles of the population in question • African-Americans: Hgb 0.5-1 lower than Caucasians Approach to Anemia • Setting: • Acute vs chronic • Isolated vs combined with leukopenia/thrombocytopenia • Pathophysiologic approach • Morphologic approach Reticulocytes • Reticulocytes life span: 3 days in bone marrow and 1 day in peripheral blood • Mature RBC life span: 110-120 days • 1% of RBCs are removed from circulation each day • Reticulocyte production index (RPI): Reticulocytes (percent) x (HCT ÷ 45) x (1 ÷ RMT): • <2 low Pathophysiologic approach • Decreased RBC production • Reduced effective production of red cells: low retic production index • Destruction of red cell precursors in marrow (ineffective erythropoiesis) • Increased RBC destruction • Blood loss Reduced RBC precursors • Low retic production index • Lack of nutrients (B12, Fe) • Bone marrow disorder => reduced RBC precursors (aplastic anemia, pure RBC aplasia, marrow infiltration) • Bone marrow suppression (drugs, chemotherapy, radiation) -
Circular of Information for the Use of Human Blood and Blood Components
CIRCULAR OF INFORMATION FOR THE USE OF HUMAN BLOOD Y AND BLOOD COMPONENTS This Circular was prepared jointly by AABB, the AmericanP Red Cross, America’s Blood Centers, and the Armed Ser- vices Blood Program. The Food and Drug Administration recognizes this Circular of Information as an acceptable extension of container labels. CO OT N O Federal Law prohibits dispensing the blood and blood compo- nents describedD in this circular without a prescription. THIS DOCUMENT IS POSTED AT THE REQUEST OF FDA TO PROVIDE A PUBLIC RECORD OF THE CONTENT IN THE OCTOBER 2017 CIRCULAR OF INFORMATION. THIS DOCUMENT IS INTENDED AS A REFERENCE AND PROVIDES: Y • GENERAL INFORMATION ON WHOLE BLOOD AND BLOOD COMPONENTS • INSTRUCTIONS FOR USE • SIDE EFFECTS AND HAZARDS P THIS DOCUMENT DOES NOT SERVE AS AN EXTENSION OF LABELING REQUIRED BY FDA REGUALTIONS AT 21 CFR 606.122. REFER TO THE CIRCULAR OF INFORMATIONO WEB- PAGE AND THE DECEMBER 2O17 FDA GUIDANCE FOR IMPORTANT INFORMATION ON THE CIRCULAR. C T O N O D Table of Contents Notice to All Users . 1 General Information for Whole Blood and All Blood Components . 1 Donors . 1 Y Testing of Donor Blood . 2 Blood and Component Labeling . 3 Instructions for Use . 4 Side Effects and Hazards for Whole Blood and P All Blood Components . 5 Immunologic Complications, Immediate. 5 Immunologic Complications, Delayed. 7 Nonimmunologic Complications . 8 Fatal Transfusion Reactions. O. 11 Red Blood Cell Components . 11 Overview . 11 Components Available . 19 Plasma Components . 23 Overview . 23 Fresh Frozen Plasma . .C . 23 Plasma Frozen Within 24 Hours After Phlebotomy . 28 Components Available . -
AND DRUG-INDUCED IMMUNE HEMOLYTIC ANEMIA George Garratty, Phd, Frcpath
PATHOPHYSIOLOGY OF AUTO- AND DRUG-INDUCED IMMUNE HEMOLYTIC ANEMIA George Garratty, PhD, FRCPath. Scientific Director American Red Cross Blood Services Southern California Region and Clinical Professor of Pathology University of California, Los Angeles [email protected] HEMOLYTIC ANEMIA Reduction of the average red blood cell life span to less than the normal range of 100- 120 days BEST TESTS TO DEFINE HEMOLYTIC ANEMIA • Hemoglobin/hematocrit • Blood film (bone marrow) • Reticulocyte count (corrected) • Hemoglobin in plasma (urine) • Bilirubin (indirect) • LDH • Haptoglobin • 51Cr RBC survival HEMOGLOBINEMIA • If hemoglobinuria is noted, make sure it is not hematuria (RBCs present). Immune-mediated hemoglobinuria must be accompanied by hemoglobinemia (i.e., hemoglobinemia alone possible, but not hemoglobinuria alone). • Hemoglobinemia can also be due to extravascular destruction [i.e., macrophage interactions (fragmentation and/or cytotoxicity)]. CLASSIFICATION OF THE HEMOLYTIC ANEMIAS ABNORMALITIES Intracellular Membrane Extracellular Hereditary Enzymes Spherocytosis Lipids (G6PD) Hemoglobin Elliptocytosis Lecithin (SCD) Stomatocytosis Acquired Environmental PNH Immune (lead) Lipids Mechanical Microangiopathic Burns Infection Hypersplenism CLASSIFICATION OF IMMUNE HEMOLYTIC ANEMIA • Alloimmune –Hemolytic transfusion reaction –Hemolytic disease of the fetus / newborn • Autoimmune (AIHA) – “Warm” – “Cold” a) cold agglutinin syndrome (CAS) b) paroxysmal cold hemoglobinuria (PCH) –Mixed / combined (warm + cold) • Drug-induced IMMUNE -
Disposal of Plasma Heme in Normal Man and Patients with Intravascular Hemolysis
Disposal of plasma heme in normal man and patients with intravascular hemolysis David A. Sears J Clin Invest. 1970;49(1):5-14. https://doi.org/10.1172/JCI106222. Research Article The clearance of plasma protein-bound heme, its sites of removal, and the reutilization of hemeiron were studied by radioisotopic techniques in normal human subjects and in patients with intravascular hemolysis. 59 In normal subjects, injected heme- Fe was bound immediately by albumin and the β1-globulin, hemopexin. Its clearance from the plasma was descr bed by a single exponential equation, and the half-life in plasma was 7-8 hr. Removal was largely by the liver. Iron reutilization began promptly, and half the injected heme-iron was incorporated into circulating red cells within one cell life-span. In patients with intravascular hemolysis, hemopexin was depleted, and injected heme was bound solely to albumin. Plasma clearance was described by a double exponential equation of the form: y = Ae-k1t + Be-k2t. The half-lives of the two components averaged 3.9 and 22.2 hr, respectively. Removal was by the liver in at least some of the patients, and iron reutilization was variable, depending on the state of body iron stores. When hemopex'n was depleted in a normal subject by repeated heme injection, clearance mimicked that observed in the patients. Find the latest version: https://jci.me/106222/pdf Disposal of Plasma Heme in Normal Man and Patients with Intravascular Hemolysis DAVID A. SEAS From the Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14620 ABSTRACT The clearance of plasma protein-bound (4), and Fairley characterized the heme-albumin com- heme, its sites of removal, and the reutilization of heme- plex or methemalbumin (5, 6). -
Linking Labile Heme with Thrombosis
Journal of Clinical Medicine Review Linking Labile Heme with Thrombosis Marie-Thérèse Hopp and Diana Imhof * Pharmaceutical Biochemistry and Bioanalytics, University of Bonn, An der Immenburg 4, 53121 Bonn, Germany; [email protected] * Correspondence: [email protected]; Tel.: +49-228-735231 Abstract: Thrombosis is one of the leading causes of death worldwide. As such, it also occurs as one of the major complications in hemolytic diseases, like hemolytic uremic syndrome, hemorrhage and sickle cell disease. Under these conditions, red blood cell lysis finally leads to the release of large amounts of labile heme into the vascular compartment. This, in turn, can trigger oxidative stress and proinflammatory reactions. Moreover, the heme-induced activation of the blood coagulation system was suggested as a mechanism for the initiation of thrombotic events under hemolytic conditions. Studies of heme infusion and subsequent thrombotic reactions support this assumption. Furthermore, several direct effects of heme on different cellular and protein components of the blood coagulation system were reported. However, these effects are controversially discussed or not yet fully understood. This review summarizes the existing reports on heme and its interference in coagulation processes, emphasizing the relevance of considering heme in the context of the treatment of thrombosis in patients with hemolytic disorders. Keywords: blood coagulation; coagulation factors; heme binding; hemolysis; hemolytic diseases; hemorrhage; labile heme; platelets; thrombosis 1. Introduction Citation: Hopp, M.