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Open AccessReview

The Role of Heme Oxygenase-1 in Remote Ischemic and Anesthetic Organ Conditioning

Department of Anesthesiology, University Hospital Duesseldorf, 40225 Duesseldorf, Germany
Author to whom correspondence should be addressed.
Antioxidants 2019, 8(9), 403;
Received: 29 July 2019 / Revised: 12 September 2019 / Accepted: 12 September 2019 / Published: 16 September 2019
The cytoprotective effects of the heme oxygenase (HO) pathway are widely acknowledged. These effects are mainly mediated by degradation of free, pro-oxidant heme and the generation of carbon monoxide (CO) and biliverdin. The underlying mechanisms of protection include anti-oxidant, anti-apoptotic, anti-inflammatory and vasodilatory properties. Upregulation of the inducible isoform HO-1 under stress conditions plays a crucial role in preventing or reducing cell damage. Therefore, modulation of the HO-1 system might provide an efficient strategy for organ protection. Pharmacological agents investigated in the context of organ conditioning include clinically used anesthetics and sedatives. A review from Hoetzel and Schmidt from 2010 nicely summarized the effects of anesthetics on HO-1 expression and their role in disease models. They concluded that HO-1 upregulation by anesthetics might prevent or at least reduce organ injury due to harmful stimuli. Due to its clinical safety, anesthetic conditioning might represent an attractive pharmacological tool for HO-1 modulation in patients. Remote ischemic conditioning (RIC), first described in 1993, represents a similar secure option to induce organ protection, especially in its non-invasive form. The efficacy of RIC has been intensively studied herein, including on patients. Studies on the role of RIC in influencing HO-1 expression to induce organ protection are emerging. In the first part of this review, recently published pre-clinical and clinical studies investigating the effects of anesthetics on HO-1 expression patterns, the underlying signaling pathways mediating modulation and its causative role in organ protection are summarized. The second part of this review sums up the effects of RIC. View Full-Text
Keywords: heme oxygenase-1; remote ischemic conditioning; anesthetic conditioning; organ protection heme oxygenase-1; remote ischemic conditioning; anesthetic conditioning; organ protection
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Bauer, I.; Raupach, A. The Role of Heme Oxygenase-1 in Remote Ischemic and Anesthetic Organ Conditioning. Antioxidants 2019, 8, 403.

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