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Circulation Research. 1999;85:663-671

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(Circulation Research. 1999;85:663-671.)
© 1999 American Heart Association, Inc.


Molecular Medicine

Induction of Heme Oxygenase-1 Suppresses Venular Leukocyte Adhesion Elicited by Oxidative Stress

Role of Bilirubin Generated by the Enzyme

Shinobu Hayashi, Rina Takamiya, Tokio Yamaguchi, Kenji Matsumoto, Shinichiro J. Tojo, Takuya Tamatani, Masaki Kitajima, Nobuya Makino, Yuzuru Ishimura, Makoto Suematsu

From the Departments of Biochemistry (R.T., T.Y., N.M., Y.I., M.S.) and Department of Surgery (S.H., K.M., M.K.), School of Medicine, Keio University, Tokyo; Pharmaceutical Frontier Research Laboratories (T.T.), JT Inc, Kanagawa; and Research Center (S.J.T.), Sumitomo Pharmaceutical Co Ltd, Osaka, Japan.

Correspondence to Makoto Suematsu, MD, PhD, Associate Professor, Department of Biochemistry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan. E-mail msuem{at}mc.med.keio.ac.jp


*    Abstract
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*Abstract
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Abstract—This study aimed to examine whether an elevated activity of heme oxygenase (HO)-1 in the tissue attenuates endothelial cell–leukocyte interactions microvessels in vivo. When rats were pretreated with an intraperitoneal injection of hemin, an HO-1 inducer, mesenteric tissues, including their microvessels, displayed a marked induction of HO-1 concurrent with an increase in plasma concentrations of bilirubin-IX{alpha}, the product of HO-catalyzed degradation of protoheme IX. In these rats, oxidative stress such as superfusion with H2O2 and ischemia-reperfusion of the tissues neither induced rolling nor exhibited adherent responses of leukocytes in venules. In contrast, the oxidative stresses evoked marked rolling and adhesion of leukocytes in the control rats without HO-1 induction. The HO-1 induction also downregulated leukocyte adhesion elicited by other pro-oxidant stimuli such as N{omega}-nitro-L-arginine methyl ester. The decreases in the oxidant-elicited leukocyte adhesive responses under HO-1–inducing conditions were restored by perfusion with zinc protoporphyrin-IX, an HO inhibitor, but not with copper protoporphyrin-IX, which did not inhibit the enzyme. Furthermore, the effects of zinc protoporphyrin-IX were repressed by superfusion with bilirubin or biliverdin at the micromolar level, but not by the same concentration of carbon monoxide, another product of HO. These results indicate that induction of the HO-1 activity serves as a potential stratagem to prevent oxidant-induced microvascular leukocyte adhesion through the action of bilirubin, a product of HO reaction.


Key Words: heme oxygenase • bilirubin • carbon monoxide • oxidative stress • endothelial cell


*    Introduction
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up arrowAbstract
*Introduction
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Heme oxygenase (HO) is the enzyme that oxidatively degrades protoheme IX to biliverdin and carbon monoxide (CO). In mammals, biliverdin is further converted into bilirubin, an endogenous radical scavenger, through the action of biliverdin reductase.1 HO responsible for heme degradation exists in 3 distinct isoforms, HO-1 and HO-2.2 3 HO-3 has recently been found, although its catalytic activity appears to be smaller than other isozymes.4 HO-2 is thought to be constitutive, whereas HO-1 is inducible by various stimuli such as cytokines, heavy metals, oxidants, and protoheme IX, the substrate for HO by itself.5 Such a diversity of stimuli that induce HO-1 expression led several investigators to speculate that HO-1 could play a role in maintaining homeostasis of organ functions. When tissues are preexposed to the HO-1 inducers, their damage and/or acute inflammatory responses are markedly attenuated in a variety of models, such as carrageenan-induced pleuritis,6 oxidant-induced lung injury,7 and endotoxin shock.8 9 However, the mechanisms by which pretreatment with HO-1 induction attenuates inflammatory responses have not fully been elucidated.

It has been widely accepted that tissue leukocyte recruitment is an important factor that determines the severity of tissue injury in acute inflammation or in ischemia-reperfusion.10 11 12 The entry of leukocytes at sites of inflammation is known to be regulated by multistep processes involving the actions of several different adhesion molecules on both leukocytes and endothelial cells; among these, endothelial cell–associated adhesion molecules such as P-selectin participate in the initial step for leukocyte recruitment, as documented by a number of previous studies.10 11 12 13 This adhesion molecule is rapidly expressed on the plasma membrane and triggers leukocyte rolling and adhesion by proinflammatory agonists such as thrombin,14 histamine,15 16 and oxygen free radicals,17 18 or by inhibition of nitric oxide synthase.19 20 This study aimed to examine whether HO-1 induction could attenuate inflammatory responses through downregulation of endothelial cell–leukocyte interactions in vivo. Our findings have provided evidence that tissue pretreatment with the HO-1 induction antagonizes oxidant-elicited leukocyte rolling and adhesion through a mechanism involving generation of HO-derived bile pigments such as biliverdin and bilirubin.


