Histotoxic hypoxia

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Histotoxic hypoxia (also called histoxic hypoxia) is the inability of cells to take up or use oxygen from the bloodstream, despite physiologically normal delivery of oxygen to such cells and tissues. [1] Histotoxic hypoxia results from tissue poisoning, such as that caused by cyanide (which acts by inhibiting cytochrome oxidase) and certain other poisons like hydrogen sulfide (byproduct of sewage and used in leather tanning).

Contents

Causes

Histotoxic hypoxia refers to a reduction in ATP production by the mitochondria due to a defect in the cellular usage of oxygen. [2]

Cyanide

An example of histotoxic hypoxia is cyanide poisoning. There is a profound drop in tissue oxygen consumption since the reaction of oxygen with cytochrome oxidase is blocked by the presence of cyanide. Cyanide binds to the ferric ion on cytochrome oxidase a3 and prevents the fourth and final reaction in the electron transport chain. This completely stops oxidative phosphorylation and prevents the mitochondria from producing ATP. [3] There are other chemicals that interrupt the mitochondrial electron transport chain (e.g., rotenone, antimycin A) and produce effects on tissue oxygenation similar to that of cyanide. Oxygen extraction decreases in parallel with the lower oxygen consumption, with a resulting increase in venous oxygen content and PvO2. Although cyanide stimulates the peripheral respiratory chemoreceptors, increasing the inspired oxygen fraction is not helpful, since there is already an adequate amount of oxygen which the poisoned cells cannot use. [2]

Treatments

Cyanide antidote kit is a widely used method in treating cyanide induced histotoxic hypoxia. It consists of three different parts that are administered one after the other. The three parts are amyl nitrite, sodium nitrite, and sodium thiosulfate. [3] The nitrites act with hemoglobin to form methemoglobin which binds cyanide. Cyanide has a preference to the ferric ion on methemoglobin over the ferric ion on cytochrome oxidase a3 and causes cyanide to be drawn out of the mitochondria. This causes the mitochondria to produce ATP again and stop histotoxic hypoxia. [3]

Ischemia

Histotoxic hypoxia can be a consequence of ischemia in the case of stroke or inflammation. In the case of inflammation, neuro-inflammatory diseases like Alzheimer's disease, Parkinson's disease and Multiple Sclerosis can all lead to histotoxic hypoxia. During a stroke, there is an interruption in the blood supply followed by reperfusion which leads to histotoxic hypoxia because of an accumulation of reactive oxygen species (ROS). [4] In the case of inflammatory diseases, histotoxic hypoxia can also be triggered by ROS from mitochondrial damage in the active lesions of chronic multiple sclerosis. Inflammatory mediators such as heme oxygynase-1(HO-1) can result in histotoxic hypoxia when they are released in excess and cause the sequestration of iron as in the cases of Alzheimer's disease, Parkinson's disease and Multiple Sclerosis. [4]

See also

Related Research Articles

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In chemistry, a cyanide is a chemical compound that contains a C≡N functional group. This group, known as the cyano group, consists of a carbon atom triple-bonded to a nitrogen atom.

<span class="mw-page-title-main">Hypoxia (medical)</span> Medical condition caused by lack of oxygen in the tissues

Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during hypoventilation training or strenuous physical exercise.

<span class="mw-page-title-main">Mitochondrion</span> Organelle in eukaryotic cells responsible for respiration

A mitochondrion is an organelle found in the cells of most Eukaryotes, such as animals, plants and fungi. Mitochondria have a double membrane structure and use aerobic respiration to generate adenosine triphosphate (ATP), which is used throughout the cell as a source of chemical energy. They were discovered by Albert von Kölliker in 1857 in the voluntary muscles of insects. The term mitochondrion was coined by Carl Benda in 1898. The mitochondrion is popularly nicknamed the "powerhouse of the cell", a phrase coined by Philip Siekevitz in a 1957 article of the same name.

