HO-1 in sickle cell disease: friend or foe?

Rochester, Minnesota -- Researchers have unexpectedly shown that sickle cell-associated kidney injury may be reduced by inhibiting the enzyme activity of a protein that commonly confers protection in other diseased states. The paper by Juncos et al., "Anomalous renal effects of tin protoporphyrin in a murine model of sickle cell disease," appears in the July issue of The American Journal of Pathology.

Sickle cell disease (SCD), which affects greater than 70,000 individuals in the US, is an inherited hemoglobin disorder that causes some red blood cells to lose their smooth round shape and assume a crescent, or sickle, shape. Sickle cells can become lodged in small capillary blood vessels, with blockage of blood flow leading to pain, stroke, and damage to most organs including the lungs, spleen, kidneys and liver.

The mechanisms underlying SCD-associated kidney disease include various forms of secondary stress, such as changes in internal kidney blood flow, induction of oxidative injury, and influx of inflammatory cells. Researchers have thought that cells combat such stress through expression of heme oxygenase-1 (HO-1), a protective enzyme that is upregulated in SCD kidneys in humans and in mouse models. New research, however, suggests that in SCD HO-1 may not be as protective as previously thought.

In an attempt to understand the specific role of HO-1 in kidney injury, Juncos et al. examined SCD mice in the presence or absence of tin protoporphyrin (SnPP), a widely accepted inhibitor of the enzyme activity of HO. Short-term SnPP treatment successfully blocked HO activity in both normal and SCD mice, reduced kidney blood flow in normal and SCD mice, but did not affect the filtration capacity of the kidney in either group. However, when chronically administered, SnPP caused inflammation and fibrosis (scarring) in normal mice but not in SCD mice; in normal mice, SnPP induced genes related to fibrosis and inflammation, whereas in SCD

Contact: Audra Cox
American Journal of Pathology

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