Stability and repair of DNA is of principal importance in cell survival. Heme oxygenase-1 (HO-1; Hmox1) is critical in maintaining cellular homeostasis, in large part through its ability to generate CO, but neither molecule has been studied in the setting of DNA damage. Naïve Hmox1 −/− mice exhibit excessive tissue levels of γ-histone H2A, whereas administration of genotoxic stressors or irradiation in HO-1-deficient cells resulted in loss of ataxia-telangiectasia mutated/ataxia telangiectasia and Rad3-related protein and breast cancer 1, early onset induction with dysfunctional γ-H2AX foci and marked elevations in DNA damage. HO-1 induction or exposure to CO induced homologous recombination-mediated DNA repair through ataxia-telangiectasia mutated/ataxia telangiectasia and Rad3-related protein. In vivo, exposure of mice to CO followed by genotoxin (Adriamycin) or radiation-induced injury led to diminished tissue DNA damage and improved survival. We characterize a joint role for HO-1 and the gasotransmitter CO for appropriate DNA repair and provide a mechanism for their potent cytoprotective effects in various pathologies.chemotherapy | heme degradation | gas biology | cytoprotection E fficient DNA damage repair and checkpoint mechanisms are critical components of normal cellular function to maintain the integrity of genomic DNA (reviewed in refs. 1 and 2). DNA lesions are induced in response to UV or ionizing radiation as well as many chemicals including endogenous metabolites and reactive oxygen species (ROS) (1). DNA repair pathways include repair of damaged bases or single-strand DNA breaks (base excision repair) and repair of double-strand DNA breaks (DSB) including homologous recombination (HR) and nonhomologous end-joining (NHEJ). The cellular response to DNA DSBs occurs via an integrated sensing and signaling network that maintains and restores genomic stability (3). DSBs are detected initially by damage sensors that trigger the activation of transducing kinases. These transducers amplify the damage signal and relay it to effector proteins, which in turn regulate cell-cycle progression, DNA repair, and apoptosis (4). DSBs are recognized by the Mre11-Rad50-Nbs1 (MRN) mediator complex which recruits ataxia telangiectasia-mutated (ATM) to the broken DNA (4). Cells also are faced with detection of replication blocks, which is mediated by an ssDNA-replication protein A complex recruiting the kinases ataxia-telangiectasia and rad3-related (ATR) and Rad17 (5). Both ATR and ATM can phosphorylate multiple target proteins [p53 binding protein 1, breast cancer 1, early onset (Brca1), checkpoint kinase 1, checkpoint kinase 2 (Chk2), and the MRN complex, among others; more than 700 proteins have been identified so far] that mediate the downstream signaling. Further, in response to DNA damage or structural alterations of chromatin, histone H2A is phosphorylated on Ser139 by ATM, ATR, or by DNA-dependent protein kinases. This phosphorylation allows recruitment of additional DNA damage-responsive proteins and the format...