Carbon monoxide (CO) poisoning leads to 50,000–100,000 emergency room visits and 1,500–2,000 deaths each year in the United States alone. Even with treatment, survivors often suffer from long-term cardiac and neurocognitive deficits, highlighting a clear unmet medical need for novel therapeutic strategies that reduce morbidity and mortality associated with CO poisoning. This review examines the prevalence and impact of CO poisoning and pathophysiology in humans and highlights recent advances in therapeutic strategies that accelerate CO clearance and mitigate toxicity. We focus on recent developments of high-affinity molecules that take advantage of the uniquely strong interaction between CO and heme to selectively bind and sequester CO in preclinical models. These scavengers, which employ heme-binding scaffolds ranging from organic small molecules to hemoproteins derived from humans and potentially even microorganisms, show promise as field-deployable antidotes that may rapidly accelerate CO clearance and improve outcomes for survivors of acute CO poisoning.

中文翻译：

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一氧化碳中毒：从微生物到治疗方法

仅在美国，一氧化碳 (CO) 中毒每年就会导致 50,000-100,000 人去急诊室就诊，并导致 1,500-2,000 人死亡。即使经过治疗，幸存者也常常患有长期的心脏和神经认知缺陷，这凸显了对降低与一氧化碳中毒相关的发病率和死亡率的新型治疗策略的明确未满足的医疗需求。这篇综述探讨了人类一氧化碳中毒的患病率和影响以及病理生理学，并重点介绍了加速一氧化碳清除和减轻毒性的治疗策略的最新进展。我们重点关注高亲和力分子的最新发展，这些分子利用 CO 和血红素之间独特的强相互作用，在临床前模型中选择性地结合和隔离 CO。这些清除剂采用血红素结合支架，范围从有机小分子到源自人类甚至微生物的血红素蛋白，有望成为可现场部署的解毒剂，可以迅速加速二氧化碳清除并改善急性二氧化碳中毒幸存者的预后。