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After subarachnoid hemorrhage (SAH), free Hb enters the VRS, and monocytes also enter VRS through recruitment. ADAM17 responds rapidly to thrombin stimulation, and CD163 is cleaved to produce a free form of CD163 (sCD163). After binding to hemoglobin (Hb), sCD163 inhibits the autoxidation of Hb on the one hand, and furtherly forms a complex with IgG on the other hand. The complex is recognized by macrophages, endothelial cells, and monocytes via the FcγR to achieve Hb clearance.
