The Absorption of Oxygen by the Lungs

Antiproliferative and Cytotoxic Activities of Fluorescein-A Diagnostic Angiography Dye

Fluorescein is a fluorescent dye used as a diagnostic tool in various fields of medicine. Although fluorescein itself possesses low toxicity, after photoactivation, it releases potentially toxic molecules, such as singlet oxygen (¹O₂) and, as we demonstrate in this work, also carbon monoxide (CO). As both of these molecules can affect physiological processes, the main aim of this study was to explore the potential biological impacts of fluorescein photochemistry. In our in vitro study in a human hepatoblastoma HepG2 cell line, we explored the possible effects on cell viability, cellular energy metabolism, and the cell cycle. We observed markedly lowered cell viability (≈30%, 75-2400 μM) upon irradiation of intracellular fluorescein and proved that this decrease in viability was dependent on the cellular oxygen concentration. We also detected a significantly decreased concentration of Krebs cycle metabolites (lactate and citrate < 30%; 2-hydroxyglutarate and 2-oxoglutarate < 10%) as well as cell cycle arrest (decrease in the G2 phase of 18%). These observations suggest that this photochemical reaction could have important biological consequences and may account for some adverse reactions observed in fluorescein-treated patients. Additionally, the biological activities of both ¹O₂ and CO might have considerable therapeutic potential, particularly in the treatment of cancer.

A brief history of carbon monoxide and its therapeutic origins

It is estimated that 10% of carbon throughout the cosmos is in the form of carbon monoxide (CO). Earth's earliest prebiotic atmosphere included the trinity of gasotransmitters CO, nitric oxide (NO), and hydrogen sulfide (H₂S), for which all of life has co-evolved with. The history of CO can be loosely traced to mythological and prehistoric origins with rudimentary understanding emerging in the middle ages. Ancient literature is focused on CO's deadly toxicity which is understandable in the context of our primitive relationship with coal and fire. Scientific inquiry into CO appears to have emerged throughout the 1700s followed by chemical and toxicological profiling throughout the 1800s. Despite CO's ghastly reputation, several of the 18th and 19th century scientists suggested a therapeutic application of CO. Since 2000, the fundamental understanding of CO as a deadly nuisance has undergone a paradigm shift such that CO is now recognized as a neurotransmitter and viable pharmaceutical candidate. This review is intended to provide a brief history on the trace origins pertaining to endogenous formation and therapeutic application of CO.

Lung morphometry: the link between structure and function

The study of the structural basis of gas exchange function in the lung depends on the availability of quantitative information that concerns the structures establishing contact between the air in the alveoli and the blood in the alveolar capillaries, which can be entered into physiological equations for predicting oxygen uptake. This information is provided by morphometric studies involving stereological methods and allows estimates of the pulmonary diffusing capacity of the human lung that agree, in experimental studies, with the maximal oxygen consumption. The basis for this "machine lung" structure lies in the complex design of the cells building an extensive air-blood barrier with minimal cell mass.

Transcriptomic and proteomic insights into innate immunity and adaptations to a symbiotic lifestyle in the gutless marine worm Olavius algarvensis

Background

The gutless marine worm Olavius algarvensis has a completely reduced digestive and excretory system, and lives in an obligate nutritional symbiosis with bacterial symbionts. While considerable knowledge has been gained of the symbionts, the host has remained largely unstudied. Here, we generated transcriptomes and proteomes of O. algarvensis to better understand how this annelid worm gains nutrition from its symbionts, how it adapted physiologically to a symbiotic lifestyle, and how its innate immune system recognizes and responds to its symbiotic microbiota.

Results

Key adaptations to the symbiosis include (i) the expression of gut-specific digestive enzymes despite the absence of a gut, most likely for the digestion of symbionts in the host's epidermal cells; (ii) a modified hemoglobin that may bind hydrogen sulfide produced by two of the worm’s symbionts; and (iii) the expression of a very abundant protein for oxygen storage, hemerythrin, that could provide oxygen to the symbionts and the host under anoxic conditions. Additionally, we identified a large repertoire of proteins involved in interactions between the worm's innate immune system and its symbiotic microbiota, such as peptidoglycan recognition proteins, lectins, fibrinogen-related proteins, Toll and scavenger receptors, and antimicrobial proteins.