*    Materials and Methods
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*Materials and Methods
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Experimental protocols to care and use animals in the present study were approved by the institutional guidelines of Keio University School of Medicine. Male Wistar rats were anesthetized and treated with an intraperitoneal injection of hemin, a potent inducer of HO-1. Mesenteric tissues were collected for Western blotting analysis and immunohistochemistry to examine the HO-1 expression.21 Alterations in plasma bilirubin concentrations were determined by an ELISA using an anti–bilirubin-IX{alpha} monoclonal antibody (MoAb) 24G7, as described previously.22 23

Leukocyte rolling and adhesion in mesenteric microvessels were examined by playback of video images recorded under an intravital microscope monitoring erythrocyte velocity.18 20 Venular leukocyte adhesion was elicited by superfusion with H2O2 on the mesentery of the control and the HO-1–induced rats. The relative leukocyte rolling velocity versus erythrocyte velocity (VW/VR) and density of adherent cells were determined. In other experiments, one of the following interventions was superfused from 10 minutes before the start of the H2O2 application until the end of the experiments: zinc protoporphyrin IX (ZnPP) or copper protoporphyrin IX (CuPP),24 or unconjugated bilirubin or CO.25 We also examined the effects of an iron chelator, desferrioxamine mesilate (DFO), on the H2O2-elicited leukocyte adhesion.20 When necessary, anti–rat P-selectin (ARP2.4, Sumitomo Pharmaceutical, Inc) was injected before the H2O2 superfusion.26 Effects of N{omega}-nitro-L-arginine methyl ester (L-NAME),20 tert-butyl hydroperoxide (BHPOx),18 histamine dihydrochloride,16 18 and folmyl methionyl leucyl phenylalanine (FMLP)27 were also tested. Separately, microvessels of rats pretreated with or without hemin were subjected to hemorrhagic shock followed by reperfusion, and adhesive responses were examined according to the previous protocols.28 We also analyzed expression of adhesion molecules expressed on neutrophils using MoAbs recognizing adhesion molecules.18 The MoAbs were WT-3 (anti-rat CD18), WT-5 (anti-rat CD11b), and HRL-3 (anti-rat L-selectin), generous gifts from Prof Masayuki Miyasaka, Osaka University School of Medicine,18 and 2H5 (anti–sialyl Lewis X-like carbohydrate structure [SLeX]).29 Separately, secretagogue activation of mast cells by H2O2 was examined by measuring the release of the enzyme ß-hexosaminidase (ß-hex), as described in the previous method,30 31 with modifications. The density of degranulated and undegranulated mast cells in the mesenteric tissue was also studied using the toluidine blue staining method as described previously.32

Expression of P-selectin in venules was examined in vivo using real-time laser confocal video microscopy.33 34 A MoAb against rat P-selectin (ARP2.4) was labeled with FITC and injected into the femoral vein. Before, and 10 minutes after, the start of superfusion of H2O2 on the mesentery, fluorescence images were captured and digitally processed. Data calibration was carried out according to our previous method, with modifications.34 On the other hand, effects of pretreatment with the HO-1 induction by hemin or with application of bilirubin on oxidative changes were examined in cultured human umbilical venous endothelial cells (HUVECs) using carboxydihydrofluorescein (CDCFH) diacetate bis-acetoxymethyl ester, an oxidant-sensing fluorochrome precursor.20 27 Differences in the H2O2-induced fluorescence elevation were determined among the groups by digital microfluorography.34 Statistical significance was determined by 1-way ANOVA with the Fisher multiple comparison test. All data were expressed as mean±SD, and P<0.05 was considered significant.

An expanded Materials and Methods section is available online at http://www.circresaha.org.


*    Results
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*Results
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Effects of HO-1 Induction on the Interaction of Leukocytes With Venular Endothelium
Figure 1Down illustrates alterations in expression of the HO-1 protein in the mesentery of hemin-treated rats. As illustrated in Western blotting analysis in Figure 1ADown, an intraperitoneal injection of hemin induced a marked increase in the protein expression, which became evident at 6 hours and peaked at 12 hours followed by a recovery to the control level at 18 hours. We therefore performed fluorescence immunohistochemistry using the same MoAb labeled with FITC in the mesenteric tissue of the 12-hour hemin-treated rats. As seen in the left portion of Figure 1BDown, the hemin-untreated mesentery exhibited little immunoreactivity of HO-1, if any, and only counterstaining with KiM2R-associated phycoerythrin on tissue macrophages was evident. On the other hand, the hemin-treated mesentery displayed marked immunoreactivities of HO-1 both in vascular regions and in the interstitial space; among these HO-1–positive cells, arteriolar and venular endothelia constituted a major site of prominent HO-1 expression. Such HO-1–associated fluorescence activities were not evident in the mesentery of the 18-hour hemin-treated rats (data not shown).



