Hemopexin metabolism in patients with altered serum levels

The rates of synthesis and degradation of hemopexin (Hx) were studied in vivo to determine the cause of altered serum levels of this protein as seen in hemolytic anemias, chronic neuromuscular diseases, and acute intermittent porphyria. The synthetic and fractional catabolic rates of Hx were measured in patients exhibiting low, normal, or elevated serum Hx levels. It was found that the elevated levels were mainly due to increased synthesis rather than decreased catabolism of Hx. In patients with elevated serum Hx levels, the mean synthetic rate of Hx (13 +/- 1.0 mg/kg/day) was twice that of the patients with normal Hx levels (6.6 +/- 0.3), whereas the fractional catabolic rate was 35.3 +/- 7.1% of the i.v. pool per day vs. 26.5 +/- 0.8 for controls. The low serum Hx levels observed in patients with sickle cell anemia appeared to be due to increased Hx catabolism (36.0 and 40.0% of the i.v. pool per day vs. 26.5 +/- 0.8 for controls) with no compensatory increase in synthesis. This latter finding is in agreement with a study in rhesus monkeys in which repeated administration of a large dose of heme caused an increase in the catabolism of hemopexin without a concurrent increase in its synthesis (J LAB CLIN MED 100:451, 1982). Our results indicate that although both synthesis and catabolism are increased in patients with elevated Hx levels, only catabolism is increased in patients with sickle cell anemia.