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Endogenous carbon monoxide production correlates weakly with severity of acute illness

Published online by Cambridge University Press:  20 January 2006

M. Scharte
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
T. A. von Ostrowski
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
F. Daudel
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
H. Freise
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
H. Van Aken
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
H. G. Bone
Affiliation:
Universitätsklinikum Münster, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Muenster, Germany
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Summary

Background and objective: The enzyme haeme oxygenase-1 is highly inducible by oxidative agents. Its product carbon monoxide is thought to exert anti-inflammatory properties. We recently showed, that critically ill patients produce higher amounts of carbon monoxide compared to healthy controls. In the present study we compare endogenous carbon monoxide production with the severity of illness of intensive care unit patients. Methods: Exhaled carbon monoxide concentration was measured in 95 mechanically ventilated, critically ill patients (mean age ± SD, 59.5 ± 15.7) on a carbon monoxide monitor. Measurements were taken every hour for 24 h in each patient. Data were analysed using Mann–Whitney rank sum test. Correlation analysis was performed with the Spearman's rank order correlation. Results: Carbon monoxide production correlated weakly with the multiple organ dysfunction score (R = 0.27; P = 0.009). Patients suffering from cardiac disease (median 22.5, interquartile range 16.2–27.4 μL kg−1 h−1 vs. median 18.2, interquartile range 14.2–21.8 μL kg−1 h−1, P = 0.008) and critically ill patients undergoing dialysis (median 25.0, interquartile range 21.4–30.2 μL kg−1 h−1, vs. median 19.4, interquartile range 14.7–23.3 μL kg−1 h−1, P = 0.004) produced significantly higher amounts of carbon monoxide compared to critically ill controls. Conclusion: The findings suggest that endogenous carbon monoxide production might reflect the severity of acute organ dysfunction.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

