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Am J Physiol Heart Circ Physiol 282: H2055-H2059, 2002. First published February 21, 2002; doi:10.1152/ajpheart.01084.2001
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Vol. 282, Issue 6, H2055-H2059, June 2002

Heme oxygenase activity in placenta: direct dependence on oxygen availability

Scott D. Appleton1, Gerald S. Marks1, Kanji Nakatsu1, James F. Brien1, Graeme N. Smith1,2,3, and Charles H. Graham1,2

1 Departments of Pharmacology and Toxicology, 2 Anatomy and Cell Biology, and 3 Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada K7L 3N6


    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

Carbon monoxide (CO), which is formed endogenously from heme catalyzed by heme oxygenase (HO), is proposed to play a role in vascular control. The mRNA and protein expression of the inducible isoform of HO (HO-1) increases in response to hypoxia, and it has been assumed that HO activity also increases. This assumption requires evaluation because the catalytic activity of HO requires three molecules of O2 for each molecule of CO formed from heme, and HO activity may be limited by O2 availability. To test the hypothesis that low physiological O2 concentrations limit HO activity, heme-derived CO formation by microsomal fractions of homogenates of chorionic villi of human placentas was determined after exposure to 0, 1, 5, or 21% O2. Results revealed that HO activity was directly dependent on O2 concentration. Thus, although hypoxia may increase HO protein and mRNA expression, there is a progressive decrease in HO activity with decreasing O2 concentration and the dependence of HO activity on O2 concentration is similar in chorionic villi from noninfarcted areas of preeclamptic and normotensive placenta.

heme oxygenase-1 expression; carbon monoxide; hypoxia


    INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

HEME OXYGENASE (HO) catalyzes the breakdown of heme in the presence of O2 and reduced NADP (NADPH) to form carbon monoxide (CO), biliverdin, and iron. Biliverdin is subsequently converted to bilirubin by biliverdin reductase. Both biliverdin and bilirubin have been shown to be potent antioxidants in several tissues (19) and CO has been proposed to play a role in cell-cell communication and in the relaxation of various blood vessels (11, 22, 23, 26). Earlier studies (16, 21), determining the stoichiometry of the HO reaction, demonstrated that HO consumed three molecules of O2 and two molecules of NADPH for every molecule of heme biotransformed.

There are two predominant isoforms of HO: HO-1 is the inducible isoform, whereas the expression of HO-2 is constitutive, and hence these isoforms are responsible for basal HO activity in cells. The expression of HO-1 can be increased in response to several cellular stresses, including exposure to heme, heavy metals (i.e., Cd2+ and Co2+), trivalent arsenicals, heat shock, ischemia, radiation, hypoxia, hyperoxia, endotoxin, inflammatory cytokines, prostaglandin A1, and hormones, as well as glutathione depletion (see Ref. 10 for a review). It is thought that HO-1 is responsible for the marked increase in HO activity during several pathological conditions and therefore is categorized as a stress enzyme designated as heat shock protein 32 (HSP32) (7).

It has been postulated that the rapid induction of HO-1 and the inhibitory effect of CO on the transcription of certain hypoxia-inducible genes provide a cytoprotective role for HO within the human placenta (1). Endogenous CO formation has been measured in dissected chorionic villi of term human placenta (14). CO has also been shown to play a role in the maintenance of placental vascular tone (9) and, to this end, a dysfunction in the HO-CO system has been associated with preeclampsia, a pathophysiological condition characterized by compromised uteroplacental blood flow and localized regions of placental hypoxia (6). Because O2 is required for HO enzymatic activity, we propose that such activity is deficient in disease states characterized by tissue hypoxia such as preeclampsia.

In the present study, our first objective was to determine the dependence of HO activity on O2 availability using the microsomal fraction of homogenate of chorionic villi from full-term human placenta as a model system. The second objective was to determine whether HO activity in the presence of various O2 concentrations is altered in chorionic villi of placentas from preeclamptic pregnancies compared with gestational age-matched normotensive pregnancies.


