New protein therapy shows promise as antidote for carbon monoxide poisoning

(medschool.umaryland.edu)

219 points | by breve 22 hours ago

13 comments

  • jfarlow 18 hours ago
    Here's the full sequence of the protein, found in the supplement [1]

    KSSEPASVSAAERRAETEQHKLEQENPGIVWLDQHGRVTAENDVALQILGPAGEQSLGVAQDSLEGIDVVQLHPEKSRDKLRFLLQSKDVGGSPVKSPPPVAMMINIPDRILMIKVSSMIAAGGASGTSMIFYDVTDLTTEPSGLPAGGSAPSHHHHHH

    It is a protein encoding the PxRcoM-1 heme binding domain with C94S mutation and a C-terminal 6xHis tag (RcoM-HBD-C94S)

    [1] https://www.pnas.org/doi/10.1073/pnas.2501389122#supplementa...

    • meisel 16 hours ago
      Thanks for that sequence, I can really picture it now
    • mhb 15 hours ago
      That doesn't look right. I think the problem is in the last quarter. Exercise for the reader.
    • sunrunner 16 hours ago
      This looks like an puzzle input to a day from Advent of Code.
    • BurningFrog 8 hours ago
      How hard is it to manufacture once you know the sequence?
  • hinkley 17 hours ago
    > Infused in the bloodstream, scavenger hemoproteins like RcoM-HBD-CCC rapidly bind to carbon monoxide molecules, reducing the time it takes to clear half of the carbon monoxide in the blood to less than a minute, compared to more than hour with pure oxygen therapy and five hours without any treatment.
    • lawlessone 15 hours ago
      I can see a market in selling this to urban cyclists..

      I've seen people doing that get quite a bit of exhaust fumes to the face.

      • hinkley 13 hours ago
        Breath control is an underrated skill.
  • kazinator 17 hours ago
    The existing methylene blue substance is also effective in cases of CO poisoning.

    1933 paper:

    https://journals.physiology.org/doi/abs/10.1152/ajplegacy.19...

    "Methylene Blue as an Antidote to CO Poisoning", Matilda Moldenhauer Brooks

    • skadamou 16 hours ago
      This paper is interesting but I want to point out there is a difference between a research paper showing that something is hypothetically feasible and something that is actually useful clinically.

      Clinically, methylene blue is used to treat a different condition, methemeglobinemia and is not used to treat carbon monoxide poisoning which relies on hyperbaric oxygen therapy.

      • kazinator 13 hours ago
        The researcher used non-human animals; it worked on them.

        The hypothetical part was only that it might also work on humans.

        In any case, it seems the result was good enough as a clinical trial from the point of view of veterinary medicine, in regard to those specific types of animals.

        • amy_petrik 8 hours ago
          We really shouldn't be taking chemicals used on animals for veteran purposes and use them on humans too. For example, ivermectin. It's a drug meant for horses similar to another horse tranquilizer, ketamine. Can you imagine a human taking ivermectin or ketamine?!? I remember during COVID people were shooting up horse medicine and it was just really bad and upsetting, like these people were crazy. I wish Kamala had won and would have banned this horse medicines like ivermectin.

          And now this whole methylene blue thing, RFK takes methylene blue. I mean, guys, this isn't even a horse veteran medicine, it's basically ink used to stain cells. I'm sorry, but everything that has an ink or pigmented color it, there is no way on earth it has a medicinal purpose. I mean. It's ink, nothing more.

          • kazinator 8 hours ago
            > We really shouldn't be taking chemicals used on animals for veteran purposes and use them on humans too.

            While I totally agree in principle, the specific substance in question (methylene blue) is used on humans already (or should I add was used, at the time of the 1933 study), and for a related emergency purpose: fixing hemoglobin that is poisoned in a certain way, giving rise to a condition called methemoglobinemia.

            > And now this whole methylene blue thing, RFK takes methylene blue.

            I have no idea about that; I don't follow tabloid stuff.

            Methylene blue isn't a now thing; it's been known for a hundred years or more.

            > there is no way on earth it has a medicinal purpose

            You might be in for a surprise when you do a 15 second web search on it.

            RFK playing around with methylene blue doesn't mean anything. If he happens to ascribing to it properties it doesn't have and using it for situations for which it has not been proven, he's engaging in dangerous quackery.