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References

Montellano PR. The mechanism of heme oxygenase. Curr Opin Chem Biol 2000; 4: 221227.Google Scholar
Maines MD. The heme oxygenase system: a regulator of second messenger gases. Annu Rev Pharmacol Toxicol 1997; 37: 517554.Google Scholar
Terry MJ, Linley PJ, Kohchi T. Making light of it: the role of plant haem oxygenases in phytochrome chromophore synthesis. Biochem Soc Trans 2002; 30: 604609.Google Scholar
Immenschuh S, Ramadori G. Gene regulation of heme oxygenase-1 as a therapeutic target. Biochem Pharmacol 2000; 60: 11211128.Google Scholar
Wagener FA, Volk HD, Willis D et al. Different faces of the heme-heme oxygenase system in inflammation. Pharmacol Rev 2003; 55: 551571.Google Scholar
Morse D, Choi AM. Heme oxygenase-1: the ‘emerging molecule’ has arrived. Am J Respir Cell Mol Biol 2002; 27: 816.Google Scholar
Otterbein LE, Choi AM. Heme oxygenase: colors of defense against cellular stress. Am J Physiol Lung Cell Mol Physiol 2000; 279: L1029L1037.Google Scholar
Horvath I, Donnelly LE, Kiss A et al. Raised levels of exhaled carbon monoxide are associated with an increased expression of heme oxygenase-1 in airway macrophages in asthma: a new marker of oxidative stress. Thorax 1998; 53: 668672.Google Scholar
Yamaya M, Sekizawa K, Ishizuka S et al. Increased carbon monoxide in exhaled air of subjects with upper respiratory tract infections. Am J Respir Crit Care Med 1998; 158: 311314.Google Scholar
Zayasu K, Sekizawa K, Okinaga S et al. Increased carbon monoxide in exhaled air of asthmatic patients. Am J Respir Crit Care Med 1997; 156: 11401143.Google Scholar
Zegdi R, Perrin D, Burdin M, Boiteau R, Tenaillon A. Increased endogenous carbon monoxide production in severe sepsis. Intens Care Med 2002; 28: 793796.Google Scholar
Scharte M, Bone HG, Van Aken H, Meyer J. Increased carbon monoxide in exhaled air of critically ill patients. Biochem Biophys Res Commun 2000; 267: 423426.Google Scholar
Bone RC, Balk RA, Cerra FB et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 16441655.Google Scholar
Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 2000; 162: 505511.Google Scholar
Draeger-Sicherheitstechnik, Draeger Sensor CO LS – 6808820 Data Sheet. Luebeck, 1997.
Monma M, Yamaya M, Sekizawa K et al. Increased carbon monoxide in exhaled air of patients with seasonal allergic rhinitis. Clin Exp Allergy 1999; 29: 15371541.Google Scholar
Kitada O, Kodama T, Kuribayashi K et al. Heme oxygenase-1 (HO-1) protein induction in a mouse model of asthma. Clin Exp Allergy 2001; 31: 14701477.Google Scholar
Amersi F, Buelow R, Kato H et al. Upregulation of heme oxygenase-1 protects genetically fat Zucker rat livers from ischemia/reperfusion injury. J Clin Invest 1999; 104: 16311639.Google Scholar
Siow RC, Sato H, Mann GE. Heme oxygenase-carbon monoxide signalling pathway in atherosclerosis: anti-atherogenic actions of bilirubin and carbon monoxide? Cardiovasc Res 1999; 41: 385394.Google Scholar
Tullius SG, Nieminen-Kelha M, Bachmann U et al. Induction of heme-oxygenase-1 prevents ischemia/reperfusion injury and improves long-term graft outcome in rat renal allografts. Transplant Proc 2001; 33: 12861287.Google Scholar
Tamion F, Richard V, Bonmarchand G et al. Induction of heme-oxygenase-1 prevents the systemic responses to hemorrhagic shock. Am J Respir Crit Care Med 2001; 164: 19331938.Google Scholar
Hancock WW, Buelow R, Sayegh MH, Turka LA. Antibody-induced transplant arteriosclerosis is prevented by graft expression of anti-oxidant and anti-apoptotic genes. Nat Med 1998; 4: 13921396.Google Scholar
Li L, Hamilton Jr RF, Holian A. Protection against ozone-induced pulmonary inflammation and cell death by endotoxin pretreatment in mice: role of HO-1. Inhal Toxicol 2000; 12: 12251238.Google Scholar
Wagener FA, Eggert A, Boerman OC et al. Heme is a potent inducer of inflammation in mice and is counteracted by heme oxygenase. Blood 2001; 98: 18021811.Google Scholar
Rucker M, Schafer T, Roesken F et al. Reduction of inflammatory response in composite flap transfer by local stress conditioning-induced heat-shock protein 32. Surgery 2001; 129: 292301.Google Scholar
Vachharajani TJ, Work J, Issekutz AC, Granger DN. Heme oxygenase modulates selectin expression in different regional vascular beds. Am J Physiol Heart Circ Physiol 2000; 278: H1613H1617.Google Scholar
Hayashi S, Takamiya R, Yamaguchi T et al. Induction of heme oxygenase-1 suppresses venular leukocyte adhesion elicited by oxidative stress: role of bilirubin generated by the enzyme. Circ Res 1999; 85: 663671.Google Scholar
Song R, Mahidhara RS, Liu F et al. Carbon monoxide inhibits human airway smooth muscle cell proliferation via mitogen-activated protein kinase pathway. Am J Respir Cell Mol Biol 2002; 27: 603610.Google Scholar
Brouard S, Otterbein LE, Anrather J et al. Carbon monoxide generated by heme oxygenase 1 suppresses endothelial cell apoptosis. J Exp Med 2000; 192: 10151026.Google Scholar
Otterbein LE, Bach FH, Alam J et al. Carbon monoxide has anti-inflammatory effects involving the mitogen- activated protein kinase pathway. Nat Med 2000; 6: 422428.Google Scholar
Song R, Mahidhara RS, Zhou Z et al. Carbon monoxide inhibits T lymphocyte proliferation via caspase-dependent pathway. J Immunol 2004; 172: 12201226.Google Scholar
Pae HO, Oh GS, Choi BM et al. Carbon monoxide produced by heme oxygenase-1 suppresses T cell proliferation via inhibition of IL-2 production. J Immunol 2004; 172: 47444751.Google Scholar
Dolinay T, Szilasi M, Liu M, Choi AM. Inhaled carbon monoxide confers anti-inflammatory effects against ventilator-induced lung injury. Am J Respir Crit Care Med 2004; 13: 13.Google Scholar
Liu XM, Chapman GB, Peyton KJ, Schafer AI, Durante W. Antiapoptotic action of carbon monoxide on cultured vascular smooth muscle cells. Exp Biol Med (Maywood) 2003; 228: 572575.Google Scholar
Zhang X, Shan P, Alam J et al. Carbon monoxide modulates Fas/Fas ligand, caspases, and Bcl-2 family proteins via the p38alpha mitogen-activated protein kinase pathway during ischemia–reperfusion lung injury. J Biol Chem 2003; 278: 2206122070.Google Scholar
Brouard S, Berberat PO, Tobiasch E et al. Heme oxygenase-1-derived carbon monoxide requires the activation of transcription factor NF-kappa B to protect endothelial cells from tumor necrosis factor-alpha-mediated apoptosis. J Biol Chem 2002; 277: 1795017961.Google Scholar