Red blood cells and hemoglobin in hypoxic pulmonary vasoconstriction.

Nitric oxide (NO) plays an important role in the modulation of hypoxic pulmonary vasoconstriction; in turn, red blood cells (RBCs) augment HPV by hemoglobin-mediated oxidation and inactivation of NO. In addition, scavenging of reactive oxygen species by RBCs may play a role in augmentation of HPV. NO delivery and/or production by RBCs does not appear to be important in the control of pulmonary vasomotor tone. This review will discuss regulation of HPV by RBCs with an emphasis on hemoglobin-NO interactions. In addition, the review will discuss how biologic (S-nitrosation) or pharmacologic (cross-linking) modification of hemoglobin may affect pulmonary circulatory-hemoglobin interactions.