-T.; Imhof, D. Worldwide, one in four people die from cardiovascular diseases related to throm- Linking Labile Heme with bosis [1]. In the case of thrombosis, an imbalance of blood coagulation occurs, leading Thrombosis. -
Direct Antiglobulin (“Coombs”) Test-Negative Autoimmune Hemolytic Anemia: a Review
YBCMD-01786; No. of pages: 9; 4C: Blood Cells, Molecules and Diseases xxx (2013) xxx–xxx Contents lists available at ScienceDirect Blood Cells, Molecules and Diseases journal homepage: www.elsevier.com/locate/bcmd Direct antiglobulin (“Coombs”) test-negative autoimmune hemolytic anemia: A review George B. Segel a,b, Marshall A. Lichtman b,⁎ a Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642-0001, USA b Department of Medicine, 601 Elmwood Avenue, Rochester, NY 14642-0001, USA article info abstract Article history: We have reviewed the literature to identify and characterize reports of warm-antibody type, autoimmune hemo- Submitted 5 December 2013 lytic anemia in which the standard direct antiglobulin reaction was negative but a confirmatory test indicated Available online xxxx that the red cells were opsonized with antibody. Three principal reasons account for the absence of a positive direct antiglobulin test in these cases: a) IgG sensitization below the threshold of detection by the commercial (Communicated by M. Lichtman, M.D., antiglobulin reagent, b) low affinity IgG, removed by preparatory washes not conducted at 4 °C or at low ionic 5December2013) strength, and c) red cell sensitization by IgA alone, or rarely (monomeric) IgM alone, but not accompanied by fi Keywords: complement xation, and thus not detectable by a commercial antiglobulin reagent that contains anti-IgG and Autoimmune hemolytic anemia anti-C3. In cases in which the phenotype is compatible with warm-antibody type, -
Studies of Hemoglobinemia and Hemoglobinuria Produced in Man by Intravenous Injection of Hemoglobin Solutions
STUDIES OF HEMOGLOBINEMIA AND HEMOGLOBINURIA PRODUCED IN MAN BY INTRAVENOUS INJECTION OF HEMOGLOBIN SOLUTIONS D. Rourke Gilligan, … , Mark D. Altschule, Evelyn M. Katersky J Clin Invest. 1941;20(2):177-187. https://doi.org/10.1172/JCI101210. Research Article Find the latest version: https://jci.me/101210/pdf STUDIES OF HEMOGLOBINEMIA AND HEMOGLOBINURIA PRODUCED IN MAN BY INTRAVENOUS INJECTION OF HEMOGLOBIN SOLUTIONS By D. ROURKE GILLIGAN, MARK D. ALTSCHULE, AND EVELYN M. KATERSKY (From the Medical Service and the Medical Research Laboratories, Beth Israel Hospital, and the Department of Medicine, Harvard Medical School, Boston) (Received for publication October 18, 1940) Hemoglobinuria is a striking feature of several then it was inspected for cloudiness or particulate matter hemolytic disorders, such as blackwater fever, the and a culture in broth was made to ascertain its sterility. As noted previously (3), the solution, after centrifuging various paroxysmal hemoglobinurias, and certain and before filtering through the Seitz filter, would re- types of acute hemolytic anemia. Available in- peatedly show further clouding on addition of a few formation indicates that hemoglobinuria in these more drops of the hypertonic saline solution. However, conditions results from intravascular hemolysis after filtration through the Seitz filter, clouding with with liberation of hemoglobin into the plasma. additional saline no longer occurred. Passage through the Seitz filter was extremely slow; accordingly, when Quantitative studies of the plasma and urine the larger volumes were prepared, the solutions were first hemoglobin and of pigments derived from hemo- filtered without sterilizing the apparatus, and the filter globin have been made recently in this laboratory pad was changed as filtration became slowed. -
