Browsing by Author "Reynolds, James D"
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Item Open Access Pharmacologic Targeting of Red Blood Cells to Improve Tissue Oxygenation.(Clin Pharmacol Ther, 2017-12-14) Reynolds, James D; Jenkins, Trevor; Matto, Faisal; Nazemian, Ryan; Farhan, Obada; Morris, Nathan; Longphre, John M; Hess, Douglas T; Moon, Richard E; Piantadosi, Claude A; Stamler, Jonathan SDisruption of microvascular blood flow is a common cause of tissue hypoxia in disease, yet no therapies are available that directly target the microvasculature to improve tissue oxygenation. Red blood cells (RBCs) autoregulate blood flow through S-nitroso-hemoglobin (SNO-Hb)-mediated export of nitric oxide (NO) bioactivity. We therefore tested the idea that pharmacological enhancement of RBCs using the S-nitrosylating agent ethyl nitrite (ENO) may provide a novel approach to improve tissue oxygenation. Serial ENO dosing was carried out in sheep (1-400 ppm) and humans (1-100 ppm) at normoxia and at reduced fraction of inspired oxygen (FiO2 ). ENO increased RBC SNO-Hb levels, corrected hypoxia-induced deficits in tissue oxygenation, and improved measures of oxygen utilization in both species. No adverse effects or safety concerns were identified. Inasmuch as impaired oxygenation is a major cause of morbidity and mortality, ENO may have widespread therapeutic utility, providing a first-in-class agent targeting the microvasculature.