HEMOGLOBIN:
STRUCTURE AND
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FUNCTIONCase 1
A 11-year-old male child was admitted with a history of
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having been found unconscious in the bathroom by the elder
brother of the patient.
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There was no evidence of associated tonic-clonicmovements, tongue bite, frothing from mouth, vomiting,
bladder, and bowel incontinence or trauma. There was no
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history of fever, seizures, headache, vomiting, and substance
abuse prior to this episode.
At the time of admission, patient was unresponsive. Pupils
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were normal size and well reacting to light, and plantar reflex
was extensor bilaterally and systemic examination was
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normal.Patient was intubated, mechanically ventilated, and was
started on antiedema measures and other supportive
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treatment
MRI: bilateral gyral swelling of the frontal and parietal lobes.
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Patient improved and was extubated on the fourth day ofadmission and was discharged in satisfactory condition after
seven days without any neurological sequelae.
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Ref: Sharma S, Gupta R, Paul BS, et al: Accidental carbon monoxide poisoning in our homes.
Indian J Crit Care Med 2009;13:169-170.
Case 2
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A 25-year-old male was found lying unconscious and broughtout after breaking open the bathroom door after one hour.
Similar Examination and MRI like Case 1
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He had residual hypoxic damage in the form of persistent
vegetative state and was discharged to a domiciliary care on
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request.Discussion
Gas geysers have emerged as a cost-effective efficient
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method for heating water at homes. Gas geysers run on
LPG, the combustion of which leads to generation of CO,
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hydrocarbons, and nitrogen oxides.CO toxicity occurs by competitive binding of CO to the
hemoglobin heme groups shifting the oxygen-
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hemoglobin dissociation curve to the left.
The predilection for the globus pallidus may relate to
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hypotensive effect of CO poisoning in the watershed territoryof the arterial supply.
Treatment: ?
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Hints:Competitive Inhibitor
Affects oxygen dissociation curve
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Learning objectives
Structure of Hemoglobin
Binding of oxygen to Hemoglobin
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Binding of CO to hemoglobin
Importance of Oxygen
Why these many symptoms by inhaling a
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gas?
ANOXIA
Oxygen needs to be transported from lungs to tissues
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efficiently to protect against anoxic episodesWhat is the mechanism for this efficient transport?
What is the biomolecule responsible and its characteristics
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that supports this function?
Hemoglobin(Hb)
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HemoglobinQuaternary structure
Hemoglobin
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Heme(4)Globin(4)
Heme : Prosthetic group
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Globin: Protein partProtoporphyrin
ring
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HbA: 2, 2
Fe2+
Structure of Heme
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Iron containing pigment heme is attached to protein globinHeme is iron porphyrin complex
called Iron protoporphyrin IX
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Conjugated double bondsRed color to Heme.
Functional form Iron in Heme is-
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Ferrous form(Fe++)
Reduced state
Structure of Globin
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Adult Hemoglobin has 4 Polypeptide chains : 2 and 2Heme Pocket
Heme Pocket is a crevice/
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hol ow hydrophobic area
Formed in the interior of
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Globin subunitsHeme group is tucked
between E and F helices
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of Globin subunit.
Amino acids in Globin chain are identified by Helix name
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and Position of a.a in that helix.E7 His ( Distal His), F8 His ( Proximal His)
Oxygen binding of Hemoglobin
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Iron has 4 covalent bondswith pyrrole rings, Fifth
coordination bond with
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proximal histidine(F8),
Sixth coordination bond
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with divalent oxygenDivalent oxygen is linked to
Fe++ of Heme and
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imidazole group of Distal
histidine(E7)
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Where did CO bind in Case 1 and 2?Hint :
Competitive binding
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Affects Mitochondrial ETC(Respiratory Chain/
Cellular respiration)
To generate AT P
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(Oxidative Phosphorylation)Treatment for CO Poisoning
Treatment includes immediate removal of the victim from the
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exposure and administration of high-flow or 100% oxygen bya non-rebreather reservoir oxygen mask
Prevention: The geyser should not be switched on after
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locking the door from inside, ventilation should be kept open
Gas geyser unit should be placed outside the bathroom with
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a hose of hot water going inside.References
