Beneficial effects of the heme oxygenase-1/carbon monoxide system in patients with severe sepsis/septic shock.
OBJECTIVE
We evaluated the relations among the arterial carbon monoxide (CO) concentration, heme oxygenase (HO)-1 expression by monocytes, oxidative stress, plasma levels of cytokines and bilirubin, and the outcome of patients with severe sepsis or septic shock.


METHODS
Thirty-six patients who fulfilled the criteria for severe sepsis or septic shock and 21 other patients without sepsis during their stay in the intensive care unit were studied. HO-1 protein expression by monocytes, arterial CO, oxidative stress, bilirubin, and cytokines were measured.


RESULTS
Arterial blood CO, cytokine, and bilirubin levels, and monocyte HO-1 protein expression were higher in patients with severe sepsis/septic shock than in non-septic patients. Increased HO-1 expression was related to the arterial CO concentration and oxidative stress. There was a positive correlation between survival and increased HO-1 protein expression or a higher CO level.


CONCLUSIONS
Arterial CO and monocyte HO-1 protein expression were increased in critically ill patients, particularly those with severe sepsis or septic shock, suggesting that oxidative stress is closely related to HO-1 expression. The HO-1/CO system may play an important role in sepsis.
Department of Emergency and Critical Care Medicine, Aichi Medical University, Nagakute-cho, Aichi, Japan, takaki@aichi-med-u.ac.jp.
Shoji
S
Takaki
Naoshi
N
Takeyama
Yuka
Y
Kajita
Teru
T
Yabuki
Hiroki
H
Noguchi
Yasuo
Y
Miki
Yasusuke
Y
Inoue
Takashi
T
Nakagawa
Hiroshi
H
Noguchi
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000368:Aged; D001663:Bilirubin / Q000378:metabolism; D002248:Carbon Monoxide / Q000378:metabolism*; D003422:Critical Care / Q000379:methods; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000235:genetics / Q000378:metabolism; D005260:Female; D051547:Heme Oxygenase-1 / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D018384:Oxidative Stress / Q000502:physiology; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*
D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D002248:Carbon Monoxide; D000080242:8-Hydroxy-2'-Deoxyguanosine; D051547:Heme Oxygenase-1; D003849:Deoxyguanosine; D001663:Bilirubin