Oxygen transport dynamics of acellular hemoglobin solutions in an isovolemic hemodilution model in swine.

BACKGROUND: One of the perceived advantages of a hemoglobin-based blood substitute is the provision of oxygen-carrying capacity. Although the hemodynamic response to the infusion of acellular hemoglobin solutions has been extensively studied, less is known about the oxygen transport dynamics of such solutions. We hypothesized that acellular hemoglobin solutions are useful oxygen carriers in anemic states and that higher P50 solutions transport O2 more efficiently than low P50 solutions. We sought to quantify O2 transport dynamics of hemoglobin solutions in an isovolemic hemodilution model in swine. METHODS: Eighteen swine were anesthetized, ventilated, and instrumented for hemodynamic measurements and for withdrawal of arterial and mixed venous blood. The swine were randomized into three groups and progressively bled from an initial hematocrit (Hct) of 30% to Hcts of 19%, 13%, and 8% using isovolemic exchange with pyridoxalated hemoglobin polyoxyethylene conjugate (PHP, n = 6); an identical hemoglobin solution without the pyridoxalation, resulting in a low P50 solution (POE-Hb, n = 6); or an osmotically similar control solution of pentastarch (PS, n = 6). Hemodynamic measurements, arterial and mixed venous O2 content, and O2 extraction ratio (ER), were determined in whole blood (WB), the red blood cell (RBC) phase, and the plasma phase utilizing a compartmentalized approach. RESULTS: Mean pulmonary arterial pressure was higher with hemodilution in the PHP and POE-Hb groups than in the PS group (p < 0.05). Cardiac index increased with hemodilution in all groups, but was significantly less than the cardiac index in the PS group at Hcts = 19% and 13%. Oxygen delivery and consumption were maintained at all hematocrits at baseline levels in the PHP and POE-Hb groups, but O2 delivery was significantly decreased in the PS group at Hct = 8% (p < 0.05 for PS vs. baseline and p < 0.05 for PHP and POE-Hb vs. PS). Oxygen extraction ratio increased with progressive hemodilution in both the RBC hemoglobin and plasma phases to a maximum of 39% for PHP and 36% for POE-Hb at Hct = 8%. The percent contribution from the plasma phase to total oxygen delivery and consumption likewise increased with hemodilution to maximum values of 52.7% (PHP) and 68.2% (POE-Hb) for delivery and 40.9% (PHP) and 39.3% (POE-Hb) for consumption. CONCLUSION: Acellular hemoglobin solutions provide a significant contribution to O2 delivery and consumption, particularly in severe anemia, in this model of isovolemic exchange. The differences in the P50 of the two hemoglobin solutions do not appear to significantly influence oxygen dynamics over the range of hematocrits studied.

Comparison of various hemoglobin polyoxyethylene conjugate solutions as resuscitative fluids after hemorrhagic shock.

BACKGROUND: Previous research suggested that splanchnic hypoperfusion occurs after resuscitation with certain acellular hemoglobin solutions. We examined the influence of maltose content and oxygen affinity on resuscitation with various hemoglobin polyoxyethylene conjugate solutions after hemorrhage. METHODS: Fifteen swine underwent hemorrhage and equal volume resuscitation with pyridoxalated hemoglobin polyoxyethylene conjugate containing 0% or 8% maltose, or low P50 conjugate, which also contained 8% maltose. Five control animals were monitored but not bled. Regional blood flow was determined by using radioactive microspheres, gastric mucosal perfusion was estimated with tonometry, and gut histopathology was evaluated. RESULTS: All hemoglobin solutions produced vasoconstriction, manifested by elevated mean systemic and pulmonary artery pressures without a significant decrease in cardiac index compared with the sham group. Resuscitation with maltose-containing solutions elevated arterial and regional PCO2 and depressed arterial pH and gastric pHi (p < 0.05 for all). Splanchnic and renal blood flows were reduced in the low P50 + 8% maltose group (p < 0.05 vs. sham and baseline for renal blood flow), possibly indicating greater regional vasoconstriction in this group. Ileal mucosal damage was more severe in the maltose-containing groups and correlated with decreased pHi. CONCLUSION: Vasoconstriction occurred in all groups but was more severe in the low P50 + 8% maltose group. Maltose-containing solutions caused respiratory acidosis, decreased pHi, and histologic evidence of mucosal injury. Pyridoxalated hemoglobin polyoxyethylene conjugate without maltose was a superior resuscitation solution in this swine model.

Chemical characterization of pyridoxalated hemoglobin polyoxyethylene conjugate.

