Heme oxygenase-1 system, inflammation and ventilator-induced lung injury
Heme oxygenase-1 system, inflammation and ventilator-induced lung injury
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DOI：
10.1016/j.ejphar.2011.12.010
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发表时间：
2012-02-29
影响因子：
5
通讯作者：
Yu, Sen-Yang
中科院分区：
文献类型：
--
作者：
An, Li;Liu, Chang-Ting;Yu, Sen-Yang
机械通气是治疗急性呼吸衰竭不可或缺的支持性干预措施。然而，机械通气可引起呼吸机所致的肺损伤，这仍然是危重病患者发病率和死亡率的主要原因之一。以炎性细胞浸润和炎性介质过度产生为特征的过度炎症反应参与了呼吸机相关性肺损伤的发病机制。目前，除保护性通气策略外，尚无其他药物干预措施可减轻呼吸机所致的肺损伤。血红素加氧酶-1(HO-1)是第一种限速酶的诱导型异构体，它能将血红素降解为一氧化碳、铁蛋白和胆红素。越来越多的证据表明，HO-1系统可能在炎症过程的调控中发挥重要的负调控作用。HO-1的这种抗炎作用主要是通过调节参与炎症的关键细胞和恢复促炎和抗炎介质之间的平衡来实现的。因此，HO-1系统有望成为呼吸机相关性肺损伤干预的治疗靶点。(C)2011爱思唯尔B.V.保留所有权利。
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 proinflammatory and anti-inflammatory mediators. Therefore, HO-1 system represents a promising therapeutic target for intervention of ventilator-induced lung injury. (C) 2011 Elsevier B.V. All rights reserved.