Polymerized bovine hemoglobin (HBOC-201)

Polymerized bovine hemoglobin (PBH) is a cell-free hemoglobin-based oxygen carrier (HBOC) designed to transport and deliver molecular oxygen to tissues in patients with severe anemia or hemorrhagic shock (Jahr et al., 2008). It is synthesized by polymerizing purified bovine hemoglobin with glutaraldehyde, which increases its molecular weight to prevent renal filtration and prolong its half-life in circulation (Mozzarelli et al., 2010). The primary therapeutic mechanism involves the reversible binding of oxygen to the heme iron sites, facilitating oxygen diffusion into tissues that may be inaccessible to red blood cells due to vasoconstriction or obstruction (Jahr et al., 2008). Despite its potential as a blood substitute, PBH is associated with significant safety risks, most notably systemic hypertension caused by the scavenging of nitric oxide, a key regulator of vascular tone (Natarajan et al., 2008; Olson et al., 2004). This nitric oxide depletion can lead to serious adverse events, including myocardial infarction and stroke, which has limited its regulatory approval in many jurisdictions (Natarajan et al., 2008). PBH remains a specialized treatment option in specific regions and for patients who cannot receive human blood products, such as those with religious objections to human blood (Jahr et al., 2008).

Other names

HBOC-201HemopureHemoglobin glutamer-250 (bovine)Glutaraldehyde-polymerized bovine hemoglobin

Reversible binding of molecular oxygen to heme iron sites for delivery to peripheral tissues and scavenging of endogenous nitric oxide.