International Journal of Molecular Sciences Review Heme Degradation in Pathophysiology of and Countermeasures to Inflammation-Associated Disease Donald David Haines 1,2 and Arpad Tosaki 2,* 1 Advanced Biotherapeutics, London W2 1EB, UK;
[email protected] 2 Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary * Correspondence:
[email protected]; Tel./Fax: +36-52-255586 Received: 27 October 2020; Accepted: 16 December 2020; Published: 18 December 2020 Abstract: The class of tetrapyrrol “coordination complexes” called hemes are prosthetic group components of metalloproteins including hemoglobin, which provide functionality to these physiologically essential macromolecules by reversibly binding diatomic gasses, notably O2, which complexes to ferrous (reduced/Fe(II)) iron within the heme porphyrin ring of hemoglobin in a pH- and PCO2-dependent manner—thus allowing their transport and delivery to anatomic sites of their function. Here, pathologies associated with aberrant heme degradation are explored in the context of their underlying mechanisms and emerging medical countermeasures developed using heme oxygenase (HO), its major degradative enzyme and bioactive metabolites produced by HO activity. Tissue deposits of heme accumulate as a result of the removal of senescent or damaged erythrocytes from circulation by splenic macrophages, which destroy the cells and internal proteins, including hemoglobin, leaving free heme to accumulate, posing a significant toxicogenic challenge. In humans, HO uses NADPH as a reducing agent, along with molecular oxygen, to degrade heme into carbon monoxide (CO), free ferrous iron (FeII), which is sequestered by ferritin protein, and biliverdin, subsequently metabolized to bilirubin, a potent inhibitor of oxidative stress-mediated tissue damage. CO acts as a cellular messenger and augments vasodilation.