    MATERIALS AND METHODS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

Reagents and solutions. Hemin, ethanolamine, bovine serum albumin (BSA), and NADPH were obtained from Sigma (St. Louis, MO). All other chemicals were at least reagent grade and were obtained from BDH (Toronto, ON, Canada). The stock solution of methemalbumin (1.5 mM hemin and 0.15 mM BSA) was prepared as previously described (24). Briefly, hemin was dissolved in 0.5 ml of aqueous 10% (wt/vol) ethanolamine. BSA dissolved in 2 ml of deionized water was added to the hemin solution. The volume was made up to 7 ml and slowly adjusted to pH 7.4 with 1 M HCl and vigorous stirring. The final volume for the stock solution was adjusted to 10 ml with deionized water. The methemalbumin stock solution was prepared with the laboratory lights turned off and was stored at -20°C for up to 1 mo.

Preparation of microsomal fraction of homogenate of chorionic villi of human placenta. Human placentas of gestational age 37-42 wk were obtained from elective caesarean deliveries of uncomplicated and gestational age-matched preeclamptic pregnancies at Kingston General Hospital. Within 1 h of delivery, samples of chorionic villi of a placental cotyledon were dissected. This region was selected because it is highly vascularized and has been previously shown to possess high levels of HO activity (13). Noninfarcted areas of chorionic villi were identified based on gross morphology and the absence of calcium deposits, which characterize areas of infarction.

To isolate microsomal fractions, 10% (wt/vol) homogenate of chorionic villi was prepared in ice-cold homogenizing buffer composed of (in mM) 20 KH2PO4, 135 KCl, and 0.10 EDTA (adjusted to pH 7.4 at 4°C with 1 M KOH) with the use of an ultrasonic probe (Sonic Dismembrator, Fisher Scientific; Toronto, ON, Canada). Microsomal fractions of the homogenates were obtained by centrifugation at 10,000 g for 20 min at 4°C, followed by centrifugation of the supernatant at 100,000 g for 60 min at 4°C. The 100,000 g pellet (microsomal fraction) was resuspended in 100 mM KH2PO4 buffer (adjusted to pH 7.4 with 1 M KOH) using a Potter-Elvehjem homogenizing system. The microsomal fraction was divided into equal aliquots, placed into microcentrifuge tubes, and stored at -80°C for up to 2 mo. HO enzymatic activity remains stable under these storage conditions (B. E. McLaughlin, unpublished observations). Protein concentrations of the microsomal fractions were determined by the Biuret method (5), which was modified as described previously (12).

Measurement of HO enzymatic activity in microsomal fractions of homogenates of chorionic villi. HO activity in the microsomal fractions of chorionic villi homogenate was determined by measuring the rate of CO formation during the NADPH-dependent oxidation of heme, as originally described by Vreman and Stevenson (25) and modified by Cook et al. (4). For chorionic villi of each placenta, HO activity was determined in the presence of four different O2 concentrations (0, 1, 5, or 21%). To each of four 3.5-ml amber glass vials (Chromatographic Specialties; Brockville, ON, Canada) was added 100 mM KH2PO4, pH 7.4, 0.2 mg microsomal protein, and methemalbumin (final concentration of 25 µM hemin and 2.5 µM BSA) in a final volume of 1 ml. While kept on ice, each vial was sealed with a Teflon-lined silicon septum and a screw cap (Chromatographic Specialties), and the headspace gas was purged with a gas mixture containing 1% O2 (balance N2; certified free of CO contamination) introduced by means of a needle system used to pierce the septum, while the contents were stirred constantly. The samples were then preincubated for 5 min in the dark at 37°C, in a shaking water bath. NADPH (0.5 mM) was added to three of the four vials, the headspace gas was displaced for 10 s with 1% O2, and the incubation was continued for another 15 min. The fourth vial, to which no NADPH was added, was used as a blank. The reaction was stopped by the placement of all vials, except one containing NADPH, on pulverized dry ice (-78°C), where they remained for 30 min until the headspace gas was analyzed for CO content. The remaining reaction vial was stored at 4°C, and the reaction mixture from this sample was injected onto a blood gas analyzer (model ABL 5, Radiometer Copenhagen) to determine the PO2. The above protocol was repeated using each of 0, 5, and 21% O2 concentrations. For each O2 concentration, CO production was corrected for the CO produced in the reaction vial that contained no NADPH (blank). To determine total HO activity in the microsomal fractions of homogenates of chorionic villi of human placenta, a sample was prepared that was not purged with gas before the HO enzymatic reaction but was equilibrated with ambient air. This was done to verify that our experimental treatment, which included purging, did not exhibit altered HO activity.

