Hemoglobin glutamer

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Hemopure is from hemoglobin by chemical crosslinking with glutaraldehyde prepared macromolecule , as the oxygen-carrying solution for the treatment of blood deficiency ( anemia ) and the oxygen supply ( ischemia is developed). Depending on the starting species and degree of polymerization, a distinction is made between the following variants:

  • Hemoglobin-Glutamer 250 (from bovine) with an average molecular weight of 250,000 Daltons (trade name Hemopure , for use in human medicine, Biopure Corporation)
  • Hemoglobin-Glutamer 200 (from bovine) with an average molecular weight of 200,000 Dalton (trade name Oxyglobin , for use in veterinary medicine, Biopure Corporation)
  • Human hemoglobin glutamer 256 with an average molecular weight of 256,000 Daltons (trade name PolyHeme , Northfield Laboratories)

Mechanism of action

The solution of the hemoglobin-based oxygen carrier (HBOC) hemoglobin-glutamer in modified Ringer's lactate solution is infused intravenously . After the infusion, the cross-linked hemoglobin molecules circulate in the plasma and transport oxygen - independently of the red blood cells. It therefore has the same effect, but is smaller, less viscous and releases oxygen in the tissue faster and more easily than normal hemoglobin. This means that it can also work if erythrocytes can no longer develop an effect due to stenoses in the blood vessels or due to low blood pressure. Another special feature is that it takes effect within a few minutes, while the effects of erythropoietic administration only become apparent after several weeks.

Veterinary medicine

Oxyglobin has been approved in the US since 1998 and in the EU since 2004 for the treatment of clinical signs of anemia in dogs. Alternatively, this can only be treated with blood transfusions, which is only possible to a limited extent in Europe due to the insufficient availability of donor blood.

Oxyglobin is for single use only and should not be given to dogs previously treated with oxyglobin.

Human medicine

As the first product in its product class (first-in-class product), Hemopure has been approved in South Africa since 2001 for the treatment of acute anemia in adults ( e.g. perioperatively) when a blood transfusion is not possible (temporary donor blood substitute ). However, it is rarely used there. Hemopure is currently still in clinical studies (phase 3) in Europe and the USA .

PolyHeme is made from human hemoglobin, whereby the native tetramer is first modified with pyridoxine and then polymerized with glutaraldehyde. PolyHeme was investigated in clinical trials, but in April 2009 the US Food and Drug Administration refused to approve PolyHeme , an artificial blood substitute developed by US biotech company Northfield Laboratories . Northfield Laboratories then stopped its work on the PolyHeme project out of destitution.

Abuse as a doping agent

Due to the easier transport of oxygen, Hemopure is a doping agent used in endurance sports. Compared to EPO , however, it works within a few minutes and maintains its effect over several hours, so it can also be injected immediately before a competition. Possible side effects are immune reactions up to shock. Bengt Saltin, head of the Danish Anti-Doping Association, confirmed its use as a doping agent in an interview with Spiegel in August 2000 ("I have sources that confirm that drivers doped with Hemopure at the last Tour de France") . Hemopure can now also be detected biochemically.

On July 20, 2007, US mountain biker Whitney Richards declared that he had been supposed to transport Hemopure to Italy in 2002 for professional cyclist Michael Rasmussen .

Individual evidence

  1. ↑ Food and Drug Association (FDA): NADA 141-067 Oxyglobin - original approval
  2. ↑ European Public Assessment Report on Oxyglobin from the European Medicines Agency (EMEA)
  3. ^ Hugo Van Aken: Intensive Care Medicine . Georg Thieme Verlag, 2007, ISBN 3-13-114872-1 , p. 455 ( limited preview in Google Book search).
  4. ^ Fierce Biotech: Northfield Labs readies liquidation plan , June 2, 2009
  5. ↑ Dopingnews.de: Oxyglobin in the blood not yet detectable and other articles ( Memento of February 8, 2007 in the Internet Archive )
  6. ↑ The mirror: just put the syringe in the leg . In: Der Spiegel . No. 33 , 2000 ( online - Aug. 14, 2000 ).
  7. ^ Institute for Biochemistry of the German Sport University Cologne: New detection methods in doping analysis - Artificial oxygen therapeutics from cross-linked bovine hemoglobin (PDF; 335 kB) -. FIT, science magazine of the German Sport University Cologne, 2 (2004) 10–12
  8. ↑ Charles Pelkey: Ex-cyclist levels doping charges at Rasmussen , VeloNews, July 20, 2007 (English)