Conclusions

We show how this worm, over the course of evolutionary time, has modified widely-used proteins and changed their expression patterns in adaptation to its symbiotic lifestyle and describe expressed components of the innate immune system in a marine oligochaete. Our results provide further support for the recent realization that animals have evolved within the context of their associations with microbes and that their adaptive responses to symbiotic microbiota have led to biological innovations.

Electronic supplementary material

The online version of this article (doi:10.1186/s12864-016-3293-y) contains supplementary material, which is available to authorized users.

Lung Structure and the Intrinsic Challenges of Gas Exchange

Structural and functional complexities of the mammalian lung evolved to meet a unique set of challenges, namely, the provision of efficient delivery of inspired air to all lung units within a confined thoracic space, to build a large gas exchange surface associated with minimal barrier thickness and a microvascular network to accommodate the entire right ventricular cardiac output while withstanding cyclic mechanical stresses that increase several folds from rest to exercise. Intricate regulatory mechanisms at every level ensure that the dynamic capacities of ventilation, perfusion, diffusion, and chemical binding to hemoglobin are commensurate with usual metabolic demands and periodic extreme needs for activity and survival. This article reviews the structural design of mammalian and human lung, its functional challenges, limitations, and potential for adaptation. We discuss (i) the evolutionary origin of alveolar lungs and its advantages and compromises, (ii) structural determinants of alveolar gas exchange, including architecture of conducting bronchovascular trees that converge in gas exchange units, (iii) the challenges of matching ventilation, perfusion, and diffusion and tissue-erythrocyte and thoracopulmonary interactions. The notion of erythrocytes as an integral component of the gas exchanger is emphasized. We further discuss the signals, sources, and limits of structural plasticity of the lung in alveolar hypoxia and following a loss of lung units, and the promise and caveats of interventions aimed at augmenting endogenous adaptive responses. Our objective is to understand how individual components are matched at multiple levels to optimize organ function in the face of physiological demands or pathological constraints.

A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement

The first descriptions of carbon monoxide (CO) and its toxic nature appeared in the literature over 100 years ago in separate publications by Drs. Douglas and Haldane. Both men ascribed the deleterious effects of this newly discovered gas to its strong interaction with hemoglobin. Since then the adverse sequelae of CO poisoning has been almost universally attributed to hypoxic injury secondary to CO occupation of oxygen binding sites on hemoglobin. Despite a mounting body of literature suggesting other mechanisms of injury, this pathophysiology and its associated oxygen centric therapies persists. This review attempts to elucidate the remarkably complex nature of CO as a gasotransmitter. While CO's affinity for hemoglobin remains undisputed, new research suggests that its role in nitric oxide release, reactive oxygen species formation, and its direct action on ion channels is much more significant. In the course of understanding the multifaceted character of this simple molecule it becomes apparent that current oxygen based therapies meant to displace CO from hemoglobin may be insufficient and possibly harmful. Approaching CO as a complex gasotransmitter will help guide understanding of the complex and poorly understood sequelae and illuminate potentials for new treatment modalities.