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Figure 1. Effects of hemin treatment on expression of HO-1 in the rat mesentery. A, Western blotting analysis of HO-1 protein as a function of time after the intraperitoneal injection of hemin. m indicates molecular markers. B, Dual-color immunohistochemistry showing the distribution of HO-1 and peritoneal macrophages in the whole-mount preparation of the mesentery excised from the 12-hour hemin-treated rats. Left and right panels, Representative laser confocal microfluorograph of the hemin-untreated mesentery and that of the hemin-treated one. Note marked expression of HO-1 in microvascular beds, including venules (v). Orange staining indicates distribution of peritoneal macrophages stained with a MoAb KiM2R in both panels. Bar=100 µm.

The TableDown illustrates differences in venular leukocyte adhesion elicited by topical superfusion of H2O2 or by hemorrhagic shock followed by reperfusion among varied time intervals after the hemin treatment. Adherent responses of leukocytes time-dependently decreased and became smallest at 12 hours in both experimental groups, suggesting that pretreatment with hemin downregulates oxidant-elicited venular leukocyte adhesion. It should be noted that plasma concentrations of bilirubin-IX{alpha} increased at 6 hours, reached a maximum level at 12 hours, and decreased at 18 hours. On the other hand, plasma concentrations of at 6, 12, and 18 hours after treatment with the hemin-untreated vehicle control were 1.0±0.3, 0.9±0.2, and 0.9±0.3 µmol/L (n=5), respectively, indicating no significant changes. These results indicated that the decrease in oxidative stress-induced adhesive changes in the HO-1–induced mesentery became most prominent at a time when the HO-1 induction and actual heme degradation reached a maximum level.


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Table 1. Differences in Adhesive Responses of Leukocytes Elicited by 500 µmol/L H2O2 or by 15-Minute Hemorrhagic Shock (HS) Followed by 20-Minute Reperfusion (R) in the Mesenteric Venules and in Plasma Concentrations of Bilirubin (BR)-IX{alpha} Undergoing the Hemin Pretreatment With Varied Time Intervals

Attenuation of H2O2-Elicited Leukocyte Rolling and Adhesion by the Induction of HO-1
Figure 2Down showed temporal alterations in rolling and adherent responses of leukocytes in venules of the mesentery elicited by the superfusion of H2O2 at 500 µmol/L. In the control rats in which HO-1 was not induced, the H2O2 superfusion evoked a marked decrease in the VW/VR values, which reached a minimum at 10 minutes after the start of superfusion, were sustained for 20 minutes, and then increased to restore the baseline level. During these events, venular shear rates did not exhibit any significant reduction (data not shown). The density of adherent leukocytes (closed circles) also elevated time dependently in response to the H2O2 superfusion and kept high levels even at 40 minutes after the start of superfusion. On the other hand, the mesenteric microvessels undergoing the 12-hour hemin treatment exhibited quite different pictures for the adhesive changes in response to the H2O2 superfusion; as indicated by open squares, the rolling velocity was not significantly reduced on the application of 500 µmol/L H2O2, suggesting little increase in the adhesion capacity, if any, between venular endothelium and leukocytes. At the same time, little elevation of the adhesion density was observed in these rats during the entire observation period. We further examined effects of different concentrations of H2O2 on the mesentery. At concentrations >1 mmol/L, H2O2 induced a significant reduction of venular shear rates, which coincided with an increase in the density of adherent cells. On the other hand, at those <500 µmol/L, we observed a transient reduction of the rolling velocity but not stationary adhesion, as was observed at 500 µmol/L. These results were consistent with previous data by Suzuki et al.35 On the basis of these findings, we used 500 µmol/L of H2O2 as a maximum concentration that did not alter microvascular shear rates and that allowed us to rule out hemodynamic effects on leukocyte adhesion in these and later experiments.



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Figure 2. Differences in time history of H2O2-induced changes in rolling and adhesion of leukocytes in the mesenteric venules between the hemin-treated and -untreated mesentery. Circles and squares indicate data collected from control and 12-hour hemin-treated rats, respectively. Values are mean±SD of 7 experiments in individual groups. {circ} and {square} denote VW/VR (%). • and {blacksquare} indicate number of adhesions per 100-µm venular segment (adhesion density). *P<0.05 as compared with {square}; {dagger}P<0.05 as compared with {blacksquare}.

