Haller Thomas, Lesser Lukas, Woyke Simon
Department of Physiology and Medical Physics, Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Eur J Clin Pharmacol. 2025 Feb;81(2):227-236. doi: 10.1007/s00228-024-03781-8. Epub 2024 Nov 25.
The shape and position of the hemoglobin-oxygen dissociation curve (ODC) is of critical importance in medicine, as it determines the uptake of O in the lungs and the delivery of O to the tissues. Numerous reports have identified affinity-modulating effects of drugs in humans. Such effects may be relevant to conditions such as pulmonary diffusion disorders, peripheral vascular disease, or coronary artery disease. The aim of this scoping review was to assess and summarize the current evidence on these effects.
The review was based on the PRISMA-ScR guidelines. We searched PubMed and the Cochrane Library and only included papers with free full-text access. The search covers all papers published before September 2024 and used the following keywords: "Oxygen affinity" or "oxygen dissociation curve" in combination with > 100 substance classes that should cover most drugs in clinical use.
The search returned 2447 hits of which 80 were selected for further full text review. In terms of discipline, cardiology accounted for the largest proportion, and in terms of effect quality, a right-ward shift resulting in improved tissue oxygenation was most common. For example, quantitative data show an increase in P of 6.1-12.4% and 25-53% for propranolol and RSR13, respectively.
Despite a substantial body of data, the effects of the vast majority of drugs on the ODC have not been studied or have not been studied in sufficient detail. The undeniable potential for medical interventions to alter the ODC calls for revival of this area of research.
血红蛋白-氧解离曲线（ODC）的形状和位置在医学中至关重要，因为它决定了肺中氧的摄取以及氧向组织的输送。众多报告已确定药物对人类的亲和力调节作用。此类作用可能与诸如肺扩散障碍、外周血管疾病或冠状动脉疾病等情况相关。本范围综述的目的是评估和总结关于这些作用的现有证据。
该综述基于PRISMA-ScR指南。我们检索了PubMed和Cochrane图书馆，仅纳入可免费获取全文的论文。检索涵盖2024年9月之前发表的所有论文，并使用了以下关键词：“氧亲和力”或“氧解离曲线”与>100种物质类别相结合，这些物质类别应涵盖大多数临床使用的药物。
检索返回2447条结果，其中80条被选作进一步的全文审查。在学科方面，心脏病学占比最大，在效应质量方面，导致组织氧合改善的右移最为常见。例如，定量数据显示，普萘洛尔和RSR13使P分别增加6.1 - 12.4%和25 - 53%。
尽管有大量数据，但绝大多数药物对ODC的作用尚未得到研究或研究不够详细。医学干预改变ODC的不可否认的潜力要求复兴这一研究领域。