History of respiratory gas exchange

As early as the 6th century B.C. the Greeks speculated on a substance pneuma that meant breath or soul, and they argued that this was essential for life. An important figure in the 2nd century A.D. was Galen whose school developed an elaborate cardiopulmonary system that influenced scientific thinking for 1400 years. A key concept was that blood was mixed with pneuma from the lung in the left ventricle thus forming vital spirit. It was also believed that blood flowed from the right to the left ventricle of the heart through pores in the interventricular septum but this view was challenged first by the Arab physician Ibn al-Nafis in the 13th century and later by Michael Servetus in the 16th century. The 17th century saw an enormous burgeoning of knowledge about the respiratory gases. First Torricelli explained the origin of atmospheric pressure, and then a group of physiologists in Oxford clarified the properties of inspired gas that were necessary for life. This culminated in the work of Lavoisier who first clearly elucidated the nature of the respiratory gases, oxygen, carbon dioxide and nitrogen. At that time it was thought that oxygen was consumed in the lung itself, and the fact that the actual metabolism took place in peripheral tissues proved to be a very elusive concept. It was not until the late 19th century that the issue was finally settled by Pflüger. In the early 20th century there was a colorful controversy about whether oxygen was secreted by the lung. During and shortly after World War II, momentous strides were made on the understanding of pulmonary gas exchange, particularly the role of ventilation-perfusion inequality. A critical development in the 1960s was the introduction of blood gas electrodes, and these have transformed the management of patients with severe lung disease.

The measurement of endogenous carbon monoxide production

Recent findings that heme oxygenase-1 can be induced by oxidative stress and inflammation in many different cellular systems, and that carbon monoxide (CO) produced as a by-product of this enzyme is a signaling molecule, have generated a major research area with hundreds of studies published over the last few years. The measurement of expired CO concentration has been used in humans as a biomarker of induced heme oxygenase resulting from inflammation or oxidative stress, but a precise method of measuring endogenous CO production that can be easily used to study patients is needed. The present study describes such a method. The described method allows calculation of the rate of heme catabolism with a precision of ±2 μmol/h, ∼10% of the mean normal rate in subjects used in this investigation. This method, which is subject-patient friendly, precise, and inexpensive to perform, should be applicable to studies performed on humans with induced heme oxygenase and studies of effects of therapy for inflammatory and hemolytic diseases.

The kinetics of the reaction of carbon monoxide with fully oxygenated haemoglobin in solution and erythrocytes

1. Spectrophotometric measurements, using a rapid mixing and stopped flow technique, have been made of the rate at which CO displaces O(2) from its combination with haemoglobin.2. In haemoglobin solutions, buffered at pH 7.2 and 9.1, the reaction proceeds by a unimolecular dissociation as proposed by Gibson & Roughton (1955). In a Ringer-Locke solution, equilibrated with a P(CO(2) ) of 3 cmHg and at pH 7.4, the reaction of HbO(2) with CO is a two-stage process, with a transition from one form of Hb(4)O(6) to another.3. An investigation of the reaction between CO and HbO(2) in erythrocytes, suspended in Ringer-Locke solution, indicates that the rate is determined by the chemical reaction and this also is a two-stage process.4. The transition is probably associated with the reaction of CO(2) with Hb(4)O(6), following the dissociation from fully saturated oxyhaemoglobin of an oxygen molecule. It alters the relative velocity constants of the reactions of O(2) and CO with Hb(4)O(6) by 100:1.5. The implications of these proposals of the equilibria of haemoglobin with CO and O(2) are discussed. The difference between the sigmoid equilibria curves at high HbO(2) and HbCO values can be explained as due to the different reaction pathways.

Errors of measurement for blood volume parameters: a meta-analysis

The volume of red blood cells (V(RBC)) is used routinely in the diagnostic workup of polycythemia, in assessing the efficacy of erythropoietin administration, and to study factors affecting oxygen transport. However, errors of various methods of measurement of V(RBC) and related parameters are not well characterized. We meta-analyzed 346 estimates of error of measurement of V(RBC) for techniques based on Evans blue (V(RBC,Evans)), 51chromium-labeled red blood cells (V(RBC,51Cr)), and carbon monoxide (CO) rebreathing (V(RBC,CO)), as well as hemoglobin mass with the carbon-monoxide method (M(Hb,CO)), in athletes and active and inactive subjects undergoing various experimental and control treatments lasting minutes to months. Subject characteristics and experimental treatments had little effect on error of measurement, but measures with the smallest error showed some increase in error with increasing time between trials. Adjusted to 1 day between trials and expressed as coefficients of variation, mean errors for M(Hb,CO) (2.2%; 90% confidence interval 1.4-3.5%) and V(RBC,51Cr) (2.8%; 2.4-3.2%) were much less than those for V(RBC,Evans) (6.7%; 4.9-9.4%) and V(RBC,CO) (6.7%; 3.4-14%). Most of the error of V(RBC,Evans) was due to error in measurement of volume of plasma via Evans blue dye (6.0%; 4.5-7.8%), which is the basis of V(RBC,Evans). Most of the error in V(RBC,CO) was due to estimates from laboratories with a relatively large error in M(Hb,CO), the basis of V(RBC,CO). V(RBC,51Cr) and M(Hb,CO) are the best measures for research on blood-related changes in oxygen transport. With care, V(RBC,Evans) is suitable for clinical applications of blood-volume measurement.

