When might transferrin, hemopexin or haptoglobin administration be of benefit following the transfusion of red blood cells?
Curr Opin Hematol
; 25(6): 452-458, 2018 11.
Article
em En
| MEDLINE
| ID: mdl-30281034
ABSTRACT
PURPOSE OF REVIEW After transfusion, a percentage of red blood cells undergo hemolysis within macrophages. Intravascular exposures to hemin and hemoglobin (Hb) can occur after storage bag hemolysis, some transfusion reactions, during use of medical assist devices and in response to bacterial hemolysins. Proteins that regulate iron, hemin and Hb either become saturated after iron excess (transferrin, Tf) or depleted after hemin (hemopexin, Hpx) and Hb (haptoglobin, Hp) excess. Protein saturation or stoichiometric imbalance created by transfusion increases exposure to non-Tf bound iron, hemin and Hb. Tf, Hpx and Hp are being developed for hematological disorders where iron, hemin and Hb contribute to pathophysiology. However, complexed to their ligands, each represents a potential iron source for pathogens, which may complicate the use of these proteins. RECENT FINDINGS:
Erythrophagocytosis by macrophages and processes of cell death that lead to reactive iron exposure are increasingly described. In addition, the effects of transfusion introduced circulatory hemin and Hb are described in the literature, particularly following large volume transfusion, infection and during concomitant medical device use.SUMMARY:
Supplementation with Tf, Hpx and Hp suggests therapeutic potential in conditions of extravascular/intravascular hemolysis. However, their administration following transfusion may require careful assessment of concomitant disease.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transfusão de Sangue
/
Hemoglobinas
/
Hemopexina
/
Transferrina
/
Eritrócitos
/
Doenças Hematológicas
Limite:
Humans
Idioma:
En
Revista:
Curr Opin Hematol
Assunto da revista:
HEMATOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article