Red blood cell, hemoglobin and heme in the progression of atherosclerosis

For decades plaque neovascularization was considered as an innocent feature of advanced atherosclerotic lesions, but nowadays growing evidence suggest that this process triggers plaque progression and vulnerability. Neovascularization is induced mostly by hypoxia, but the involvement of oxidative stress is also established. Because of inappropriate angiogenesis, neovessels are leaky and prone to rupture, leading to the extravasation of red blood cells (RBCs) within the plaque. RBCs, in the highly oxidative environment of the atherosclerotic lesions, tend to lyse quickly. Both RBC membrane and the released hemoglobin (Hb) possess atherogenic activities. Cholesterol content of RBC membrane contributes to lipid deposition and lipid core expansion upon intraplaque hemorrhage. Cell-free Hb is prone to oxidation, and the oxidation products possess pro-oxidant and pro-inflammatory activities. Defense and adaptation mechanisms evolved to cope with the deleterious effects of cell free Hb and heme. These rely on plasma proteins haptoglobin (Hp) and hemopexin (Hx) with the ability to scavenge and eliminate free Hb and heme form the circulation. The protective strategy is completed with the cellular heme oxygenase-1/ferritin system that becomes activated when Hp and Hx fail to control free Hb and heme-mediated stress. These protective molecules have pharmacological potential in diverse pathologies including atherosclerosis

A hem érfal komponensekre kifejtett közvetlen és közvetett patofiziológiai hatásai = Pathologic effects of heme on components of vessel wall via direct and indirect mechanisms

Kimutattuk, hogy az atheroma lipid magja prooxidáns környezetet teremt, ahol a vörösvértestek szétesnek, a hemoglobin ferri- és ferrylhemoglobinná oxidálódik, és a felszabaduló hem és vas lipidoxidációt indít el. Leírtuk, hogy a hemoglobin oxidáció (ferrylhemoglobin keletkezése) a vascularis endothelium aktiválása révén kifejezett proinflammatorikus hatással rendelkezik. Demonstráltuk, hogy a hemoxigenáz-1 (Hmox1 gén) megelőzi a malária központi idegrendszeri szövődményeit kísérleti állatmodellben. A jótékony hatásokat a szénmonoxid hemoglobinhoz történő kötődése okozta, megakadályozva a hemoglobin oxidációt és a hem disszociációját, ami az idegrendszeri szövődmények kialakulásáért felelős. Kutatásaink felvetik annak a lehetőségét, hogy a nemespenésszel érlelt élelmiszerek, nevezetesen a sajttermékek, és a sziderofórokat tartalmazó funkcionális élelmiszerek beiktatása a diétában csökkentik a szív és érrendszeri megbetegedések előfordulását. Felfetük, hogy a hemoxigenáz-1/ferritin rendszer aktivitása hatékonyan gátolja a kalcifikációt és a simaizomsejtek csontsejt irányú transzformációját, és a hatást elsősorban a ferritin nehéz láncának ferroxidáz aktivitása közvetíti, másodsorban a biliverdinnek köszönhető. Továbbá, eredményeik bizonyítékot szolgáltat arra vonatkozóan, hogy a hem-stressz gátolja a csont mineralizációt, és ez a hemoxigenáz-1/ferritin aktivációnak köszönhető, közelebbről a forroxidáz aktivitásnak. | We demonstrated that interior of advanced atheromatous lesions is a pro-oxidant environment in which erythrocytes are lysed, hemoglobin is readily oxidized to ferri- and ferrylhemoglobin, and released heme and iron promote further oxidation of lipids. We revealed that oxidized hemoglobin, i.e. ferrylhemoglobin, acts as a proinflammatory agonist that targets vascular endothelial cells. We reported that heme oxygenase-1 (encoded by Hmox1) prevents the development of experimental cerebral malaria. These effects were mediated by the binding of carbon monoxide to hemoglobin, preventing hemoglobin oxidation and the generation of free heme, a molecule that triggers cerebral malaria pathogenesis. The consumption of mold-ripened food products such as aged cheeses and the introduction of functional foods and food additives rich in fungal iron chelators in diets may lower the risk of cardiovascular diseases. We conclude that induction of the heme oxygenase-1/ferritin system in response to heme prevents phosphate -mediated calcification and osteoblastic differentiation of human smooth muscle cells mainly via the ferroxidase activity of ferritin. Our studies provided evidence that heme decreases mineralization and demonstrates that this suppression is provided by heme-induced upregulation of ferritin. In addition, we conclude that inhibition of osteoblast activity, mineralization, and specific gene expression is attributed to the ferroxidase activity of ferritin

Calcification process is inhibited by ferritin system in human heart valves

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Influence of Iron on Bone Homeostasis

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Hypoxia Triggers Osteochondrogenic Differentiation of Vascular Smooth Muscle Cells in an HIF-1 (Hypoxia-Inducible Factor 1)-Dependent and Reactive Oxygen Species-Dependent Manner

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Activation of Nrf2/HO-1 Antioxidant Pathway by Heme Attenuates Calcification of Human Lens Epithelial Cells

Cataract, an opacification in the crystalline lens, is a leading cause of blindness. Deposition of hydroxyapatite occurs in a cataractous lens that could be the consequence of osteogenic differentiation of lens epithelial cells (LECs). Nuclear factor erythroid 2-related factor 2 (Nrf2) controls the transcription of a wide range of cytoprotective genes. Nrf2 upregulation attenuates cataract formation. Here we aimed to investigate the effect of Nrf2 system upregulation in LECs calcification. We induced osteogenic differentiation of human LECs (HuLECs) with increased phosphate and calcium-containing osteogenic medium (OM). OM- induced calcium and osteocalcin deposition in HuLECs. We used heme to activate Nrf2, which strongly upregulated the expression of Nrf2 and heme oxygenase-1 (HO-1). Heme-mediated Nrf2 activation was dependent on the production of reactive oxygens species. Heme inhibited Ca deposition, and the OM-induced increase of osteogenic markers, RUNX2, alkaline phosphatase, and OCN. Anti-calcification effect of heme was lost when the transcriptional activity of Nrf2 or the enzyme activity of HO-1 was blocked with pharmacological inhibitors. Among products of HO-1 catalyzed heme degradation iron mimicked the anti-calcification effect of heme. We concluded that heme-induced upregulation of the Nrf2/HO-1 system inhibits HuLECs calcification through the liberation of heme iron