Requirement of HO Activities for Downregulation of Leukocyte Adhesion
We then inquired whether the enzyme activity of HO-1 could be necessary to attenuate the oxidant-elicited adhesive responses in the 12-hour hemin-treated rats. To that end, effects of local superfusion with ZnPP, an HO inhibitor, were examined. At 20 minutes after the start of superfusion of 0.5 µmol/L ZnPP with H2O2, the VW/VR value was significantly decreased as compared with that measured under the superfusion with H2O2 alone (1.1±0.6 versus 2.7±0.2%, P<0.05, mean±SD of 7 experiments). At the same time, the treatment with the same concentration of ZnPP alone did not significantly alter the baseline VW/VR value in the group (2.5±0.4%, n=5). On the other hand, treatment with 0.5 µmol/L CuPP, a metalloprotoporphyrin that did not inhibit HO, did not mimic the effects of ZnPP, which could restore the H2O2-elicited VW/VR reduction (2.4±0.5%, n=5). Because no significant differences in venular shear rates were observed among these groups (data not shown), these results suggest that the HO activity in situ could downregulate the H2O2-induced enhancement of adhesion between leukocytes and venular endothelium. The ZnPP-induced restoration of the rolling responses was abolished by pretreatment with an anti–P-selectin MoAb ARP2.4 (2.6±0.5%, n=5), suggesting that P-selectin is involved in the rolling response elicited by H2O2 plus ZnPP in the 12-hour hemin-treated mesenteric venules.

Figure 3Down illustrates effects of ZnPP, an HO inhibitor, and the anti–P-selectin MoAb on the density of venular leukocyte adhesion in control and 12-hour hemin-treated rats. As already illustrated in Figure 2Up, the H2O2 superfusion elicited a significant increase in the density of leukocyte adhesion in the control mesentery. This change was not altered by cosuperfusion with 0.5 µmol/L ZnPP or CuPP. At the same time, treatment with ZnPP or with CuPP at this concentration per se did not elicit leukocyte adhesion per se (data not shown). The H2O2-induced elevation of the adhesion density was attenuated completely by pretreatment with an anti–P-selectin MoAb, ARP 2.4. The adhesive changes were also inhibited significantly by pretreatment of DFO, an iron chelator, suggesting that iron-mediated oxyradical propagation is necessary to evolve the H2O2-elicited adhesion, as will be discussed later. These results suggest that the HO-induced leukocyte adhesion is not altered by inhibition of the HO activity and is mediated by P-selectin in the control rats.



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Figure 3. Effects of ZnPP, the anti–P-selectin MoAb ARP2.4, and DFO on H2O2-induced leukocyte adhesion in the mesenteric venules. Upper and lower portions of each panel indicate data collected from control (HO-1 induction [-]) and 12-hour hemin-treated (HO-1 induction [+]) rats, respectively. Data are mean±SD of 6 to 8 experiments in each group. *P<0.05 as compared with the control in the HO-1 induction (-) group; {dagger}P<0.05 as compared with the H2O2-treated rats in the HO-1 induction (-) group; #P<0.05 as compared with the H2O2-treated rats in the HO-1 induction (-) group; **P<0.05 as compared with the H2O2-treated rats in the HO-1 induction (+) group; $P<0.05 as compared with the H2O2 plus ZnPP–treated rats in the HO-1 induction (+) group.

On the other hand, a reduction of the H2O2-induced leukocyte adhesion in the hemin-treated rats was significantly reversed by cosuperfusion with 0.5 µmol/L ZnPP, but not with the same concentration of CuPP. Again, the ZnPP-induced recovery of the H2O2-induced adhesive changes was attenuated either by pretreatment with ARP2.4 or in part by that with DFO. These results collectively suggest that the enzyme activity of HO plays a crucial role in acquisition of resistance against the H2O2-elicited, and P-selectin-mediated, rolling and adhesion of leukocytes in the HO-1–induced mesenteric microcirculation.

Effects of Exogenously Applied Bilirubin and CO on Leukocyte Adhesion In Vivo
The data showing the ZnPP-induced recovery of adhesive responses of leukocytes in the hemin-treated mesentery tempted us to examine whether bilirubin and/or CO could alter the H2O2-induced rolling and adhesion of leukocytes (Figure 4Down). The upper and lower left panels illustrate alterations by coperfusion with varied concentrations of bilirubin in the H2O2-induced changes in leukocyte rolling and adhesion in the hemin-untreated control group, respectively. As indicated by the open circles, the bilirubin superfusion dose-dependently attenuated both rolling and adherent responses, and 5 µmol/L of the reagent was sufficient to fully inhibit the H2O2-elicited changes. On the other hand, the superfusion with biliverdin at 10 µmol/L but not with the same concentration of CO significantly attenuated the rolling and adherent responses elicited by H2O2, as shown in closed circles and open squares, respectively.