Diffusion theory in biology: a relic of mechanistic materialism

Diffusion theory explains in physical terms how materials move through a medium, e.g. water or a biological fluid. There are strong and widely acknowledged grounds for doubting the applicability of this theory in biology, although it continues to be accepted almost uncritically and taught as a basis of both biology and medicine. Our principal aim is to explore how this situation arose and has been allowed to continue seemingly unchallenged for more than 150 years. The main shortcomings of diffusion theory will be briefly reviewed to show that the entrenchment of this theory in the corpus of biological knowledge needs to be explained, especially as there are equally valid historical grounds for presuming that bulk fluid movement powered by the energy of cell metabolism plays a prominent note in the transport of molecules in the living body. First, the theory's evolution, notably from its origins in connection with the mechanistic materialist philosophy of mid nineteenth century physiology, is discussed. Following this, the entrenchment of the theory in twentieth century biology is analyzed in relation to three situations: the mechanism of oxygen transport between air and mammalian tissues; the structure and function of cell membranes; and the nature of the intermediary metalbolism, with its implicit presumptions about the intracellular organization and the movement of molecules within it. In our final section, we consider several historically based alternatives to diffusion theory, all of which have their precursors in nineteenth and twentieth century philosophy of science.

The velocity with which carbon monoxide displaces oxygen from combination with hœmoglobin.—Part I

The object of the work described in this paper was to determine the velocity of the reaction CO + O 2 Hb ⇌ O 2 + COHb, in the hope thereby of throwing further light upon the physico-chemical behaviour of hæmoglobin. There are two reasons which make it specially difficult to devise a successful method of making this measurement. (a) The reaction was found by preliminary experiments to be a swift one, lasting not more than a few seconds ; this made it necessary to estimate the respective concentrations of the different reacting substances instantaneously. This puts out of court the usual methods by gas analysis because of the considerable time taken by such methods.

Thermodynamics of local linkage effects. Contracted partition functions and the analysis of site-specific energetics

A thermodynamic theory is presented for the description of local, site-specific linkage effects in biological macromolecules. The theory is developed from a basic isomorphism involving the intensive quantities of a thermodynamic system at equilibrium. Local linkage effects can be cast within the same mathematical framework as the one used in the statistical thermodynamic theory of global linkage effects involving different ligands. In addition to this parallel, local linkage effects give rise to apparent violations of thermodynamic stability that can be of relevance in energy transduction phenomena. It is also shown that the canonical partition function for the macromolecule as a whole can be expressed in terms of contracted partition functions that greatly simplify calculations of the relevant thermodynamic properties of individual sites. Site-specific Hill plots, partition coefficients and free energies of linkage are introduced and their properties discussed in connection with those of analogous global quantities. Calculation of the free energies of linkage for human hemoglobin yields a minimal phenomenological scheme for the coupling among subunits.

Information theory and the analysis of ligand-binding data

The phenomenological principles of information theory are used in the analysis of ligand-binding phenomena in biological macromolecules. Information maps are constructed to visualize regions of ligand chemical potential with maximum amount of information and to devise suitable experimental strategies therefrom. Extensive simulation studies and analysis of experimental data also point out the properties of information used as a weighting procedure in nonlinear least-squares analyses.