Approach to Immune-Mediated Hemolytic Anemia DR
OCTOBER 2017 Approach to Immune-Mediated Hemolytic Anemia DR. ANDREW MACKIN BVSc BVMS MVS DVSc FANZCVSc DipACVIM Professor of Small Animal Internal Medicine Mississippi State University College of Veterinary Medicine, Starkville, MS Immune-mediated hemolytic anemia (IMHA) is a common cause of anemia in dogs and cats. IMHA can be either primary (idiopathic or autoimmune) or secondary. Primary IMHA, a classic autoimmune disorder with no recognised underlying cause, is the most frequent form of IMHA in dogs and also occurs, less frequently, in cats. The condition typically affects young adult and middle-aged animals, and is most common in cocker spaniels, English springer spaniels, poodles, and old English sheepdogs, although there may also be geographic clusters in other breeds (in Mississippi, for example, we see a bad form of IMHA in Dachshunds). Breed predispositions strongly suggest that there is an inherited susceptibility to IMHA and, in fact, there has been shown to be a strong association between several DLA-79 mutations and multiple immune-mediated diseases, including IMHA, in dogs. Neutered dogs (both male and female) appear to be more prone to IMHA than intact dogs of either sex. IMHA can also occur secondary to a wide range of infectious, inflammatory or neoplastic processes. Important causes of secondary IMHA in small animals include Feline Leukemia Virus (FeLV) or hemobartonellosis (mycoplasmosis or hemoplasmosis) in cats, and or neoplasia (particularly lymphosarcoma) in dogs. Various medications have also been reported to trigger IMHA. Modified live vaccines have also been implicated, but it is hard to establish causation and, even if vaccines may trigger the occasional case of IMHA, this appears to be an uncommon phenomenon. -
Immunohematology JOURNAL of BLOOD GROUP SEROLOGY and EDUCATION
Immunohematology JOURNAL OF BLOOD GROUP SEROLOGY AND EDUCATION V OLUME 20, NUMBER 3, 2004 This Issue of Immunohematology Is Supported by a Contribution From Dedicated to Education in the Field of Blood Banking Immunohematology JOURNAL OF BLOOD GROUP SEROLOGY AND EDUCATION VOLUME 20, NUMBER 3, 2004 CONTENTS 137 Letter to the readers Introduction to the review articles S.T.NANCE 138 Review: drug-induced immune hemolytic anemia—the last decade G.GARRATTY 147 Review: what to do when all RBCs are incompatible—serologic aspects S.T.NANCE AND P.A.ARNDT 161 Review: transfusing incompatible RBCs—clinical aspects G. MENY 167 Review: evaluation of patients with immune hemolysis L.D. PETZ 177 Case report: exacerbation of hemolytic anemia requiring multiple incompatible RBC transfusions A.M. SVENSSON,S.BUSHOR,AND M.K. FUNG 184 Delayed hemolytic transfusion reaction due to anti-Fyb caused by a primary immune response: a case study and a review of the literature H.H. KIM,T.S.PARK, S.H. OH, C.L. CHANG,E.Y.LEE,AND H.C. SON 187 Maternal alloanti-hrS—an absence of HDN R. KAKAIYA,J.CSERI,B.JOCHUM,L.GILLARD,AND S. SILBERMAN 190 193 C O M M U N I C A T I O N S Letter to the Editor-in-Chief Letter to the Editors Immunohematology to be listed in Index Medicus HAMA (Human Anti-Mouse Antibodies) do not and MEDLINE Cause False Positive Results in PAKPLUS S.G. SANDLER L.A.TIDEY,S.CHANCE,M.CLARKE,AND R.H.ASTER Reply to letter M.F.LEACH AND J.P.AUBUCHON 195 196 Letters From the Editor-in-Chief SPECIAL SECTION Ortho dedication Exerpts from the American Red Cross Reference The final 20th anniversary issue Laboratory Newsletter—1976 198 199 202 ANNOUNCEMENTS ADVERTISEMENTS INSTRUCTIONS FOR AUTHORS EDITOR-IN-CHIEF MANAGING EDITOR Delores Mallory, MT(ASCP)SBB Mary H. -