CO levels in the headspace gas of each sample were quantitated with the use of a gas chromatograph (model RGA3, Trace Analytical; Menlo Park, CA) equipped with a ×13 molecular sieve and a chemical-spectrophotometric detector that quantitates, at 254 nm, elemental Hg formed from the reaction of CO with HgO, as described by Odrcich et al. (17). The amount of CO in the headspace gas was determined by interpolating the peak area of the chromatographic signal on the linear CO standard curve (10-170 pmol CO), which had a correlation coefficient of 0.999 (n = 4 determinations). The rate of formation of CO in the microsomal fractions of chorionic villi homogenates was expressed as nanomoles CO formed per milligram of protein per hour. NADPH-dependent formation of CO was calculated by subtracting the value for CO produced in the sample not containing NADPH (blank) from the value for CO formed in samples containing NADPH.

Data analysis. The HO enzymatic activity in the microsomal fractions of chorionic villi homogenates incubated at each O2 concentration was expressed as nanomoles CO formed per milligram of protein per hour. The data are presented as group means ± SD for four normotensive placentas and five preeclamptic placentas. Parametric statistical analysis of the HO activity data of microsomal fraction of chorionic villi homogenate of normotensive placentas for the different O2 concentrations was conducted by one-way repeated-measures analysis of variance. For a statistically significant F statistic (P < 0.05), a post hoc Newman-Keuls test was conducted to determine which experimental groups were statistically different (P < 0.05). Comparison of the HO activity in chorionic villi from uncomplicated and preeclamptic pregnancies was conducted by two-way analysis of variance for differences in HO activity between the two pregnancy conditions and among the three O2 concentrations. For a statistically significant F statistic for O2 concentration (P < 0.05), a one-way repeated-measures analysis of variance was conducted, followed by a Newman-Keuls post hoc test to determine which experimental groups were statistically different (P < 0.05). For a statistically significant F statistic between the two pregnancy conditions, a Student's t-test was used. HO enzymatic activity values for tissues obtained from normotensive and preeclamptic pregnancies were also analyzed as a scatterplot. The curve of best fit was determined separately for data collected from uncomplicated and preeclamptic placentas by using nonlinear regression analysis and the Michaelis-Menten constant (Km) for PO2 was calculated.


    RESULTS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

It has been assumed that the levels of expression of HO-1 mRNA and protein correlate with the activity of the enzyme. In some situations of cellular stress, this may be true. However, because three molecules of O2 are required for each molecule of CO and biliverdin generated during heme metabolism, we hypothesized that regardless of the levels of HO enzyme present, CO production is reduced when O2 levels are low.

Therefore, using the microsomal fraction of homogenates of chorionic villi from term human placenta as a model system, the first objective of this study was to determine the dependence of HO (HO-1 and HO-2) activity on O2 availability. Accordingly, the headspace gas of sealed reaction vials, containing human chorionic villi microsomal fraction and a source of heme, was replaced with 0, 1, 5, or 21% O2 (balance N2). The mean PO2 values achieved and corrected to atmospheric PO2 of 154 mmHg are shown in Fig. 1. From the PO2 values obtained from control samples equilibrated in ambient air, a correction factor was determined for that data set and was applied to subsequent PO2 measurements obtained. The corrected PO2 values of the reaction mixtures were 18.0 ± 2.4, 25.9 ± 3.9, 53.1 ± 5.7, and 166.1 ± 25.2 mmHg when the headspace gas was purged with 0, 1, 5, and 21% O2, respectively. Therefore, by purging the headspace gas with decreasing amounts of O2, we were able to decrease the PO2 of the reaction mixture. The HO enzymatic activity at these PO2 values also decreased in a corresponding manner (Fig. 2), and the HO enzymatic activities of the samples purged with 0, 1, 5, and 21% O2 were significantly different from each other (P < 0.05). There was no significant difference in HO activity between samples exposed to ambient air compared with samples for which the headspace gas was purged with 21% O2 (data not shown). The HO-catalyzed oxidation of heme to biliverdin is a three-step process, each of which requires one molecule of O2 (8). Therefore, diminished O2 concentration will likely lower HO activity, thereby decreasing the formation of biliverdin and two intermediates in biliverdin formation. In addition, HO activity would be controlled by heme and NADPH concentrations as well as by the activity of cytochrome P-450 reductase. It is also likely that the concentrations of heme and NADPH and cytochrome P-450 reductase activity would be influenced by decreased O2 concentrations.