Pyridoxalated hemoglobin polyoxyethylene conjugate (PHP) was developed in the 1980s as an oxygen carrier and is now under development for treatment of nitric oxide-dependent, volume refractory shock. PHP is made by derivatizing human stroma-free hemoglobin with pyridoxal-5-phosphate and polyoxyethylene (POE). A unique aspect of using POE for modification is that unlike its mono-methoxy polyethylene glycol (PEG) relatives, POE is bifunctional. The result of derivatization of stroma-free hemoglobin is a complex mixture of modified hemoglobin and other red cell proteins. The molecular weight profile, based on size exclusion chromatography, is bimodal and has a number average molecular weight of approximately 105¿ omitted¿000 and a weight average molecular weight of approximately 187¿ omitted¿000. The mixture of hemoglobin molecules has on average 3.3 pyridoxal and 5.0 polyoxyethylene units per tetramer. A portion of the tetramers are linked by POE crosslinks. The hemoglobin tetramers retain their ability to dissociate into dimer pairs and only a small percentage of the dimer pairs are not modified with POE. The SDS-PAGE profile exhibits the ladder-like appearance commonly associated with polyethylene glycol-modified proteins. The isoelectric focusing profile is broad, demonstrating a pI range of 5.0-6.5. The hydrodynamic size of PHP was determined to be approximately 7.2 nm by dynamic light scattering. Soluble red blood cell proteins, such as catalase, superoxide dismutase, and carbonic anhydrase, are present in PHP and are also modified by POE.

Detection of residual polyethylene glycol derivatives in pyridoxylated-hemoglobin-polyoxyethylene conjugate.

Purified hemoglobin solutions have been shown to cause renal toxicity in animals. Safe use of hemoglobin based therapeutics in humans requires modification of the hemoglobin molecule to prevent this toxicity. Hemoglobin modification may be accomplished by crosslinking the dimers within the hemoglobin tetramer or by derivatization of the alpha and/or beta subunits such that their size and/or charge prevents filtration by the glomeruli. Pyridoxylated hemoglobin polyoxyethylene conjugate (PHP) consists of hemoglobin molecules modified with alpha-carboxymethyl, omega-carboxymethoxy polyoxyethylene (POE). We have developed a high performance liquid chromatography-based (HPLC) method which can quantitate residual POE at levels of 0.1 mg/ml or greater. The detection of POE at this level of sensitivity requires the use of an evaporative light scattering detector (ELSD). A differential refractometer may also be used for POE detection, however the limit of quantitation for this detector is approximately 10 fold greater than that observed for the evaporative light scattering detector, resulting in a reduction in sensitivity. The successful use of this method requires sample deproteination using trichloroacetic acid. The reliability of the method has been demonstrated by spike recovery, precision, and reproducibility studies in PHP and buffer solutions.

In vitro processing by signal peptidase I of precursor maltose-binding protein species with alterations in and around the signal peptide.

Processing of 37 precursor maltose-binding protein (preMBP) species by purified signal peptidase I (SPase I) was assayed. The in vitro reaction was inefficient compared to processing in Escherichia coli cells. The extent of preMBP processing in vitro was higher when SPase I was present during translation as compared to processing after translation was arrested by chloramphenicol. Complete conversion of wild-type (wt) preMBP (greater than 90%) to mature protein required 4300-fold more enzyme than substrate during a 15 min reaction. Most preMBP species with alterations in the signal peptide processing region that were efficiently processed (greater than 85%) in vivo were also processed in vitro, although the efficiency of processing was usually lower than the corresponding in vivo value. Increasing the level of SPase I in the in vitro reaction often increased the extent of preMBP processing. A number of amino acid substitutions in the processing region that drastically reduced or eliminated processing in vivo also eliminated processing in vitro. Processing occurred at an alternate site in some mutant preMBP species in vivo, but this event occurred very inefficiently in vitro. Amino acid substitutions in the hydrophobic core or in the charged regions at the N-terminus of the signal peptide and early mature region of preMBP slightly reduced in vitro processing as compared to processing of wt preMBP, regardless of their effect on secretion in vivo.

Cloning, sequence analysis, and overexpression of Escherichia coli folK, the gene coding for 7,8-dihydro-6-hydroxymethylpterin-pyrophosphokinase.

The gene coding for the Escherichia coli enzyme 7,8-dihydro-6-hydroxymethylpterin-pyrophosphokinase has been cloned and sequenced. This gene, designated folK, codes for a protein of 159 amino acids, including an amino-terminal methionine. The protein was overexpressed in E. coli MC4100 by cloning the gene behind the lacUV5 promoter in a high-copy-number plasmid. The enzyme was purified to homogeneity. Amino-terminal analysis of the purified protein showed that the amino-terminal methionine had been removed. The compositional molecular mass (17,945 Da) was identical to the molecular mass determined by mass spectrometry. The enzyme was observed to have a large number of proline residues and migrated anomalously in sodium dodecyl sulfate-polyacrylamide gels, with an apparent molecular mass of 23,000 Da.