Cold Agglutinin Disease
Cold Agglutinin Disease Donald R. Branch, PhD Professor of Medicine and Laboratory Medicine and Pathobiology, University of Toronto Scientist, Centre for Innovation, Canadian Blood Services Toronto, Ontario CANADA AABB Boston – October 14, 2018 Disclosures None related to this presentation Outline of talk • Brief review of intra and extravascular hemolysis • Clinical aspects of cold agglutinin disease • Serologic aspects of cold agglutinin disease • Serologic problem resolutions • Management Antibody-Mediated Hemolysis Cover of Transfusion 2015 Jul;55 Suppl 2 Cold Agglutinin Disease • CAD – also known as cold agglutinin syndrome (CAS) • Accounts for approximately 13%-32% of autoimmune hemolytic anemias (AIHA) • Most common type after warm AIHA • Due to IgM antibody having mostly anti-I/I specificity • Hemolysis due to complement activation • Extravascular due to C3b deposition and removal by liver phagocytes • Intravascular due to complete complement mediated lysis (severe cases) • Often characterized by RT agglutination in EDTA tubes to the extent that the sample appears to be clotted • DAT is positive with C3 only • Occurs as acute or chronic • Acute secondary to lymphoproliferative diseases (CLL) or Mycoplasma pneumoniae infections • Can have monoclonal antibody; ie, Waldenström’s macroglobulinemia • Chronic seen in elderly and may result in Raynaud’s phenomena and hemoglobinuria if exposed to extreme cold Features of CAD • Mild disease • Raynaud’s phenomenon • Slight to moderate anemia [Hb ≥ 8 g/dL] • Agglutination of EDTA at RT while -
Hemopexin and Haptoglobin: Allies Against Heme Toxicity from Hemoglobin Not Contenders
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Frontiers - Publisher Connector REVIEW published: 30 June 2015 doi: 10.3389/fphys.2015.00187 Hemopexin and haptoglobin: allies against heme toxicity from hemoglobin not contenders Ann Smith 1* and Russell J. McCulloh 2, 3 1 School of Biological Sciences, University of Missouri-Kansas City, Kansas City, MO, USA, 2 Pediatric and Adult Infectious Diseases, Children’s Mercy-Kansas City, Kansas City, MO, USA, 3 School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA The goal here is to describe our current understanding of heme metabolism and the deleterious effects of “free” heme on immunological processes, endothelial function, systemic inflammation, and various end-organ tissues (e.g., kidney, lung, liver, etc.), with particular attention paid to the role of hemopexin (HPX). Because heme toxicity is the impetus for much of the pathology in sepsis, sickle cell disease (SCD), and other hemolytic conditions, the biological importance and clinical relevance of HPX, the predominant heme binding protein, is reinforced. A perspective on the function Edited by: Magnus Gram, of HPX and haptoglobin (Hp) is presented, updating how these two proteins and Lund University, Sweden their respective receptors act simultaneously to protect the body in clinical conditions Reviewed by: that entail hemolysis and/or systemic intravascular (IVH) inflammation. Evidence from Jozsef Balla, University of Debrecen, Hungary longitudinal studies in patients supports that HPX plays a Hp-independent role in genetic Bo Akerstrom, and non-genetic hemolytic diseases without the need for global Hp depletion.