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Should modulation of p50 be a therapeutic target in the critically ill?

Srinivasan, AJ; Morkane, C; Martin, DS; Welsby, IJ; (2017) Should modulation of p50 be a therapeutic target in the critically ill? Expert Review of Hematology , 10 (5) pp. 449-458. 10.1080/17474086.2017.1313699. Green open access

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Abstract

INTRODUCTION: A defining feature of human hemoglobin is its oxygen binding affinity, quantified by the partial pressure of oxygen at which hemoglobin is 50% saturated (p50), and the variability of this parameter over a range of physiological and environmental states. Modulation of this property of hemoglobin can directly affect the degree of peripheral oxygen offloading and tissue oxygenation. AREAS COVERED: This review summarizes the role of hemoglobin oxygen affinity in normal and abnormal physiology and discusses the current state of the literature regarding artificial modulation of p50. Hypoxic tumors, sickle cell disease, heart failure, and transfusion medicine are discussed in the context of recent advances in hemoglobin oxygen affinity manipulation. EXPERT COMMENTARY: Of particular clinical interest is the possibility of maintaining adequate end-organ oxygen availability in patients with anemia or compromised cardiac function via an increase in systemic p50. This increase in systemic p50 can be achieved with small molecule drugs or a packed red blood cell unit processing variant called rejuvenation, and human trials are needed to better understand the potential clinical benefits to modulating p50.

Type: Article
Title: Should modulation of p50 be a therapeutic target in the critically ill?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/17474086.2017.1313699
Publisher version: http://dx.doi.org/10.1080/17474086.2017.1313699
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Hemoglobin, oxygen binding affinity, p50, 2,3-diphosphoglycerate, oxygen dissociation curve, RBC storage lesion, rejuvenation, efaproxiral, ITPP, tissue oxygenation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/1552465
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