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El óxido nítrico inhalado permite la transfusión de sangre artificial sin hipertensión

Binglan Yu¹, Michael J Raher, Gian Paolo Volpato

¹Anesthesia Center for Critical Care Research of the Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

|April 9, 2008

Resumen

Se puede prevenir la vasoconstricción sistémica causada por los transportadores de oxígeno basados en hemoglobina (HBOC). El óxido nítrico inhalado (NO) administrado antes de la infusión de HBOC mitiga este efecto secundario sin causar methemoglobinemia.

Área de la Ciencia:

Ingeniería Biomédica Ingeniería Biomédica.
Farmacología Farmacología.
Fisiología Fisiología Fisiología.

Sus antecedentes:

El desarrollo clínico de los transportadores de oxígeno basados en hemoglobina (HBOC) está limitado por la vasoconstricción sistémica.
Comprender el mecanismo de la vasoconstricción inducida por HBOC es crucial para el avance terapéutico.

Objetivo del estudio:

Investigar el mecanismo por el cual las HBOC causan vasoconstricción sistémica.
Evaluar la eficacia del óxido nítrico (NO) en la prevención de la vasoconstricción inducida por el COBH.

Principales métodos:

Los experimentos se llevaron a cabo en ratones de tipo salvaje y con deficiencia de óxido nítrico sintetasa (NOS3) en el endotelio, así como en corderos.
Los animales recibieron infusiones de hemoglobina tetramérica murina o HBOC-201.
Las intervenciones incluyeron la inhalación de NO o la administración de nitrito de sodio antes de la infusión de HBOC.

Principales resultados:

La infusión intravenosa de HBOC indujo vasoconstricción sistémica en ratones de tipo salvaje, pero no en ratones con deficiencia de NOS3.
La administración inhalada de NO o nitrito de sodio impidió la hipertensión inducida por HBOC en ratones sin causar methemoglobinemia.
El NO inhalado también impidió la hipertensión inducida por HBOC en corderos.

Conclusiones:

Las HBOCs causan vasoconstricción sistémica por la eliminación de óxido nítrico (NO) endoteliales producidos por NOS3.
El pretratamiento con NO inhalado puede prevenir eficazmente la vasoconstricción inducida por HBOC en múltiples especies.
Esta estrategia ofrece un enfoque prometedor para mitigar los efectos secundarios relacionados con HBOC.

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