Current aspects in pharmacology of modified hemoglobins

Blood substitutes are products that are designed to replace whole blood (or) red blood cells in the field of transfusion medicine. There are two major classes that belong to this new therapeutics: (i) modified hemoglobins and (ii) perfluorocarbons. Modified hemoglobins have made tremendous progress in the past decade and are being considered for a wide variety of conditions like trauma, elective surgery, oxygenation of tumors to make them more sensitive to radiation therapy, stroke etc. Although, these agents are primarily used for oxygen delivery, their pharmacological actions have been significantly important. Several mechanisms are being explored to explain these pharmacological effects. Modified hemoglobins suffer several drawbacks including hypertension, renal toxicity, and pulmonary hypertension that restrict their development. This review deals with the clinical status and pharmacological actions of modified hemoglobins presently in advanced stages of development and some of the newer generation hemoglobin based therapeutics are also discussed.