ELSEVIER
Toxicology 121 (1997) 81 90
TOXICOLOGY
A proposed biochemical mechanism involving hemoglobin for
blast overpressure-induced injury
Nabil M. Elsayed a,b,*, Nikolai V. Gorbunov a, Valerian E. Kagan c
a Department of Respiratory Research, Division of Medicine, Walter Reed Army Institute of Research, Washington,
DC 20307, USA
b Department of Environmental and Occupational Health, School of Public Health, University of California, Los Angeles,
CA 90024, USA
c Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15238, USA
Abstract
Blast overpressure (BOP) is the abrupt, rapid, rise in atmospheric pressure resulting from explosive detonation,
firing of large-caliber weapons, and accidental occupational explosions. Exposure to incident BOP waves causes
internal injuries, mostly to the hollow organs, particularly the ears, lungs and gastrointestinal tract. BOP-induced
injury used to be considered of military concern because it occurred mostly in military environments during military
actions or training, and to a lesser extent during civilian occupational accidents. However, in recent years with the
proliferation of indiscriminate terrorist bombings worldwide involving civilians, blast injury has become a societal
concern, and the need to understand the biochemical and molecular mechanism(s) of injury, and to find new and
effective methods for treatment gained importance. In general, past BOP research has focused on the physiological
and pathological manifestations of incapacitation, thresholds of safety, and on predictive modeling. However, we
have been studying the molecular mechanism of BOP-induced injury, and recently began to have an insight into that
mechanism, and recognize the role of hemoglobin released during hemorrhage in catalyzing free radical reactions
leading to oxidative stress. In this report we discuss the biochemical changes observed after BOP exposure in rat
blood and lung tissue, and propose a biochemical mechanism for free radical-induced oxidative stress that can
potentially complicate the injury. Moreover, we observed that some antioxidants can interact with Hb oxidation
products (oxy-, met- and oxoferrylHb) and act as prooxidants that can increase the damage rather than decrease it.
© 1997 Elsevier Science Ireland Ltd.
Keywords: Blast overpressure; High energy impulse noise; Hemoglobin-induced injury; Lipid peroxidation; Antioxi-
dant depletion; Prooxidants; Methemoglobin; Oxoferryl hemoglobin
* Corresponding author. Tel: + 1 301 2957447; fax: + 1 301 2957804; e-mail: dr._nabil_elsayed@wrsmtp-ccmail.army.mil.
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