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American Academy of Pediatrics
Article

Heme Oxygenase Biology: Part 2: Neonatal Disorders

Stephanie Schulz, Hui Zhao, Ronald J. Wong and David K. Stevenson
NeoReviews March 2012, 13 (3) e158-e165; DOI: https://doi.org/10.1542/neo.13-3-e158
Stephanie Schulz
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Hui Zhao
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Ronald J. Wong
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David K. Stevenson
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Abstract

A number of neonatal disorders have etiologies originating from acute inflammation and the destructive action of reactive oxygen species. As previously described in Part 1, heme oxygenase (HO) and its byproducts provide a newborn with antioxidative, antiapoptotic, anti-inflammatory, and cytoprotective defenses during the perinatal period. A finely balanced expression of the inducible HO-1 isoform is critically important for normal development of a number of organs. For example, increases in bilirubin levels observed in newborn infants provide significant antioxidant protection at birth and during the first few weeks after birth. However, if not tightly controlled, harmful levels may be reached and cause irreversible bilirubin-induced neurotoxicity (kernicterus). In addition, HO-1 and the constitutive HO-2 isoform are important in pulmonary vascular development during the perinatal period. In the developing brain, the upregulation of HO-1 expression may be adaptive and beneficial or a part of a pathological inflammatory process. Furthermore, there is strong evidence that HO and its byproduct, carbon monoxide (CO), play a significant role in maintaining intestinal barrier function and regulating inflammatory and apoptotic pathways. Therefore, disruption of this balanced HO-1 expression may lead to a number of neonatal disorders.

  • Abbreviations:
    BPD;
    bronchopulmonary dysplasia
    CO;
    carbon monoxide
    HI;
    hypoxic-ischemic
    HO;
    heme oxygenase
    IL;
    interleukin
    IR;
    ischemic-reperfusion
    Mps;
    metalloporphyrins
    NEC;
    necrotizing enterocolitis
    RDS;
    respiratory distress syndrome
    ROS;
    reactive oxygen species
    TB;
    total bilirubin
    WT;
    wild-type
    • Copyright © 2012 by the American Academy of Pediatrics

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    NeoReviews
    Vol. 13, Issue 3
    1 Mar 2012
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    Heme Oxygenase Biology: Part 2: Neonatal Disorders
    Stephanie Schulz, Hui Zhao, Ronald J. Wong, David K. Stevenson
    NeoReviews Mar 2012, 13 (3) e158-e165; DOI: 10.1542/neo.13-3-e158

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    Heme Oxygenase Biology: Part 2: Neonatal Disorders
    Stephanie Schulz, Hui Zhao, Ronald J. Wong, David K. Stevenson
    NeoReviews Mar 2012, 13 (3) e158-e165; DOI: 10.1542/neo.13-3-e158
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    • Article
      • Abstract
      • Objectives
      • HO in Neonatal Jaundice
      • HO in Fetal and Neonatal Lung Development
      • HO in Neonatal Brain Development
      • HO in Necrotizing Enterocolitis
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    • Updated Guidance: Prevention and Management of Perinatal Group B Streptococcus Infection
    • Neonatal Encephalopathy: Beyond Hypoxic-Ischemic Encephalopathy
    • Perinatal Stroke: A Practical Approach to Diagnosis and Management
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