血红素加氧酶-1对脓毒症患者胃肠道保护作用研究进展

Update in the Protective Effect of Hemeoxygenase-1 on the Gastrointestinal Tract of Sepsis

血红素加氧酶-1(heme oxygenase-1,HO-1)是一种应激反应蛋白,可降解血红素生成CO、胆红素、二价铁。HO-1在大多数组织内呈低水平表达,多种氧化应激损伤可诱导其表达上调,进而发挥抗炎、抗氧化、抗凋亡作用。脓毒症是由感染引发的全身炎症反应综合征(the systemic inflammatory response syndrome,SIRS),可诱发脓毒性休克、多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)。胃肠道是人体最大的细菌库,脓毒症时,肠黏膜屏障受损,肠道细菌及内毒素移位,诱发MODS,故胃肠道被认为是MODS的始动器官。近年研究表明,HO-1在多种组织器官起到细胞保护作用,关于HO-1在胃肠道的表达调节也逐步深入,本文就HO-1的生物学特性与表达调控及其对脓毒症患者胃肠道功能保护作用作一综述。

Heme oxygenase-1(HO-1) is one of stress-responsive proteins,which degrades hemeinto carbon monoxide(CO), bilirubin and free iron.Expression of HO-is low in most tissues and is transcriptionally induced in response to oxidative stress.HO-1 has protective roles including anti-inflammatory,antioxidant and anti-apoptotic effect.Sepsis is regarded as an infection-induced systemic inflammatory response syndrome(SIRS),which may lead to septic shock and multiple organ dysfunction syndrome(MODS).Gastrointestinal tract serves as a reservoir for bacteria.Injury of gastrointestinal mucosa barrier may result in invasion of bacteria and endotoxin,which may cause MODS.Therefore,gastrointestinal tract is considered as the initiator of MODS.HO-1 has recently been demonstrated to be cyto-protective in variety of tissues and organs including gastrointestinal tract.The present article reviewed mechanism of HO-1 expression and its biological functions,particularly,the protective effect of HO-1 in gastrointestinal tract in sepsis.