Engineering Therapeutics to Detoxify Hemoglobin, Heme, and Iron

Ivan S. Pires, François Berthiaume, Andre F. Palmer

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Hemolysis (i.e., red blood cell lysis) can increase circulatory levels of cell-free hemoglobin (Hb) and its degradation by-products, namely heme (h) and iron (Fe). Under homeostasis, minor increases in these three hemolytic by-products (Hb/h/Fe) are rapidly scavenged and cleared by natural plasma proteins. Under certain pathophysiological conditions, scavenging systems become overwhelmed, leading to the accumulation of Hb/h/Fe in the circulation. Unfortunately, these species cause various side effects such as vasoconstriction, hypertension, and oxidative organ damage. Therefore, various therapeutics strategies are in development, ranging from supplementation with depleted plasma scavenger proteins to engineered biomimetic protein constructs capable of scavenging multiple hemolytic species. In this review, we briefly describe hemolysis and the characteristics of the major plasma-derived protein scavengers of Hb/h/Fe. Finally, we present novel engineering approaches designed to address the toxicity of these hemolytic by-products.

Original languageEnglish (US)
Pages (from-to)1-21
Number of pages21
JournalAnnual Review of Biomedical Engineering
StatePublished - Jun 8 2023
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Biomedical Engineering


  • Haptoglobin
  • Heme
  • Hemoglobin
  • Hemolysis
  • Hemopexin
  • Iron


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