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Fig. 1.   PO2 values (corrected for atmospheric O2 concentration) of microsomal fractions of homogenates of chorionic villi from normotensive pregnancies in samples where the headspace gas was replaced with 0, 1, 5, or 21% O2.



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Fig. 2.   Heme oxygenase (HO) activity (nanomoles CO formed per milligram of protein per hour) at corresponding PO2 values (reported in Fig. 1) in microsomal fractions of homogenates of chorionic villi from normotensive pregnancies. In these samples, the headspace gas was replaced with 0, 1, 5, and 21% O2. a,b,c,dP < 0.05, group means are statistically different from each other.

The second objective was to determine whether HO activity in the presence of various O2 concentrations is altered in chorionic villi of placentas obtained from preeclamptic pregnancies compared with gestational age-matched normotensive pregnancies. The impaired uteroplacental perfusion that occurs in preeclampsia due to maladaptation of the uteroplacental spiral arterioles results in localized regions of hypoxia (6). We assessed the relationship between PO2 and HO activity in chorionic villi microsomal preparations obtained from noninfarcted areas of placentas from preeclamptic pregnancies and found it to be similar to that in chorionic villi microsomal preparation from noninfarcted areas of placentas from normotensive women (Fig. 3). Samples equilibrated in ambient air were also tested and compared. There was no statistically significant difference when group means for HO activity of the microsomal fraction of homogenates of chorionic villi of placentas from preeclamptic pregnancies were compared with group means of HO activity of the microsomal fractions of homogenates of chorionic villi isolated from placentas of normotensive women at each O2 concentration (Fig. 3). Moreover, nonlinear regression analysis revealed a significant correlation between HO activity and PO2 of the reaction mixture (Fig. 4) for each of preeclamptic and normotensive pregnancies. From each curve of best fit, the Km for PO2 was determined to be 43 ± 15 and 52 ± 18 mmHg for HO enzymatic activity in the microsomal fraction of chorionic villi homogenate from normotensive and preeclamptic placentas, respectively.


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Fig. 3.   HO activity (nanomoles CO formed per milligram of protein per hour) in microsomal fractions of homogenates of chorionic villi isolated from noninfarcted regions of placentas obtained from preeclamptic and normotensive pregnancies. The headspace gas in these samples was replaced with 0 and 5% O2. * P < 0.05 vs. control; ** P < 0.05 vs. 5% O2 and control.



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Fig. 4.   Scatterplot of HO activity (nanomoles CO formed per milligram of protein per hour) vs. PO2 (mmHg) for the microsomal fractions of homogenates of human chorionic villi obtained from normotensive and preeclamptic pregnancies. The curves represent the results of nonlinear regression analysis for both normotensive (broken line) and preeclamptic (solid line) data.


    DISCUSSION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

In a recent study, Carraway and colleagues (2) examined HO-1 protein and mRNA expression as well as HO enzymatic activity in the rat lung after exposure in an altitude chamber to 395 mmHg (17,000 ft) for up to 21 days. These workers found that the expression of HO-1 protein increased in rats exposed to hypoxia for the first 7 days and decreased thereafter. Moreover, the enzyme activity was elevated only after 1 day of hypoxia and then returned to control values thereafter. The authors attribute their findings to the fact that the Km for PO2, reported by them as 8 mmHg, is an important predictor of the behavior of the enzyme during hypoxia. Both in vivo and in vitro studies in the placenta and other tissues have shown an increase in HO-1 mRNA and protein expression in response to hypoxia, and it has been assumed that the increase in HO-1 protein expression and/or HO-1 mRNA is accompanied by an increase in HO activity (3). Throughout pregnancy, O2 levels in the placenta have been reported to change from ~17 mmHg in the first trimester to 60 mmHg after week 13 of gestation (18). Thus one can expect corresponding fluctuations in HO enzymatic activity. Moreover, a variety of tissues, including malignant tumors, have been shown to exhibit large PO2 gradients (20). Unfortunately, in the vast majority of studies, HO activity has been measured in the presence of ambient O2 levels, which are extremely high and nonphysiological, whereas the enzyme in situ functions in the presence of much lower O2 concentrations. The results of the present study suggest that the actual levels of HO enzymatic activity in most tissues are lower than previously measured.