            People kill themselves with fentanyl, yet it's an important drug, and on the World Health's Organization list of Essential Medicines: https://list.essentialmeds.org/ (scroll down to the F section).

            Oh, look what else is in this list of essential medicines! Methylthioninium chloride. A.k.a. methylene blue.

            Yet here you are, claiming that there is no way it has a medicinal purpose?! But you're sure you are smarter than that RFK.

          • phatskat 3 hours ago
            > Can you imagine a human taking ivermectin or ketamine?!?

            While I can only believe the ivermectin stuff because it happened (and the crossover of people who took it is pretty strong with people likely to think drinking bleach cures autism…), I 100% can believe people take ketamine because I have, and I will again - it’s fun!

            Note to the curious: always do your homework. Start at Erowid and learn about any new drug, be sure to get reliably safe drugs, and the golden rule (via Rick and Morty during a Deadmau5 NYE of all places): you can always take more drugs, but you can never take less.

  • PaulHoule 8 hours ago
    I guess CO kills you because it sticks to a protein (Hemoglobin), this is a protein that it binds even tighter to.

    What I find hilarious though is that my RSS reader loves to show me articles about ways of turning the harmful gas CO2 into the useful gas CO, back when I was a kid it was the other way around!

  • searine 19 hours ago
    This research was funded by multiple NIH grants, a Department of Defense grant, and the Martin Family Foundation.
  • dtgriscom 20 hours ago
    How is this administered? Seems like a crucial detail to omit.
    • elric 19 hours ago
      > This has the potential to become a rapid, intravenous antidote for carbon monoxide

      So intravenously, presumably.

    • DonHopkins 19 hours ago
      You can spread it on bread, melt it over pancakes, rub it all over corn on the cob, put it in baked potatoes, etc, promise!
  • sandworm101 15 hours ago
    CO poisioning is one of those strange cases treatable using scuba diving. Recompression therapy, which can be theoretically aped under water, can be like magic. In some cases the patient just wakes up like nothing is wrong. No drugs. No invasive treatment. Get deep enough and hemoglobin isnt totally necessary for getting O2 where it needs to be.

    https://www.ncbi.nlm.nih.gov/books/NBK470531/

  • bananapub 20 hours ago
    not very on topic, but for those who missed one of the more surreal reddit threads in history:

    - [MA] Post-it notes left in apartment [0]

    - and the update from OP a while later [1]

    [0]: https://www.reddit.com/r/legaladvice/comments/34l7vo/ma_post...

    [1]: https://www.reddit.com/r/AskReddit/comments/49zfvb/what_is_t...

    • gus_massa 20 hours ago
      It looks like he found a note in his room and see some strange thing in the window, and someone somehow says it's CO but it may be that the OP has unrelated hallucinations. Is this a symptom of CO poisoning? I think you only get sleepy, faint and die.
      • phatskat 3 hours ago
        Reading in a bit more, the second post links to a comment thread where further down they talk about post-it notes.

        The original thread about the post its had some updates along the lines of: someone in comments suggested OP get a CO detector. OP says “ya know, I have one. Maybe I should take it out of the box and plug it in.” Later OP said their detector rated the CO at 100ppm! They went to the hospital lol.

        Last update I saw was four months after - OP was guessing their recovery would go on for another year, and there was likely some permanent damage but overall they felt confident at getting back to 80%, maybe even 99%.

      • maxbond 19 hours ago
        Chronic exposure can lead to memory loss, yes. You're describing the symptoms of acute exposure.
      • hinkley 19 hours ago
        CO exposure is accumulative. If you’re around an intense source of it you’re toast. But with a small point source or decent ventilation it kills you slower.

        And your body produces new blood cells every day, so minor sources like wood smoke or burning a candle don’t dose you enough to be a problem, unless perhaps your day job is as an athlete.