<span class="mw-page-title-main">Oxidative phosphorylation</span> Metabolic pathway

Oxidative phosphorylation or electron transport-linked phosphorylation or terminal oxidation is the metabolic pathway in which cells use enzymes to oxidize nutrients, thereby releasing chemical energy in order to produce adenosine triphosphate (ATP). In eukaryotes, this takes place inside mitochondria. Almost all aerobic organisms carry out oxidative phosphorylation. This pathway is so pervasive because it releases more energy than alternative fermentation processes such as anaerobic glycolysis.

<span class="mw-page-title-main">Electron transport chain</span> Cellular electron transfer

An electron transport chain (ETC) is a series of protein complexes and other molecules that transfer electrons from electron donors to electron acceptors via redox reactions (both reduction and oxidation occurring simultaneously) and couples this electron transfer with the transfer of protons (H+ ions) across a membrane. The electrons that transferred from NADH and FADH2 to the ETC involves 4 multi-subunit large enzymes complexes and 2 mobile electron carriers. Many of the enzymes in the electron transport chain are membrane-bound.

<span class="mw-page-title-main">Cytochrome c oxidase</span> Complex enzyme found in bacteria, archaea, and mitochondria of eukaryotes

The enzyme cytochrome c oxidase or Complex IV, is a large transmembrane protein complex found in bacteria, archaea, and mitochondria of eukaryotes.

<span class="mw-page-title-main">Methemoglobinemia</span> Condition of elevated methemoglobin in the blood

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In chemistry, reactive oxygen species (ROS) are highly reactive chemicals formed from diatomic oxygen. Examples of ROS include peroxides, superoxide, hydroxyl radical, singlet oxygen, and alpha-oxygen.

<span class="mw-page-title-main">Generalized hypoxia</span> Medical condition

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<span class="mw-page-title-main">Methemoglobin</span> Type of hemoglobin

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<span class="mw-page-title-main">Oxygen–hemoglobin dissociation curve</span>

The oxygen–hemoglobin dissociation curve, also called the oxyhemoglobin dissociation curve or oxygen dissociation curve (ODC), is a curve that plots the proportion of hemoglobin in its saturated (oxygen-laden) form on the vertical axis against the prevailing oxygen tension on the horizontal axis. This curve is an important tool for understanding how our blood carries and releases oxygen. Specifically, the oxyhemoglobin dissociation curve relates oxygen saturation (SO2) and partial pressure of oxygen in the blood (PO2), and is determined by what is called "hemoglobin affinity for oxygen"; that is, how readily hemoglobin acquires and releases oxygen molecules into the fluid that surrounds it.

<span class="mw-page-title-main">Inner mitochondrial membrane</span>

The inner mitochondrial membrane (IMM) is the mitochondrial membrane which separates the mitochondrial matrix from the intermembrane space.

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<span class="mw-page-title-main">Bernhard Kadenbach</span> German biochemist (1933–2021)

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<span class="mw-page-title-main">Pathophysiology of Parkinson's disease</span> Medical condition

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References

  1. "Forms of hypoxia". courses.kcumb.edu. Archived from the original on 2007-12-22.
  2. 1 2 Pittman RN. "Chapter 7: Oxygen Transport in Normal and Pathological Situations: Defects and Compensations". Regulation of Tissue Oxygenation . Retrieved 6 May 2012.
  3. 1 2 3 Hamel, Jillian (2011-02-01). "A Review of Acute Cyanide Poisoning With a Treatment Update". Critical Care Nurse. 31 (1): 72–82. doi:10.4037/ccn2011799. ISSN   0279-5442. PMID   21285466.
  4. 1 2 Goel, Rajesh; Bagga, Parveen (December 2010). "Cobalt chloride induced histotoxic cerebral hypoxia: A new experimental model to study neuroprotective effect". Journal of Pharmaceutical Education & Research. 1: 88–95.