Heme oxygenase-1 system, inflammation and ventilator-induced lung injury.
Mechanical ventilation is an indispensable supportive intervention for acute respiratory failure. However, mechanical ventilation can provoke ventilator-induced lung injury, which remains one of the major causes of morbidity and mortality in critically ill patients. Excessive inflammatory response characterized by infiltration of inflammatory cells and overproduction of inflammatory mediators contributes to the pathogenesis of ventilator-induced lung injury. At present, apart from the protective ventilation strategy, no other pharmacological intervention is available to attenuate ventilator-induced lung injury. Heme oxygenase-1 (HO-1) is the inducible isoform of the first and rate-limiting enzyme which degrades heme into carbon monoxide, ferritin and bilirubin. Accumulating evidence suggests that HO-1 system may function as a crucial negative regulator in the modulation of inflammatory process. This anti-inflammatory action of HO-1 is mediated essentially by the regulation of the key cells involved in inflammation and restoration of the balance between pro-inflammatory and anti-inflammatory mediators. Therefore, HO-1 system represents a promising therapeutic target for intervention of ventilator-induced lung injury.
Nanlou respiratory diseases department, Chinese PLA General Hospital, Beijing 100853, China.
Li
L
An
Chang-Ting
CT
Liu
Min-Jun
MJ
Yu
Zhen-Hong
ZH
Chen
Xue-Guang
XG
Guo
Peng-Wang
Jun-Feng
JF
Wang
Xiang-Qun
XQ
Fang
Yan-Hong
YH
Gao
Sen-Yang
SY
Yu
D000818:Animals; D051547:Heme Oxygenase-1 / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D055397:Ventilator-Induced Lung Injury / Q000201:enzymology* / Q000276:immunology / Q000517:prevention & control / Q000628:therapy
D051547:Heme Oxygenase-1