Heme oxygenase‑1 improves the survival of ischemic skin flaps (Review)

• Published in: Molecular medicine reports Vol. 23; no. 4
• Main Authors: Zheng, Yinhua, Li, Zhenlan, Yin, Min, Gong, Xu
• Format: Journal Article
• Language: English
• Published: Greece Spandidos Publications 01.04.2021; Spandidos Publications UK Ltd; D.A. Spandidos
• Subjects: Animals; Apoptosis; Biliverdin; Binding sites; Blood; Blood platelets; Carbon monoxide; Cardiovascular system; Care and treatment; Cell adhesion & migration; Development and progression; Diabetes; Enzymes; Flaps (Surgery); Genetic aspects; Health aspects; Heat shock proteins; Heavy metals; Heme; Heme oxygenase (decyclizing); Heme Oxygenase-1 - metabolism; Hemoglobin; Humans; Hypoxia; Inflammation; Ischemia; Ischemia - enzymology; Ischemia - pathology; Metabolites; Microsomes; Nitric oxide; Oxidants; Oxidases; Oxidation; Oxidative stress; Oxygenase; Review; Risk factors; Sepsis; Skin; Skin - enzymology; Skin - pathology; Skin Transplantation; Surgery; Surgical Flaps; Survival; Tumor necrosis factor-TNF; China
• ISSN: 1791-2997; 1791-3004
• DOI: 10.3892/mmr.2021.11874

Heat shock protein 32 (Hsp32), also known as heme oxygenase‑1 (HO‑1), is an enzyme that exists in microsomes. HO‑1 can be induced by a variety of stimuli, including heavy metals, heat shock, inflammatory stimuli, heme and its derivatives, stress, hypoxia, and biological hormones. HO‑1 is the rate‑limiting enzyme of heme catabolism, which splits heme into biliverdin, carbon monoxide (CO) and iron. The metabolites of HO‑1 have anti‑inflammatory and anti‑oxidant effects, and provide protection to the cardiovascular system and transplanted organs. This review summarizes the biological characteristics of HO‑1 and the functional significance of its products, and specifically elaborates on its protective effect on skin flaps. HO‑1 improves the survival rate of ischemic skin flaps through anti‑inflammatory, anti‑oxidant and vasodilatory effects of enzymatic reaction products. In particular, this review focuses on the role of carbon monoxide (CO), one of the primary metabolites of HO‑1, in flap survival and discusses the feasibility and existing challenges of HO‑1 in flap surgery.