        • hinkley 17 hours ago
          Also looks like the half-life of CO in the blood is around five hours.
  • pfdietz 15 hours ago
    This looks like a therapy you can only get once in your life, after which it has acted like a vaccine and your immune system would react to it.
    • dekhn 11 hours ago
      Typically, protein therapeutics are "humanized" before being pushed through the drug approval process. Part of that is ensuring that the therapeutic isn't extremely likely to trigger an immune response. It's a nontrivial problem.
    • isk517 14 hours ago
      If getting carbon monoxide poisoning once isn't enough to make you invest in a few detectors then I don't know what will
  • DonHopkins 22 hours ago
    >New Protein Therapy Shows Promise as Antidote for Carbon Monoxide Poisoning

    So Shatner was right all along: not only is Promise Margarine good for lowering your cholesterol level, but it can also treat carbon monoxide poisoning! And it tastes like butter, promise.

    https://www.youtube.com/watch?v=n3wf717fKFE

    • majkinetor 21 hours ago
      I don't see a relation of any kind and I hate commercials maybe more than anybody else, but it's always a good time for a funny one with Shatner :)
      • DonHopkins 19 hours ago
        Sheez, I can't believe I have to explain that Shatner shows Promise as antidote for high cholesterol too.
        • selimthegrim 16 hours ago
          He just played New Orleans. Somebody should’ve been throwing tubs of Promise margarine at the stage.
  • heyoleftycunts 16 hours ago
    [flagged]
  • narrator 21 hours ago
    [flagged]
    • skadamou 18 hours ago
      Methylene blue is actually used to treat acquired cases of a similar condition called methemeglobinemia which is when the iron in heme is oxide from Fe2+ to Fe3+ [1]. This is different from carbon monoxide poisoning which is caused by carbon monoxide binding more tightly to hemoglobin than oxygen preventing oxygen from effectively getting into your blood.

      [1] https://www.uptodate.com/contents/methemoglobinemia?search=m...

      • Herodotus38 17 hours ago
        Ahh I bet that is where the confusion is. I am a physician and I have used methylene blue in severe shock and methemoglobinemia but I was a bit worried the parent comment believed it’s a valid CO treatment.
      • kazinator 17 hours ago
        Initially suspecting that since CO poisoning and methemeglobinemia are not the same, methylene blue might not work in CO cases, I did about three seconds of web searching and found a 1933 paper about an experiment (on animals) showing methylene blue to be effective in CO poisoning.
    • Herodotus38 19 hours ago
      Hello, I would be interested if you could give evidence that methylene blue "works great" for carbon monoxide poisoning in humans.

      It is not the standard of care in any guidelines I can find from any country. There is a paper from 2018 out of china showing some benefit in a rat model: https://onlinelibrary.wiley.com/doi/10.1111/bcpt.12940

    • gus_massa 20 hours ago
      IANAMD I made a quick search and the evidence of methylene blue as a carbon monoxide antidote looks controversial.

      IIUC part of the effect is oxidizing/reducing the iron atom in the hemoglobin, and that changes how strong is the bound with the O2, CO, NO. But my chemistry is not enough to give a good guess of the results.

    • EvanAnderson 21 hours ago
      Methylene blue has a fun/shocking side-effect.
    • majkinetor 21 hours ago
      God forbid we have alternatives that work in minutes
      • lagniappe 19 hours ago
        Given that MB is commonly supported by those with right leaning politics, if the above is true, it won't be reported on for risk of appearing to support the "wrong" party.
        • darth_avocado 19 hours ago
          Why would a treatment be not made available if it’s effective? What’s the conspiracy in letting people suffer and die?
          • immibis 14 hours ago
            Well, money would be the most obvious one, but the parent comment is talking about the anti-science regime currently in power in the USA. I can't remember which, but I thought I read they banned some effective treatments because RFK Jr (famous conspiracy theorist now in charge of the country's health) didn't believe in them. They shut down research into mRNA medicines. at least, because they think it's population control to keep you docile, or something like that. There was also a mass shooting at a CDC office on similar grounds.
        • jayd16 19 hours ago
          It's been around for a century but it's a political conspiracy to keep it unknown??
        • Traubenfuchs 19 hours ago
          [flagged]
          • jrajav 19 hours ago
            "hey, speeding down the highway 35mph over the limit could kill you, especially if you are fat and old. you SHOULD drive under the speed limit, but you don't have to."

            No, the point is that it could kill other people. Speed all you want when you're on your own private roads.

            Laws are generally meant to ensure public safety and the ability for us to live and cooperate together with mutual trust. They usually do end up restricting your personal freedoms to that end. Deal with it.

          • tekno45 19 hours ago
            [flagged]