Carbon monoxide and oxygen binding to human hemoglobin F0

Differential binding curve measurements of carbon monoxide and oxygen binding to human hemoglobin F0 under near-physiological conditions (0.1 M NaCl and 15 mM 2,3-diphosphoglyceric acid, pH 7.35, and 37 degrees C) have allowed a detailed description of the binding and linkage between these two gaseous ligands. Comparison with human hemoglobin A0 under identical solution conditions shows that fetal hemoglobin F0 binds oxygen and carbon monoxide with higher affinity than human hemoglobin A0, but with the same cooperativity. Construction of the partition coefficient surface for carbon monoxide and oxygen binding reveals a failure of Haldane's laws for both hemoglobins. Linkage graphs are used to explore the phenomenological properties of the system. The graphs provide a quantitative description of the mechanism of carbon monoxide toxicity on oxygen transport by hemoglobin in vivo and demonstrate striking similarities between the functional properties of fetal and adult hemoglobins.

Linkage effects in a model for cell survival after radiation

A thermodynamic treatment for the effects of radiation on cell survival is proposed. The treatment is an extension of the linear-quadratic model (K.H. Chadwick and H.P. Leenhouts, Phys. Med. Biol. 13 (1973) 78) following the principles of linkage thermodynamics (E. Di Cera, S.J. Gill and J. Wyman, Proc. Natl. Acad. Sci. U.S.A. 85 (1988) 5077). Linkage effects between chemical binding to DNA and radiation action are considered, along with the synergism between different types of radiations. A simple mathematical condition is found for the additivity of radiation doses that result in an isoeffect. The resolvability of the model parameter is investigated by simulations and statistical analysis of the distributions obtained.

Identical linkage and cooperativity of oxygen and carbon monoxide binding to Octopus dofleini hemocyanin

Employment of high-precision thin-layer methods has enabled detailed functional characterization of oxygen and carbon monoxide binding for (1) the fully assembled form with 70 binding sites and (2) the isolated chains with 7 binding sites of Octopus dofleini hemocyanin. The striking difference in the cooperativities of the two ligands for the assembled decamer is revealed through an examination of the binding capacities and the partition coefficient, determined as functions of the activities of both ligands. A global analysis of the data sets supported a two-state allosteric model assuming an allosteric unit of 7. Higher level allosteric interactions were not indicated. This contrasts to results obtained for arthropod hemocyanins. Oxygen and carbon monoxide experiments performed on the isolated subunit chain confirmed the presence of functional heterogeneity reported previously [Miller, K. (1985) Biochemistry 24, 4582-4586]. The analysis shows two types of binding sites in the ratio of 4:3.

Carbon monoxide binding to human hemoglobin A0

The carbon monoxide binding curve to human hemoglobin A0 has been measured to high precision in experimental conditions of 600 microM heme, 0.1 M N-(2-hydroxyethyl)piperazine-N'-2-ethanesulfonic acid, 0.1 M NaCl, 10 mM inositol hexaphosphate, 1 mM disodium ethylenediaminetetraacetic acid, pH 6.94, and 25 degrees C. Comparison to the oxygen binding curve in the same experimental conditions demonstrates that the two curves are not parallel. This result invalidates Haldane's two laws for the partitioning between carbon monoxide and oxygen to human hemoglobin. The partition coefficient is found to be 263 +/- 27 at high saturation, in agreement with previous studies, but is lowered substantially at low saturation. Although the oxygen and carbon monoxide binding curves are not parallel, both show the population of the triply ligated species to be negligible. The molecular mechanism underlying carbon monoxide binding to hemoglobin is consistent with the allosteric model [Di Cera, E., Robert, C. H., & Gill, S. J. (1987) Biochemistry 26, 4003-4008], which accounts for the negligible contribution of the triply ligated species in the oxygen binding reaction to hemoglobin [Gill, S. J., Di Cera, E., Doyle, M. L., Bishop, G. A., & Robert, C. H. (1987) Biochemistry 26, 3995-4002]. The nature of the different binding properties of carbon monoxide stems largely from the lower partition coefficient of the T state (123 +/- 34), relative to the R state (241 +/- 19).(ABSTRACT TRUNCATED AT 250 WORDS)

