Competitive inhibition of carbon monoxide transport: evidence against a carrier

The existence of a saturable carbon monoxide (CO) carrier in the lung remains controversial. The carrier hypothesis was invoked to explain data that indicated that pulmonary diffusing capacity for CO (DLCO) decreases with increasing CO concentration. To test this hypothesis, we measured DLCO in 14 normal adult subjects at three alveolar CO concentrations (60, 660, and 2,060 ppm). Each mixture contained a constant amount of labeled C18O (60 ppm) and a balance of unlabeled C16O. If a saturable carrier exists at increasing CO concentrations, the unlabeled CO would compete for most of the sites on the carrier molecule, effectively inhibiting the uptake of the labeled C18O. C18O diffusing capacities (mean +/- SD) for the three levels of CO were 34.9 +/- 5.6, 33.0 +/- 6.0, and 34.7 +/- 7.8. There were no significant differences (P greater than 0.2) among the three levels. In another group of subjects we repeated the study using a gas mixture containing 130 ppm C18O. No significant differences were found. As a result, we find no evidence to support a CO carrier hypothesis.