, Volume 193, Issue 2, pp 183–187 | Cite as

Carboxyhemoglobin and Methemoglobin in Asthma

  • Robert Naples
  • Dan Laskowski
  • Kevin McCarthy
  • Emmea Mattox
  • Suzy A. A. Comhair
  • Serpil C. Erzurum


Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n = 32) and asthmatics (n = 31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among groups, but arterial COHb was higher in asthmatics than controls (p = 0.04). Venous COHb was similar among groups, and thus, arteriovenous COHb (a-v COHb) concentration difference was greater in asthma compared with controls. Venous MetHb was lower in asthma compared to controls (p = 0.01) and correlated to venous NO (p = 0.009). The greater a-v COHb in asthma suggests CO offloading to tissues, but lower than normal MetHb suggests countermeasures to avoid adverse effects of high NO on gas transfer.


Carboxyhemoglobin Asthma Methemoglobin Nitric oxide Hemoglobin 



We would like to thank Masimo for providing us with the loan of their equipment. This work is supported by HL099303, HL081064, HL103453, HL109250, and UL1 RR024989 from the National Center for Research Resources.

Conflict of interests



  1. 1.
    Nadeem A, Chhabra SK, Masood A et al (2003) Increased oxidative stress and altered levels of antioxidants in asthma. J Allergy Clin Immunol 111:72–78CrossRefPubMedGoogle Scholar
  2. 2.
    Brooks J (1937) The action of nitrite on haemoglobin in the absence of oxygen. Proc Royal Soc Lond B Biol Sci 123:368–382CrossRefGoogle Scholar
  3. 3.
    Slebos D-J, Ryter S, Choi AM (2003) Heme oxygenase-1 and carbon monoxide in pulmonary medicine. Respir Res 4:7CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Ryter S, Otterbein LE, Morse D et al (2002) Heme oxygenase/carbon monoxide signaling pathways: regulation and functional significance. Mol Cell Biochem 234–235:249–263CrossRefPubMedGoogle Scholar
  5. 5.
    Yasuda H, Yamaya M, Yanai M et al (2002) Increased blood carboxyhaemoglobin concentrations in inflammatory pulmonary diseases. Thorax 57:779–783CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Maines MD (1997) The heme oxygenase system: a regulator of second messenger gases. Annu Rev Pharmacol Toxicol 37:517–554CrossRefPubMedGoogle Scholar
  7. 7.
    Zayasu K, Sekizawa K, Okinaga S et al (1997) Increased carbon monoxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med 156:1140–1143CrossRefPubMedGoogle Scholar
  8. 8.
    Horvath I, Loukides S, Wodehouse T et al (1998) Raised levels of exhaled carbon monoxide are associated with an increased expression of heme oxygenase-1 in airway macrophages in asthma: a new marker of oxidative stress. Thorax 53:668–672CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Yasuda H, Sasaki T, Yamaya M et al (2004) Increased arteriovenous carboxyhemoglobin differences in patients with inflammatory pulmonary diseases. Chest 125:2160–2168CrossRefPubMedGoogle Scholar
  10. 10.
    Otterbein LE, Choi AM (2000) Heme oxygenase: colors of defence against cellular stress. Am J Physiol Lung Cell Mol Physiol 279:L1029–L1037PubMedGoogle Scholar
  11. 11.
    Morse D, Lin L, Choi AM et al (2009) Heme oxygenase-1, a critical arbitrator of cell death pathways in lung injury and disease. Free Radic Biol Med 47:1–12CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Ryter S, Alam J, Choi AM (2006) Heme oxygenase/carbon monoxide: from basic science to therapeutic applications. Physiol Rev 86:583–650CrossRefPubMedGoogle Scholar
  13. 13.
    Antonini E, Brunori M (1971) Hemoglobin and myoglobin in their reactions with ligands. North-Holland, AmsterdamGoogle Scholar
  14. 14.
    Kaneko FT, Arroliga AC, Dweik RA et al (1998) Biochemical reaction products of nitric oxide as quantitative markers of primary pulmonary hypertension. Am J Respir Crit Care Med 158:917–923CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Robert Naples
    • 1
  • Dan Laskowski
    • 1
    • 2
  • Kevin McCarthy
    • 2
  • Emmea Mattox
    • 1
  • Suzy A. A. Comhair
    • 1
  • Serpil C. Erzurum
    • 1
    • 2
  1. 1.Department of Pathobiology, Lerner Research InstituteCleveland ClinicClevelandUSA
  2. 2.Respiratory InstituteCleveland ClinicClevelandUSA

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