Methemoglobin reduction under near physiological conditions

A 32-Year-Old Female with AIDS, Pneumocystis jiroveci Pneumonia, and Methemoglobinemia

We report a case of methemoglobinemia with significant hemoglobin desaturation in a young female with AIDS who was being treated for Pneumocystis jiroveci pneumonia. A review of the etiology, pathophysiology, and treatment of methemoglobinemia is presented.

Oxidant stress and haemolysis of the human erythrocyte

The erythrocyte is a highly specialised cell with a limited metabolic repertoire. As an oxygen shuttle, it must continue to perform this essential task while exposed to a wide range of environments on each vascular circuit, and to a variety of xenobiotics across its lifetime. During this time, it must continuously ward off oxidant stress on the haeme iron, the globin chain and on other essential cellular molecules. Haemolysis, the acceleration of the normal turnover of senescent erythrocytes, follows severe and irreversible oxidant injury. A detailed understanding of the molecular mechanisms underlying oxidant injury and its reversal, and of the clinical and laboratory features of haemolysis is important to the medical toxicologist. This review will also briefly review glucose-6-phosphate deficiency, a common but heterogeneous range of enzyme-deficient states, which impairs the ability of the erythrocyte to respond to oxidant injury.

Hemoglobin autooxidation/oxidation mechanisms and methemoglobin prevention or reduction processes in the bloodstream. Literature review and outline of autooxidation reaction

The amount of circulating methemoglobin in healthy humans is the result of a balance between methemoglobin production (from autooxidation and oxidation) and hemoglobin reduction. Hemoglobin autooxidation and oxidation are very complex and are not well understood. This article analyses the literature on hemoglobin autooxidation, oxidation and reduction and sets out a sequence of reactions for the oxidation of hemoglobin and the ways in which the percentage of methemoglobin is regulated or methemoglobin production prevented. Most of the information concerns erythrocyte hemoglobin, but plasma extracellular hemoglobin (from hemolysis or hemoglobin-based blood substitutes) is also considered where possible.