Placental diffusing capacity for carbon monoxide in unanesthetized guinea pigs

In unanesthetized pregnant guinea pigs 5-7 ml of maternal blood which had been equilibrated with carbon monoxide (CO) was reinfused into the sow's carotid artery. Three serial blood samples were withdrawn from the sow and a single terminal fetal sample obtained for determination of CO content and hemoglobin concentration. Transplacental CO uptake (VCO) was determined as the product of fetal blood CO content and fetal CO space (11.8% of fetal weight). Placental diffusing capacity (DPCO) was calculated by dividing VCO by the mean partial pressure difference between maternal and fetal blood. DPCO (ml-min(-1)/torr) increased significantly with gestational age: 45-50 days = 0.0413, 51-57 days = 0.1092 and 58-68 days = 0.1858. This increase paralleled fetal weight but was not related to placental weight.

Placental diffusing capacities at varied carbon monoxide tensions

To test the hypothesis that carbon monoxide transfer across the placenta is, in part, a facilitated process, we have looked for evidence of saturation kinetics for carbon monoxide. In eight pregnant ewes, fetal to maternal carbon monoxide transfer was examined in a preparation in which the fetal side of the placenta was perfused with blood. The carboxyhemoglobin concentrations on the fetal side of the placenta were varied from 4.8 to 70% in 23 measurements. At increased carbon monoxide tensions, the transfer from fetus to mother always decreased. The slope of log rate of carbon monoxide transfer vs. log partial pressure gradient across the placenta was significantly different from 1. Placental membrane diffusing capacity was calculated separately from total placental diffusing capacity which includes hemoglobin reaction rates and erythrocyte membrane diffusion. Placental membrane diffusing capacity decreased at increased carbon monoxide tensions. Placental permeability for urea did not change with increasing carbon monoxide tensions. These results are consistent with the hypothesis that carbon monoxide diffusion in the placenta is, in part, carrier mediated.

The Bohr effect on the reaction of carbon monoxide with fully oxygenated haemoglobin

1. The rate at which CO displaces O2 from its combination with haemoglobin in solution, has been measured spectrophotometrically, using a rapid-mixing stopped-flow technique. 2. In the presence of CO2, the reaction proceeds by a unimolecular dissociation, with a rate constant r. 3. The relationship of the reciprocal of r to the ratio PO2/PCO is nonlinear, and a different curve is obtained at each CO concentration. 4. Measurements were made of the rate of the reaction when the pH was varied, with constant or varying PCO2. In both situations the value of r was found to have a miximum, for a given PO2/PCO ratio and CO cencentration, at pH 7.2. 5. An analysis of these results suggest that the Bohr effect, of pH and PCO2, is a dynamic equilibrium between four stable tertiary states of each of the alpha and beta chains. Each intermediatory complex has different rate constants for CO and O2.

The effect of temperature on the reaction of carbon monoxide with oxygenated haemoglobin

1. The rate at which carbon monoxide displaces oxygen from its combination with haemoglobin in solution, has been measured spectrophotometrically, using a rapid-mixing stopped-flow technique. 2. In the presence of carbon dioxide, the reaction proceeds by a unimolecular dissociation, with a rate constant r. 3. The relationship of the reciprocal of r to the ratio PO2/PCO is non-linear, and a different curve is obtained at each carbon monoxide concentration. 4. From measurements of the rate constant at temperatures between 5 and 35 degrees C, it is concluded that the non-linearity is due to the formation at a finite rate of an intermediate complex, CO2Hb4O6, by the reaction of carbon dioxide with Hb4O6.