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Figure 4. Effects of exogenously applied bilirubin and CO on H2O2-induced changes in rolling and adhesion of leukocytes in mesenteric venules. Left and right panels, Data collected from hemin-untreated (HO-1 induction [-]) and 12-hour hemin-treated (HO-1 induction [+]) groups, respectively. Open and shaded circles, Data collected from venules treated with superfusion with H2O2 in control rats and from those superfused with H2O2 in the presence of 0.5 µmol/L ZnPP in the hemin-pretreated rats under varied concentrations of bilirubin, respectively. Closed circles, Data measured in the presence of biliverdin in the both group. Open and shaded squares, Data collected from the mesentery superfused with CO plus H2O2 in the control rats and those collected under superfusion with the same concentrations of CO and H2O2 plus 0.5 µmol/L ZnPP in the hemin-treated rats, respectively. *P<0.05 as compared with the data from venules treated with H2O2 in the absence of bilirubin; {dagger}P<0.05 as compared with the data from venules treated with H2O2 in the absence of biliverdin in both groups.

The upper and lower right panels of Figure 4Up depict alterations in rolling and adherent responses of leukocytes in the hemin-treated rats (HO-1 induction [+]). As shown above and also as indicated by the open circles in these panels, these rats were characterized by a marked reduction of the adhesive responses to the oxidative impacts, and the inhibition of the HO activity by ZnPP was necessary to restore the H2O2-induced adhesive responses, as indicated by shaded circles plotted at no bilirubin treatment. Bilirubin dose-dependently attenuated the ZnPP-dependent restoration of the H2O2-elicited rolling and adherent changes. Again, such effects of bilirubin were mimicked by biliverdin (closed circles), but not by CO (shaded squares). These results indicate that supplement of bilirubin at micromolar levels can inhibit the H2O2-induced rolling and adhesion of leukocytes in the venules, and downregulation of adhesive responses in the HO-1-induced rats appears to be ascribable to the effects of biliverdin and/or bilirubin but not to those of CO.

Reduction of L-NAME– or Hydroperoxide-Induced Leukocyte Adhesion in the Hemin-Treated Rats
We further inquired whether downregulation of leukocyte adhesion in the HO-1–induced mesentery could occur on application of other stimuli that are known to induce adherent changes. Four different stimuli, 500 µmol/L BHPOx, 100 µmol/L L-NAME, 10 µmol/L histamine, and 100 nmol/L FMLP, were chosen to examine differences in venular leukocyte adhesion between the control and the 12-hour hemin-treated rats; as seen in the open bars of the left panel of Figure 5Down, superfusion with these reagents under the given concentrations evoked a marked increase in the adherent cells. These results were also consistent with the previous observations.18 20 In the 12-hour hemin-treated rats, the adhesive responses elicited by BHPOx or by L-NAME were significantly attenuated, whereas those elicited by histamine or by FMLP superfusion were still evident and comparable with the responses in the hemin-untreated group. On the other hand, as shown by flow cytometric analysis in the right panels of Figure 5Down, the hemin treatment did not significantly alter the expression of adhesion molecules on circulating neutrophils such as SLeX-like carbohydrate structure, L-selectin, and CD11b/CD18. The expression of L-selectin and CD11b/CD18 on lymphocytes was also examined but with no significant differences (data not shown). These results suggest that downregulation of the leukocyte adhesion in the HO-1–overexpressed microvessels occurs through leukocyte-independent mechanisms.



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Figure 5. Differences in the venular leukocyte adhesion induced by L-NAME, BHPOx, histamine, or FMLP in the mesenteric venules between the control and the 12-hour hemin-treated rats. Left, Alterations in the density of venular leukocyte adhesion. Control, No treatment with adhesion-inducing reagents. Closed and open columns and bars, Mean±SD of measurements from 5 to 6 hemin-treated (HO-1[+]) and vehicle-treated (HO-1[-]) rats, respectively. *P<0.05 as compared with the control data; {dagger}P<0.05 as compared with the hemin-untreated controls. Right, Laser flow cytometric analysis of expression of SLeX-like carbohydrate structure (SLeX), L-selectin, CD11b/CD18 on circulating neutrophils in the 12-hour hemin-treated rats. BG denotes the background fluorescence recorded in the absence of primary MoAbs. Population of the cells as a function of fluorescence intensities was plotted.