Other studies (3, 15) of term human placenta report the existence of HO-1 mRNA and protein but do not report enzymatic activity. These studies make the assumption that the existence of HO protein in their experimental tissue preparation indicates a functional enzymatic system whereby CO, biliverdin, and iron are formed from the HO-catalyzed oxidation of heme, and a role for each of these products is inferred. Because of our studies, some of the conclusions reached by previous investigators might require reconsideration.

Although it has been proposed that CO generated from HO catalytic activity plays a role in the regulation of placental blood flow (9), the function of HO in the maintenance of placental homeostasis may be broader. As indicated earlier, biliverdin and subsequently bilirubin are products of HO-mediated heme catabolism, which have potent antioxidant properties. Thus HO may also play an important role in protecting the placenta and the fetus from oxidative stress damage that could occur during the establishment of the uteroplacental circulation at the end of the first trimester (18) or during conditions characterized by abnormal uteroplacental blood flow, like preeclampsia.

In conclusion, the present study demonstrates that in the microsomal fractions of homogenates of chorionic villi from term human placenta, 1) HO activity decreases with decreasing O2 availability and 2) the direct dependence of HO activity on O2 concentration is similar in chorionic villi from noninfarcted areas of preeclamptic and normotensive placentas.


    ACKNOWLEDGEMENTS

The authors thank Dr. Gendie Lash for collection of the placentas, Dr. Henk Vreman for collaboration and use of the reduction-gas analyzer, and Brian McLaughlin for assistance in this study.


    FOOTNOTES

This work was supported by the Heart and Stroke Foundation of Ontario Grants NA-4438 and T-3361.

Address for reprint requests and other correspondence: C. H. Graham, Dept. of Anatomy and Cell Biology, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada K7L 3N6 (E-mail: grahamc{at}post.queensu.ca).

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

First published February 21, 2002;10.1152/ajpheart.01084.2001

Received 10 December 2001; accepted in final form 18 February 2002.


    REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

1.   Ahmed, A, Rahman M, Zhang X, Acevedo CH, Nijjar S, Rushton I, Bussolati B, and St. John J. Induction of placental heme oxygenase-1 is protective against TNFalpha -induced cytotoxicity and promotes vessel relaxation. Mol Med 6: 391-409, 2000[Web of Science][Medline].

2.   Carraway, MS, Ghio AJ, Carter JD, and Piantadosi CA. Expression of heme oxygenase-1 in the lung in chronic hypoxia. Am J Physiol Lung Cell Mol Physiol 278: L806-L812, 2000[Abstract/Free Full Text].

3.   Caudill, TK, Resta TC, Kanagy NL, and Walker BR. Role of endothelial carbon monoxide in attenuated vasoreactivity following chronic hypoxia. Am J Physiol Regulatory Integrative Comp Physiol 275: R1025-R1030, 1998.

4.   Cook, MN, Marks GS, Vreman HJ, Nakatus K, Stevenson DK, and Brien JF. Ontogeny of heme oxygenase activity in the hippocampus, frontal cerebral cortex, and cerebellum of the guinea pig. Dev Brain Res 92: 18-23, 1996.

5.   Gornall, AG, Bardawill CJ, and David MM. Determination of serum proteins by means of the biuret reaction. J Biol Chem 177: 751-766, 1949[Free Full Text].

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7.   Keyse, SM, and Tyrrell RM. Heme oxygenase is the major 32-kDA stress protein induced in human skinfibroblasts by UVA radiation, hydrogen peroxide, and sodium arsenite. Proc Natl Acad Sci USA 86: 99-103, 1989[Abstract/Free Full Text].

8.   Koenigs Lightning, L, Hong-wei H, Moënn-Loccoz P, Loehr TM, Schullar DJ, Poulos TL, and Ortiz de Montellano PR. Disruption of an active site hydrogen bond converts human heme oxygenase-1 in a peroxidase. J Biol Chem 276: 10612-10619, 2001[Abstract/Free Full Text].

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10.   Maines, MD. The heme oxygenase system: a regulator of second messenger gases. Annu Rev Pharmacol Toxicol 37: 517-554, 1997.

11.   Marks, GS, Brien JF, Nakatsu K, and McLaughlin BE. Does carbon monoxide have a physiological function? Trends Pharmacol Sci 12: 185-188, 1991.

12.   Marks, GS, McLaughlin BE, Vreman HJ, Stevenson DK, Nakatsu K, Brien JF, and Pang SC. Heme oxygenase activity and immunohistochemical localization in bovine pulmonary artery and vein. J Cardiovasc Pharmacol 30: 1-6, 1997[Web of Science][Medline].