1. Victor W. Rodwell, David A. Bender, Kathleen M. Botham, Peter J. Kennel y, P. Anthony Weil.
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Harper's Illustrated Biochemistry, 30th Edition2. Denise R. Ferrier; Lippincott Illustrated Reviews Biochemistry, 7th Edition
3. Kasper, Fauci, Hauser et al., Harrison's Principles of Internal Medicine, 19th Edition
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Why 2,3 BPG reduces in stored blood?During storage of RBCs, large amounts of lactate are formed
and blood pH drops rapidly.
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When the pH falls below 7.2, the bisphosphoglyceratephosphatase wil be activated and the normally high
concentration of 2,3-DPG is rapidly depleted
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Duhm J, Gehrlach E. Metabolism and function of 2,3- diphosphoglycreate in red blood cells.
Greenwalt TJ, Jamieson GA, editors. The human red cell in vitro. New York: Grune & Stratton; 1974. p. 111-48.
Where was 2,3 BPG in Glycolysis?
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Was it 1,3 BPG or 2,3 BPG?What do 2,3 BPG has to do with
Oxygenation and Oxygen transport?
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In Hb 4 polypeptide chains
are visualized as two
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identical dimers, ()1and ()2 held by
Ionic bonds and
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Hydrophobic interactions,
Two dimers are linked to
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each other by weak polarbonds.
Taut and Relaxed forms of Hb
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T Form of HbR Form Of Hb
Deoxy Hb is in T form
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Oxy Hb is in R form binds
binds with CO2,H+ and
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only with Oxygen2,3BPG
T form has salt bridges
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Salt bridges are broken inlinked in between the dimer between the dimer subunits
subunits
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during oxygenation of Hb.
More constrained form
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Less constrained formT form has low affinity for R form has higher affinity
Oxygen
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for Oxygen
T form of Hb predominates R form of Hb predominates
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in low pO2at high pO2
How does these bonds break on
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Oxygenation?Changes in Hb on oxygenation
Fe moves into plane of of heme
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22 moves 150 relative to 11
(0.3A0 to 0.1A0 )
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Features of oxygenation of HbOxygen links to Ferrous form of Iron, of Heme ( Reversible,
non-enzymatic, no oxidation of Ferrous)
One Hb molecule with 4 Heme can bind to four O2
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molecules
Shows c operative binding like allosteric regulatio
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Fol ows Hil s equationDue to tetrametric structure o Hb
Makes it efficient in oxygen transport
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How cooperative binding mechanismmakes Hb efficient in oxygen transport
Allows 100% saturation at pO2 much lower than
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what it actually requires
Hemoglobin picks up the largest possible load of
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Oxygen in the lungs, and delivers the Oxygenwhere and when needed.
Role of 2,3 BPG in release of oxygen
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One molecule of 2,3-BPG binds
to a pocket, formed by the two -
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globin chains, in the center ofthe deoxyhemoglobin tetramer
This pocket contains several
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positively charged aminoacids(lysine, valine) that form
ionic bonds with the
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negatively charged
phosphate groups of 2,3-
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BPG.Stabilizes T form of deoxyHb
Consequence of Transfusing stored blood
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Hemoglobin deficient in 2,3-BPG thus acts as an oxygen
"trap" rather than as an oxygen transport system.
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Transfused RBCs are able to restore their depleted suppliesof 2,3-BPG in 6?24 hours.
However, severely il patients may be compromised if
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transfused with large quantities of such 2,3-BPG?"stripped"
blood
The maximum storage time for red cells has been
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doubled (21 to 42 days, with median time of 15 days)
by changes in H+, phosphate and hexose sugar
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concentrationResponse of 2,3-BPG levels to chronic
hypoxia or anemia
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Al osteric effect of 2,3 BPGon oxygen affinity
2,3 BPG concentration
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increases in RBC in
hypoxia/ anemia
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HbF: Low affinity for 2,3BPG
Thank You!
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