Considering that degranulation of mast cells is known to evoke venular leukocyte rolling and adhesion,36 we next examined whether a sensitivity of the cells to H2O2 could differ between the hemin-treated and -untreated mesenteric tissues. The percentage densities of degranulated mast cells in the hemin-untreated tissues before and after H2O2 application at 500 µmol/L were 8.0±3.8% and 8.1±5.4%, whereas those in the hemin-treated tissues were 7.7±4.2% and 7.2±4.3% (mean±SD of 5 separate experiments), respectively, indicating that this concentration of H2O2 did not evolve notable degranulation of mast cells in both groups. Using the isolated mast cells, we also examined effects of 500 µmol/L H2O2 on the degranulation in vitro but were unable to detect measurable levels of the ß-hex release (6.1±0.9% in no treatment versus 6.6±0.8% in the H2O2 treatment; n=5). On the other hand, the same cells exhibited significant ß-hex release, at 60.2±5.2% (P<0.05, n=5), on the application of 1 µg/mL compound 48/80, a stimulator of mast cell degranulation. These results suggest that the hemin treatment did not evoke measurable alterations in the population of degranulated mast cells under basal and H2O2-stimulated conditions. Thus, the mechanism for downregulation of leukocyte adhesion in the hemin-treated mesentery is unlikely to be ascribable to the altered sensitivity of mast cells, at least under the current experimental conditions.

Reduction of H2O2-Elicited Venular P-Selectin Expression in the Hemin-Treated Mesentery
Figure 6Down illustrates representative pictures of the P-selectin–associated laser confocal fluorescence images captured before (baseline) and 10 minutes after the start of the H2O2 superfusion at 500 µmol/L (H2O2) in the hemin-untreated and -treated preparations. On the H2O2 application, the fluorescence intensities along venular endothelium in the hemin-untreated mesentery (HO-1[–]) became markedly increased. Under these circumstances, the H2O2 superfusion evoked only little leukocyte adhesion if any, as shown in the right upper panel. These results suggest that the MoAb ARP2.4 administered into the circulation mainly binds to P-selectin expressed on the H2O2-treated venular endothelium and thereby blocks leukocyte adhesion in situ. On the other hand, the mesenteric venules in the hemin-treated rats (HO-1[+]) exhibited only little elevation of the fluorescence on the H2O2 superfusion at the same concentration.



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Figure 6. Representative pictures showing downregulation of the H2O2-elicited P-selectin translocation in the mesenteric microvascular endothelium in the hemin-treated rats. A and B, Representative microfluorographs in the hemin-untreated (HO-1[-]) and hemin-treated (HO-1[+]) mesenteric tissues. Left and middle portions of the panels indicate microfluorographs of the FITC-labeled anti–P-selectin MoAb, which were captured before (baseline) and 10 minutes after the H2O2 superfusion (H2O2), respectively; right portions show transillumination images in each group (TR). a indicates arteriole; v, venule. Bar=30 µm.

We attempted to quantify H2O2-elicited changes in the venular FITC labeling by calibrating the fluorescence activities. Figure 7ADown illustrates the net increase in the venular fluorescence intensities on a 10-minute exposure to 500 µmol/L H2O2. As seen, in the hemin-untreated control, the H2O2 exposure induced a marked increase in the ARP2.4-associated fluorescence. The H2O2-induced fluorescence elevation was attenuated almost completely by pretreatment with the bilirubin superfusion at 10 µmol/L. On the other hand, the venules of the hemin-pretreated rats exhibited only small elevation of the fluorescence on the application of H2O2. The absence of H2O2-induced elevation of fluorescence was markedly restored by supplementation with 0.5 µmol/L ZnPP, reaching the level equivalent to that observed in the hemin-untreated venules undergoing H2O2 exposure. It should be noted that pretreatment with either bilirubin or DFO significantly repressed the ZnPP-elicited restoration of the fluorescence elevation. Most importantly, as shown in the upper portion of Figure 7ADown, the H2O2-induced elevation of the fluorescence in the hemin-untreated mesenteric preparations or in those pretreated with hemin plus ZnPP was not evident when the fluorescence-labeled ARP2.4 was replaced by FITC-labeled nonspecific IgG. These results suggest that the differences in the H2O2-induced alterations among these groups occurred specifically because of those in the P-selectin labeling in vivo. Collectively, downregulation of the H2O2-induced rolling and adherent responses of leukocytes in the hemin-treated rats is likely to be ascribable to decreased responses of the P-selectin translocation. Effects of the HO-1 induction or bilirubin on the H2O2-induced oxidative changes were also examined. As seen in Figure 7BDown, HUVECs undergoing the HO-1 induction exhibited lesser oxidative responses on H2O2 application. Different effects of 500 µmol/L H2O2 on CDCFH oxidation among the groups are summarized in Figure 7CDown. The data show that the H2O2-induced oxidative changes were attenuated significantly by the HO-1 induction or by the bilirubin application, and that ZnPP restored the H2O2-induced changes in the HO-1–induced HUVECs. Furthermore, the ZnPP-elicited restoration of oxidative changes was again cancelled by application of bilirubin or DFO. These results suggest that the HO-1 induction, as well as bilirubin supplementation, attenuates intracellular oxidant generation elicited by H2O2.