13.   McLaughlin, BE, Hutchinson JM, Graham CH, Smith GN, Marks GS, Nakatsu K, and Brien JF. Heme oxygenase activity in term human placenta. Placenta 21: 870-873, 2000[Web of Science][Medline].

14.   McLaughlin, BE, Lash G, Graham CH, Smith GN, Vreman HJ, Stevenson DK, Marks GS, Nakatsu K, and Brien JF. Endogenous carbon monoxide formation by chorionic villi of term human placenta. Placenta 22: 886-888, 2001[Web of Science][Medline].

15.   McLean, M, Bowman M, Clifton V, Smith R, and Grossman AB. Expression of the heme oxygenase-carbon monoxide signalling system in human placenta. J Clin Endocrinol Metab 85: 2345-2349, 2000[Abstract/Free Full Text].

16.   Noguchi, M, Tadashi Y, and Kikuchi G. A stoichiometric study of heme degradation catalyzed by the reconstituted heme oxygenase system with special consideration of the production of hydrogen peroxide during the reaction. J Biochem (Tokyo) 93: 1027-1036, 1983.

17.   Odrcich, MJ, Graham CH, Kimura KA, McLaughlin BE, Marks GS, Nakatsu K, and Brien JF. Heme oxygenase and nitric oxide synthase in the placenta of the guinea-pig during gestation. Placenta 19: 509-516, 1998[Web of Science][Medline].

18.   Rodesch, F, Simon P, Donner C, and Jauniaux E. Oxygen measurements in endometrial and trophoblastic tissues during early pregnancy. Obstet Gynecol 80: 283-285, 1992[Web of Science][Medline].

19.   Stocker, R, and Ames BN. Potential role of conjugated bilirubin and copper in the metabolism of lipid peroxides in bile. Proc Natl Acad Sci USA 84: 8130-8134, 1987[Abstract/Free Full Text].

20.   Sutherland, RM, Sordat B, Bamat J, Gabbert H, Bourrat B, and Mueller-Klieser W. Oxygenation and differentiation in multicellular spheroids of human colon carcinoma. Cancer Res 46: 5320-5329, 1986[Abstract/Free Full Text].

21.   Tenhunen, R, Marver HS, and Schmid R. Microsomal heme oxygenase: characterization of the enzyme. J Biol Chem 244: 6388-6394, 1969[Abstract/Free Full Text].

22.   Vedernikov, YP, Gräser T, and Vanin AF. Similar endothelium-independent arterial relaxation by carbon monoxide and nitric oxide. Biomed Biochim Acta 8: 601-603, 1989.

23.   Verma, A, Hirsch DJ, Glatt CE, Ronnett GV, and Snyder SH. Carbon monoxide: a putative neural messenger. Science 259: 381-384, 1993[Abstract/Free Full Text].

24.   Vreman, HJ, Ekstrand BC, and Stevenson DK. Selection of metalloporphyrin heme oxygenase inhibitors based on potency and photoreactivity. Pediatr Res 33: 195-200, 1993[Web of Science][Medline].

25.   Vreman, HJ, and Stevenson DK. Heme oxygenase activity as measured by carbon monoxide production. Anal Biochem B168: 31-38, 1988.

26.   Vincent, SR, and Maines MD. Brain heme oxygenase isoenzymes and nitric oxide synthase are co-localized in select neurons. Neuroscience 63: 223-231, 1993.


Am J Physiol Heart Circ Physiol 282(6):H2055-H2059
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S. D. Appleton, G. S. Marks, K. Nakatsu, J. F. Brien, G. N. Smith, C. H. Graham, and G. E. Lash
Effects of hypoxia on heme oxygenase expression in human chorionic villi explants and immortalized trophoblast cells
Am J Physiol Heart Circ Physiol, March 1, 2003; 284(3): H853 - H858.
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Am. J. Physiol. Heart Circ. Physiol.Home page
G. E. Lash, B. E. McLaughlin, S. K. MacDonald-Goodfellow, G. N. Smith, J. F. Brien, G. S. Marks, K. Nakatsu, and C. H. Graham
Relationship between tissue damage and heme oxygenase expression in chorionic villi of term human placenta
Am J Physiol Heart Circ Physiol, January 1, 2003; 284(1): H160 - H167.
[Abstract] [Full Text] [PDF]


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