Clinical Significance of Serum Hemeoxygenase-1 as a New Biomarker for the Patients with Interstitial Pneumonia

Abstract

Background Serum hemeoxygenase-1 (HO-1) has been proposed to be a biomarker of lung disease activity and prognosis. The present study aimed at evaluating whether HO-1 could be a useful marker for evaluating disease activity and predicting prognosis in patients with interstitial pneumonia (IP). Materials and Methods Serum HO-1 levels of newly diagnosed or untreated patients with IP were measured at hospitalization. We evaluated the relationships between serum HO-1 and other serum biomarkers, high resolution CT (HRCT) findings, and hospital mortality. Results Twenty-eight patients with IP, including 14 having an acute exacerbation (AE) and 14 not having an AE, were evaluated. The patients having an AE had significantly higher HO-1 levels than those not having an AE (53.5 ng/mL vs. 24.1 ng/mL; p < 0.001), and the best cut-off level to discriminate between having an AE or not having an AE was 41.6 ng/mL. Serum HO-1 levels were positively correlated with serum levels of surfactant protein-D (r=0.66, p < 0.001) and the ground glass opacity score (calculated from HRCT; r=0.40, p=0.036). Patients who subsequently died in hospital had presented with significantly higher HO-1 levels than those who did not die in hospital (64.8 ng/mL vs. 32.0 ng/mL; p=0.009). Conclusion Serum HO-1 may serve as a useful biomarker for detecting AE or predicting hospital mortality in patients with IP.

Aging and Progression of Beta-Amyloid Pathology in Alzheimer’s Disease Correlates with Microglial Heme-Oxygenase-1 Overexpression

“…HO-1 is suggested to be released to the extracellular space by exocytosis or via exosomes [54]. This is in line with studies that reported that HO-1 is up-regulated in cerebrospinal fluid (CSF) or plasma in different inflammatory-related diseases [55,56]. In fact, in PD patients HO-1 was found up-regulated in the saliva, CSF and plasma [57][58][59].…”

Serum Heme Oxygenase-1 Measurement is Useful for Evaluating Disease Activity and Outcomes in Patients With Acute Respiratory Distress Syndrome and Acute Exacerbation of Interstitial Lung Disease

“…Mumby et al reported that HO-1 protein concentrations are signi cantly elevated in lung tissue and bronchoalveolar lavage uid taken from ARDS patients compared with controls, and HO-1 expression contributes to changes in iron mobilization, signalling, and regulation seen in this condition (11). We have also demonstrated the usefulness of measuring serum HO-1 in the diagnosis and prognosis of patients with ARDS and AE-ILDs (12,13).…”

“…HO-1, a rate-limiting enzyme in heme catabolism, has antioxidative activities in patients with diffuse parenchymal lung disease (17)(18)(19). We previously investigated whether evaluating the degree of oxidative stress by measuring serum HO-1 using the sandwich ELISA method is useful for assessing disease activities and predicting prognosis in patients with ARDS and AE-ILDs (12,13). The present study was an integrated analysis of these.…”

“…As a protective reaction against oxidative stress, HO-1 protein has been reported to increase in lung tissue including alveolar macrophages, alveolar and bronchial epithelium, interstitium, and endothelium taken from patients with ARDS or AE-ILDs, contributing to the changes in iron mobilization, signalling, and regulation seen in these conditions (11,13). We found that in the patient with AE of idiopathic pulmonary brosis (IPF), high HO-1 expression was observed mainly in alveolar macrophages, while HO-1 expression in brotic lesions or alveolar macrophages was not conspicuous in stable IPF (20).…”

Serum heme oxygenase-1 measurement is useful for evaluating disease activity and outcomes in patients with acute respiratory distress syndrome and acute exacerbation of interstitial lung disease

“…Mumby et al reported that HO-1 protein concentrations are signi cantly elevated in lung tissue and bronchoalveolar lavage uid taken from ARDS patients compared with controls, and HO-1 expression contributes to changes in iron mobilization, signalling, and regulation seen in this condition (18). Also, we have demonstrated the usefulness of measuring serum HO-1 in the diagnosis and prognosis of patients with ARDS and AE-ILDs (19,20). Therefore, we speculate that HO-1 characterized as stress response protein with rapid response induced by various stimuli and with various physiological activities caused by HO-1 metabolites could re ect pulmonary cellular damage induced by ROS and RNS more closely and directly.…”