Association of heme-oxygenase 1, hemopexin, and heme levels with markers of disease severity in COVID-19.

Experimental biology and medicine (Maywood, N.J.) 2023 Feb

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Heme-oxygenase 1 (HO-1) is an enzyme with well-known anti-inflammatory and antioxidant properties, whose levels have been previously associated with disease severity in the context of sterile and infectious diseases. Moreover, the heme/HO-1 pathway has been associated with prothrombotic changes in other diseases. Accordingly, the potential of modulating HO-1 levels for the treatment of COVID-19 was extensively speculated during the COVID-19 pandemic, but very few actual data were generated. The aim of our study was to explore the association of HO-1, heme, and hemopexin (HPX) levels with COVID-19 severity and with markers of inflammation and coagulation activation. The study was conducted in 30 consecutive patients with COVID-19 admitted due to hypoxemia, and 30 healthy volunteers matched by sex, age, and geographic region. HO-1 and HPX levels were measured by enzyme immunoassay (ELISA) and heme levels were measured by a colorimetric method. A comprehensive panel of coagulation and fibrinolysis activation was also used. Patients with COVID-19 presented increased levels of HO-1 when compared to controls (5741 ± 2696 vs 1953 ± 612 pg/mL, respectively, P < 0.0001), as well as a trend toward increased levels of HPX (3.724 ± 0.880 vs 3.254 ± 1.022 mg/mL, respectively; P = 0.06). In addition, HO-1 and HPX levels reduced from admission to day + 4. HO-1 levels were associated with duration of intensive care unit stay and with several markers of coagulation activation. In conclusion, modulation of HO-1 could be associated with the prothrombotic state observed in COVID-19, and HO-1 could also represent a relevant biomarker for COVID-19. New independent studies are warranted to explore and expand these findings.

Citation

Franciele de Lima, Carla Roberta Peachazepi Moraes, Mayck Silva Barbosa, Bruna Bombassaro, André C Palma, Sergio San Juan Dertkigil, Maria Luiza Moretti, Fernanda Andrade Orsi, Joyce M Annichino-Bizzacchi, Eli Mansour, Licio A Velloso, Erich Vinicius De Paula. Association of heme-oxygenase 1, hemopexin, and heme levels with markers of disease severity in COVID-19. Experimental biology and medicine (Maywood, N.J.). 2023 Feb;248(4):309-316