Hemoglobin (AMENIA)

A protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body and carries carbon dioxide back to the lungs. Testing for the amount of hemoglobin in the blood is usually part of a complete blood cell (CBC) test.

Hemoglobin, an iron-containing protein in the blood of many animals—in the red blood cells (erythrocytes) of vertebrates—that transports oxygen to the tissues. Hemoglobin forms an unstable reversible bond with oxygen. In the oxygenated state, it is called oxyhemoglobin and is bright red; in the reduced state, it is purplish-blue.

Hemoglobin develops in cells in the bone marrow that become red blood cells. When red cells die, hemoglobin is broken up: iron is salvaged, transported to the bone marrow by proteins called transferrins, and used again in the production of new red blood cells; the remainder of the hemoglobin forms the basis of bilirubin, a chemical that is excreted into the bile and gives the feces their characteristic yellow-brown color.

Each hemoglobin molecule is made up of four heme groups surrounding a globin group, forming a tetrahedral structure. Heme, which accounts for only 4 percent of the weight of the molecule, is composed of a ringlike organic compound known as a porphyrin to which an iron atom is attached. It is the iron atom that binds oxygen as the blood travels between the lungs and the tissues. There are four iron atoms in each molecule of hemoglobin, which accordingly can bind four molecules of oxygen. Globin consists of two linked pairs of polypeptide chains.

Hemoglobin S is a variant form of hemoglobin that is present in persons who have sickle cell anemia, a severe hereditary form of anemia in which the cells become crescent-shaped when oxygen is lacking. The abnormal sickle-shaped cells die prematurely and may become lodged in small blood vessels, potentially obstructing the microcirculation and leading to tissue damage. The sickling trait is found mainly in people of African descent, though the disease also occurs in persons of Middle Eastern, Mediterranean, or Indian descent.