Five-coordinate neuroglobin and use thereof as a blood substitute
Described herein is the finding that a mutant form of human neuroglobin (H64L) with a stable five-coordinate geometry reduces nitrite to nitric oxide approximately 2000-times faster than the wild type neuroglobin. Five-coordinate neuroglobin is also capable of binding and releasing oxygen. Based on these findings, the use of five-coordinate neuroglobin as a blood substitute is described herein. Particularly provided is a method of replacing blood and/or increasing oxygen delivery to tissues in a subject by administering to the subject a therapeutically effective amount of neuroglobin with a stable five-coordinate geometry. In some cases, five-coordinate neuroglobin is administered in combination with another therapeutic agent or composition, such as a second blood replacement product (for example, a hemoglobin-based oxygen carrier), a blood product (such as red blood cells, serum or plasma) or whole blood.
1. A method of replacing blood in a subject, comprising administering to the subject a therapeutically effective amount of neuroglobin with a stable five-coordinate geometry, wherein the amino acid sequence of the stable five-coordinate neuroglobin is at least 95% identical to SEQ ID NO: 9 and comprises a leucine at amino acid residue 64, thereby replacing blood in the subject.
2. The method of claim 1 , wherein the subject has or is at risk of developing a disease, disorder or injury associated with a deficiency in red blood cells and/or hemoglobin, or associated with a reduction in oxygen delivery to tissues.
3. The method of claim 2 , wherein the disease, disorder or injury comprises a bleeding disorder, a bleeding episode, anemia, shock, ischemia, hypoxia, anoxia, hypoxaemia, a burn, an ulcer, ectopic pregnancy, microcystosis, rhabdomyolysis, hemoglobinopathy, spherocytosis, hemolytic uremic syndrome, thalassemia, disseminating intravascular coagulation, stroke or yellow fever.
4. The method of claim 3 , wherein the bleeding episode results from anticoagulant overdose, aneurysm, blood vessel rupture, surgery, traumatic injury, gastrointestinal bleeding, pregnancy, hemorrhage or infection.
5. The method of claim 3 , wherein the bleeding disorder comprises hemophilia A, hemophilia B, hemophilia C, Factor VII deficiency, Factor XIII deficiency, a platelet disorder, a coagulopathy, favism, thrombocytopenia, vitamin K deficiency or von Willebrand's disease.
6. The method of claim 3 , wherein the anemia comprises microcytic anemia, iron deficiency anemia, heme synthesis defect, globin synthesis defect, sideroblastic defect, normocytic anemia, anemia of chronic disease, aplastic anemia, hemolytic anemia, macrocytic anemia, megaloblastic anemia, pernicious anemia, dimorphic anemia, anemia of prematurity, Fanconi anemia, hereditary spherocytosis, sickle-cell anemia, warm autoimmune hemolytic anemia or cold agglutinin hemolytic anemia.
7. The method of claim 3 , wherein shock comprises septic shock, hemorrhagic shock or hypovolemic shock.
8. The method of claim 1 , wherein the subject suffers from or is at risk of suffering from myocardial infarction, stroke, ischemia-reperfusion injury, pulmonary hypertension or vasospasm.
9. The method of claim 1 , wherein the stable five-coordinate neuroglobin is human neuroglobin.
10. The method of claim 9 , wherein the human neuroglobin is recombinant human neuroglobin.
11. The method claim 1 , wherein the amino acid sequence of the stable five-coordinate neuroglobin is at least 99% identical to SEQ ID NO: 9 and comprises a leucine at amino acid residue 64.
12. The method of claim 1 , wherein the amino acid sequence of the stable five-coordinate neuroglobin comprises SEQ ID NO: 9.
13. The method of claim 1 , wherein the amino acid sequence of the stable five-coordinate neuroglobin consists of SEQ ID NO: 9.
14. The method of claim 1 , wherein the stable five-coordinate neuroglobin is administered to the subject intravenously.
15. The method of claim 1 , further comprising administering to the subject a second blood replacement product, a blood product or whole blood.
16. The method of claim 15 , wherein the second blood replacement product comprises a hemoglobin-based oxygen carrier, artificial red blood cells or an oxygen releasing compound.
17. The method of claim 15 , wherein the blood product comprises packed red blood cells, plasma or serum.
18. The method of claim 1 , wherein the subject is a human.
19. The method of claim 1 , wherein the subject is a non-human animal.