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Figure 7. Downregulation of the H2O2-induced P-selectin-associated fluorescence enhancement in venules and oxidative changes in cultured HUVECs by HO-1 induction or by bilirubin. A, Differences in the H2O2-elicited local IgG labeling among the groups. In the present study, calibration lines showing the relationship between concentrations of FITC-labeled IgG and gray level intensities were almost identical between the anti–P-selectin IgG MoAb (ARP2.4) and nonspecific IgG, as seen in the inset. Data in the main panel represent mean±SD of 6 to 8 different venular segments in the mesentery from 5 individual rats and indicate the H2O2-elicited net elevation of the fluorescence expressed as concentrations of each IgG, which yield equivalent gray-level intensities on microfluorographs. B, Differences in dose-dependent elevation of intracellular oxidant generation between hemin-treated [HO-1(+)] and –untreated [HO-1(-)] HUVECs. C, Differences in relative changes in the H2O2-induced oxidant generation as judged by the net increase ({Delta}) in CDCFH oxidation among the groups. Groups correspond to those in the lower portion of panel A. *P<0.05 as compared with the data collected from rats untreated with H2O2; {dagger}P<0.05 as compared with the group treated with H2O2 alone in the HO-1(-) mesentery; #P<0.05 as compared with the H2O2-induced response in the HO-1(+) mesentery; and **P<0.05 as compared with the response elicited by H2O2 plus ZnPP in the HO-1(+) mesentery.


*    Discussion
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up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
*Discussion
down arrowReferences
 
The current study demonstrates that microvascular endothelial cells overexpressing HO-1 become resistant to oxidative stress and resultant upregulation of leukocyte adhesion and suggests the role of bilirubin generated through the enzyme reaction. Recent studies, including those using HO-1–knockout mice, have shown that the induction of HO-1 helps to ameliorate tissue injury or inflammatory changes in a variety of experimental models.37 38 39 40 However, these previous studies did not fully address molecule(s) responsible for the HO-1–dependent attenuation of inflammatory responses. Our results provide for the first time in vivo evidence showing that pretreatment with the HO-1 induction helps reduce tissue leukocyte recruitment through mechanisms involving bilirubin, which is capable of inhibiting the very initial process of cell attachment, that is, leukocyte rolling on the endothelial surface.

There are several possibilities through which HO activity could contribute to a reduction of the tissue sensitivity to oxidative stress. First, the HO reaction is attributable to a decrease in the substrate protoheme IX, which is known to enhance oxidant-induced cell injury.41 Second, the HO reaction can exert its ability to reduce oxidative stress through biological actions of its reaction products, CO and biliverdin. Biliverdin and its reduced product bilirubin scavenge various oxidants, such as hydroxyl radical, singlet oxygen, and lipid hydroperoxides and are thus considered endogenous antioxidants that protect cells from oxidative insults.1 42 On the other hand, CO is known to function as a vasorelaxing mediator that could guarantee ample blood supply to microvascular beds.26 Furthermore, CO has the ability to inhibit cytochrome P-450, which can promote oxidation of fatty acids.23 43 Among these putative mechanisms by which HO-1 activity can attenuate the impact of oxidative stress, our study shed light on the importance of bilirubin, which was actually elevated in plasma and downregulated the H2O2-induced P-selectin translocation, as well as rolling and adhesion of leukocytes in venules. On the other hand, the current study did not show any antioxidative or antiadhesive properties of CO, another product that is generated stoichiometrically through the HO reaction, as topical application of this gaseous monoxide at concentrations comparable with bilirubin did not repress the leukocyte adhesion elicited by H2O2 and ZnPP in hemin-treated rats. Our results thus provided evidence in vivo for such a product-specific antioxidative mechanism under the HO-1–inducing conditions that has not fully been addressed in previous results obtained in experiments using HO-1 gene-targeting mice,40 whereas such inhibitory actions of bilirubin on locomotion of inflammatory cells were reported previously in cultured systems.44

