NG. Genetic suppression of HO-1 exacerbates renal damage: reversed by an increase in the antiapoptotic signaling pathway. Am J Physiol Renal Physiol 292: F148 --F157, 2007. First published August 29, 2006; doi:10.1152/ajprenal.00261.2006.-Apoptosis has been shown to contribute to the development of acute and chronic renal failure. The antiapoptotic action of the heme oxygenase (HO) system may represent an important protective mechanism in kidney pathology. We examined whether the lack of HO-1 would influence apoptosis in clipped kidneys of two-kidney, one-clip (2K1C) rats. Five-day-old Sprague-Dawley rats were injected in the left ventricle with Ϸ5 ϫ 10 9 colony-forming units/ml of retrovirus containing rat HO-1 antisense (LSN-RHO-1-AS) or control retrovirus (LXSN). After 3 mo, a 0.25-mm U-shaped silver clip was placed around the left renal artery. Animals were killed 3 wk later. Clipping the renal artery in LSN-RHO-1-AS rats did not result in increased HO-1 expression. In contrast to LXSN animals, 2K1C LSN-RHO-1-AS rats showed increased expression of cyclooxygenase 2 (COX-2) and higher 3-nitrotyrosine (3-NT) content as well as increased expression of the proapoptotic protein Apaf-1 and caspase-3 activity. Clipping the renal artery in LXSN rats resulted in increased expression of the antiapoptotic proteins Bcl-2 and Bcl-xl, while clipping the renal artery in LSN-RHO-1-AS rats did not change Bcl-2 levels and decreased the levels of Bcl-xl. Treatment of LSN-RHO-1-AS rats with cobalt protoporphyrin resulted in induction of renal HO-1, which was accompanied by decreases in blood pressure, COX-2, 3-NT, and caspase-3 activity, and increased expression of anti-apoptotic molecules (Bcl-2, Bcl-xl, Akt and p-Akt) in the clipped kidneys. These findings underscore the prominent role of HO-1 in counteracting apoptosis in this 2K1C renovascular hypertension model. heme oxygenase; hypertension; 2K1C; apoptosis; oxidative stress HEME OXYGENASE (HO) CATALYZES the rate-liming step in heme degradation, producing iron, carbon monoxide (CO), and biliverdin, which is rapidly converted to bilirubin. Two major HO isoforms, the products of two distinct genes, have been described: HO-1, an inducible isoform, and HO-2, a constitutively expressed isoform. HO-1 is induced by heme and a variety of nonheme stimuli, including heavy metals, reactive oxygen species (ROS), nitric oxide (NO), ANG II, endotoxin, and cytokines (1, 2). In general, upregulation of HO-1 serves as an adaptive and beneficial response to these stimuli.Induction of HO-1 has been shown to play a cytoprotective role in renal injury secondary to rhabdomyolysis (32), ischemia-reperfusion injury (31), glomerulonephritis (16), renal transplant rejection (7), and nephrotoxins (e.g., cisplatin) (4). Under these conditions, the protective effects of HO were related to degradation of the toxic free-heme moiety and stimulation of efflux of prooxidant iron from the cells, and also to the biological actions of bilirubin, a potent antioxidant (41) and CO, a vasodilatory and anti-infla...