Respiratory function of the placenta as determined with carbon monoxide in sheep and dogs

A technique is described for studying the respiratory function of the placenta using carbon monoxide, a gas whose exchange across the placenta between the maternal and fetal circulations is limited by diffusion rather than blood flow. During the steady state before the introduction of CO, the normal concentration of carboxyhemoglobin in the ewe, [COHb](M), is approximately 0.90%, and that in the fetus is 2.9%, the ratio [COHb](F)/[COHb](M) being 3.2. In dogs the corresponding values are 1.9%, 4.8%, and 2.4%. After the introduction of CO into the mother animal, CO diffused across the placenta slowly with an equilibration half-time of approximately 2 hours. The average carbon monoxide diffusing capacity (D(Pco)) of the placenta during maternal to fetal exchange was 0.54 ml per (minute x mm Hg x kg fetal weight) (SD +/- 0.13) in sheep and 0.57 ml per (minute x mm Hg x kg) (SD +/- 0.18) in dogs. The fetal to maternal placental diffusing capacity in two sheep was 0.54 ml per (minute x mm Hg x kg). Calculations considering the relative rates of reaction of O(2) and CO with red cell hemoglobin and the relative rates of diffusion of the two gases suggest that the true D(Po2) should be about 1.2 to 2 times greater than the D(Pco) or 0.65 to 1.1 per (minute x mm Hg x kg). This is about 5 times greater than the reported value of D(Po2) calculated from measurements of P(O2) in the mixed uterine and umbilical venous blood. With a diffusing capacity of this magnitude the maternal and fetal placental end capillary P(O2) would approach equilibrium, becoming too small to measure, and the calculation of D(Po2) would be unreliable. We suggest that the apparent end capillary P(o2) gradients of 15 to 20 mm Hg, obtained from sampling uterine and umbilical venous blood, result from a combination of uneven distribution of maternal and fetal placental blood flow and from placental oxygen consumption.

The production of carbon monoxide from hemoglobin in vivo

Dogs anesthetized with pentobarbital were shown to produce carbon monoxide at an average rate of 0.21 +/- (SD) 0.05 ml per hour. After intravenous injection of erythrocytes damaged by incubation with N-ethylmaleimide, CO was produced in excess of base-line production for 3 to 4 hours with an average yield of 0.89 +/- (SE) 0.046 mumole of carbon monoxide to 1 mumole of heme degraded. After intravenous injection of N-ethylmaleimide (NEM)-treated erythrocytes containing hemoglobin labeled with (14)carbon, (14)CO was produced. Its specific activity was approximately one-eighth that of the injected heme. It was also produced after intravenous injection of solutions of hemoglobin-(14)C and of reconstituted methemoglobin containing hemin-(14)C, but not after injections of methemoglobin containing globin-(14)C. The average yields of (14)CO from metabolized heme in the experiments with damaged erythrocytes and hemoglobin solutions were 89 +/- (SE) 4.6 and 97 +/- (SE) 17.0%, respectively. These results demonstrate that the CO produced during hemoglobin degradation arises from the heme moiety. The yield of (14)CO after injection of hemoglobin-(14)C solutions decreased significantly to values of 35 and 42% in two experiments when exogenous CO was added to the body stores, resulting in blood carboxyhemoglobin levels of 11.3 and 13.2% saturation. This finding suggests that oxidative metabolism is required during catabolism of hemoglobin to CO and that carboxy-hemoglobin levels in this range are sufficient to cause inhibition. After intravenous injection of either hemin-(14)C or protoporphyrin-(14)C, (14)CO was also produced. After injection of protoporphyrin-(14)C labeled bilirubin was isolated from gall bladder bile, and labeled hemin was isolated from the liver. It is thus very likely that protoporphyrin is converted to heme before the formation of CO. There was a large difference between the maximal rates of catabolism of hemoglobin to CO observed after injection of damaged erythrocytes and hemoglobin solutions. The limiting parameters in these processes are not yet clear.

Considerations of the physiological variables that determine the blood carboxyhemoglobin concentration in man

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