Division of Internal Medicine, University Hospital, Zurich CH-8091, Switzerland.
Cold Spring Harb Perspect Med. 2013 Jun 1;3(6):a013433. doi: 10.1101/cshperspect.a013433.
Hemoglobin (Hb) has multiple pathophysiologic effects when released into the intravascular space during hemolysis. The extracellular effects of Hb have resulted in novel models of toxicity, which help to explain endothelial dysfunction and cardiovascular complications that accompany genetic hemolytic anemias, malaria, blood transfusion, and atherosclerosis. The majority of models focus on nitric oxide (NO) depletion; however, in local tissue environments, Hb can also act as a pro-oxidant and inflammatory agent. This can alter cellular differentiation with the potential to deviate immune responses. The understanding of these mechanisms set in the context of natural scavenger and detoxification systems may accelerate the development of novel treatment strategies.
当血红蛋白（Hb）在溶血过程中释放到血管腔内时，它具有多种病理生理作用。Hb 的细胞外作用导致了新的毒性模型的出现，这些模型有助于解释伴随遗传性溶血性贫血、疟疾、输血和动脉粥样硬化的内皮功能障碍和心血管并发症。大多数模型都集中在一氧化氮（NO）耗竭上；然而，在局部组织环境中，Hb 也可以作为一种促氧化剂和炎症剂。这可能会改变细胞分化，并有可能改变免疫反应。在天然清除和解毒系统的背景下理解这些机制，可能会加速新的治疗策略的发展。