Inter-molecular degradation of signal peptidase I in vitro.

Highly purified preparations of signal peptidase I (36 kDa) were found to undergo an apparent inter-autocatalytic degradation at 4 degrees C and 37 degrees C. The disappearance of the 36 kDa protein coincided with the stable appearance of a 31 kDa and a 5 kDa species. Amino-terminal sequencing of the 31 kDa product indicated a site specific cleavage following Ala38-Gln-Ala of signal peptidase I. The 31 kDa fragment was purified and shown to have 100-fold less activity than the native enzyme, with pre-maltose binding protein as a substrate.

Purification and partial characterization of 7,8-dihydro-6-hydroxymethylpterin-pyrophosphokinase and 7,8-dihydropteroate synthase from Escherichia coli MC4100.

The enzymes 7,8-dihydroxymethylpterin-pyrophosphokinase (HPPK) and 7,8-dihydropteroate synthase (DHPS), which act sequentially in the folate pathway, were purified to homogeneity from crude extracts of Escherichia coli MC4100. The enzymes represent less than 0.01% of the total soluble protein. HPPK was purified greater than 10,000-fold; the native enzyme appears to be a monomer with a molecular mass of 25 kDa and a pI of 5.2. DHPS was purified greater than 7,000-fold; the native enzyme has an apparent molecular mass of 52 to 54 kDa and is composed of two identical 30-kDa subunits. The amino-terminal sequences for both enzymes have been determined.

Purification and Characterization of Glycerol Dehydratase from Lactobacillus reuteri.

A coenzyme B(12)-dependent glycerol dehydratase from Lactobacillus reuteri has been purified and characterized. The dehydratase has a molecular weight of approximately 200,000, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis yielded a single major band with a molecular weight of 52,000. K(m) values for substrates and coenzyme B(12) were in the millimolar and the submicromolar range, respectively.

Utilization of Glycerol as a Hydrogen Acceptor by Lactobacillus reuteri: Purification of 1,3-Propanediol:NAD Oxidoreductase.

Lactobacillus reuteri utilizes exogenously added glycerol as a hydrogen acceptor during carbohydrate fermentations, resulting in higher growth rates and cell yields than those obtained during growth on carbohydrates alone. Glycerol is first converted to 3-hydroxypropionaldehyde by a coenzyme B(12)-dependent glycerol dehydratase and then reduced to 1,3-propanediol by an NAD -dependent oxidoreductase. The latter enzyme was purified and determined to have a molecular weight of 180,000; it is predicted to exist as a tetramer of identical 42,000-molecular-weight subunits.

Chemical characterization of an antimicrobial substance produced by Lactobacillus reuteri.

Lactobacillus reuteri converts glycerol into a potent cell growth inhibitor. This substance, termed reuterin, inhibits the growth of gram-positive and gram-negative bacteria as well as yeasts, fungi, and protozoa. Semipreparative chromatography was used to purify reuterin, and Fourier transform infrared spectroscopy and liquid chromatography-mass spectrometry were used to establish the molecular weight as well as the molecular functionality of the reuterin molecule. Nuclear magnetic resonance studies of purified reuterin carried out with deuterium oxide confirmed the presence of two three-carbon compounds, beta-hydroxypropionaldehyde and the corresponding hydrated acetal, and a six-carbon cyclic dimer of the aldehyde. Further nuclear magnetic resonance studies with deuterated methanol revealed that in this solvent the compound existed as a three-carbon compound in a methoxy form. Trimethylsilyl derivatives of reuterin were analyzed by gas chromatography-mass spectrometry, and a molecule was identified which had a molecular weight corresponding to a disilylated dimeric structure. On the basis of the above information, reuterin was determined to be an equilibrium mixture of monomeric, hydrated monomeric, and cyclic dimeric forms of beta-hydroxypropionaldehyde. This was subsequently confirmed by chemical synthesis.

Production and isolation of reuterin, a growth inhibitor produced by Lactobacillus reuteri.

Lactobacillus reuteri is a prominent member of the Lactobacillus population in the gastrointestinal ecosystem of humans, poultry, swine, and other animals. Reuterin is a newly discovered, broad-spectrum antimicrobial substance produced by this species during fermentation of glycerol. In this report, we describe procedures for (i) producing reuterin in sufficient amounts to isolate from a fermentation mixture and (ii) isolating this substance by high-performance liquid chromatography. By using uniformly labeled [14C]glycerol, reuterin was identified as a product of glycerol fermentation associated with the production of beta-hydroxypropionic acid and trimethylene glycol.