It should be noted in the current study that tissue pretreatment with HO-1 downregulated venular leukocyte adhesion elicited by H2O2, BHPOx, and L-NAME, but did not attenuate that elicited by histamine or FMLP. These results are not surprising, in that H2O2, BHPOx, and L-NAME share the oxidant-propagating mechanism on endothelial cells. When topically applied on the mesentery, the former 3 reagents can induce overproduction of hydroperoxides in microvascular endothelial cells that is followed by P-selectin-mediated leukocyte adhesion, as shown by previous studies.18 20 28 On the other hand, histamine or FMLP can elicit receptor-mediated P-selectin expression or directly upregulate expression of CD11/CD18 on marginating neutrophils, respectively, and does not primarily induce oxidative changes in the venular endothelium. In this context, pretreatment with HO-1 induction serves as a potential stratagem to ameliorate venular leukocyte adhesion specifically promoted by direct oxidative impacts (eg, BHPOx) and/or by pro-oxidant reagents (eg, L-NAME), but not that induced by oxidant-independent mechanisms (eg, histamine, FMLP). Further investigation on quantitative determination of the P-selectin expression45 is needed to resolve the question of whether the inhibitory action of the HO-1 induction or bilirubin on the oxidant-elicited and P-selectin–mediated leukocyte adhesion in vivo, shown in the current study, is applicable to other organ microvascular systems.

It is not known what kinds of cells in the HO-1–overexpressed mesentery were responsible for bilirubin generation. However, several lines of evidence lead us to suggest that microvascular endothelial cells serve as an important site for the enzyme reaction of HO-1. First, as seen in Figure 1Up, the microvascular endothelium exhibited a most prominent response of the enzyme induction in the hemin-treated rats. Second, at least under the current experimental conditions, mast cells were unlikely to display any visible degranulation on stimulation with H2O2 in both the control and the hemin-treated groups. In addition, tissue macrophages in the mesenteric interstitial space appear to express little HO-1 expression, if any, in the both groups. Third, local superfusion with ZnPP, an HO inhibitor, on the mesentery significantly restored the H2O2-induced P-selectin translocation in the venular endothelium overexpressing HO-1. Finally, and most importantly, bilirubin at physiologically reasonable concentrations repressed the ZnPP-elicited recovery of the H2O2-induced leukocyte adhesion and mimicked effects of the HO-1 induction. Because the plasma bilirubin concentrations in the hemin-pretreated rats were still greater than the control, even under the local ZnPP superfusion (data not shown), these findings suggest that a continuous generation of this heme-degrading product in microvessels is necessary to maintain their antiadhesive property.

Of interest is that only 5 to 10 µmol/L bilirubin is sufficient to ameliorate adhesive responses elicited by as much as 500 µmol/L H2O2. Considering that bilirubin tends to accumulate in the cell membrane and efficiently captures superoxide, hydroxyl radicals, and lipid hydroperoxide radicals but not H2O2 directly,1 46 it is not unreasonable to hypothesize that most of the H2O2 applied on the mesentery in vivo could be degraded rapidly by antioxidant enzymes that abundantly occur in intravascular space (eg, catalase and glutathione peroxidase in circulating erythrocytes), and the rest could participate in propagation of oxyradical species responsible for endothelial P-selectin translocation. Such a hypothesis is supported by the current findings showing inhibitory effects of an iron chelator, DFO, on H2O2-induced P-selectin expression and leukocyte adhesion.17 Detailed kinetics of the bilirubin generation in and around the endothelial cells in the HO-1–pretreated tissue should also be examined in the future. However, the present results suggest that microvascular endothelial cells constitute an important cellular component sensing tissue overloading of protoheme IX: When exposed to the stimulus, regional tissues undergo oxidative injury and increase their ability to decompose the heme molecules by inducing HO-1, and finally become less sensitive to oxidative stress through bilirubin-dependent mechanisms. Such a notion is well supported by a previous study in vitro showing that transfection of the HO-1 gene renders endothelial cells less susceptible to heme-mediated oxidative stress.38

We utilized overloading of free heme molecules as a tool to induce HO-1. Clinical situations in which tissues are exposed to excessive amounts of heme involve rhabdomyolysis,47 intravascular hemolysis, and endotoxemia,48 which are known to trigger the release of myoglobin or hemoglobin as a source of protoheme IX. Under these circumstances, microvascular endothelium serves as a primary site exposed to circulating heme molecules. In this context, one may speculate that the HO-1 induction in the endothelial cells could not only detoxify excessive heme molecules in circulation but also help reduce unnecessary leukocyte recruitment into damaged tissues under aforementioned disease conditions. On the other hand, besides the overloading of heme or ischemia-reperfusion,49 there are several alternate procedures to obtain the HO-1 induction, such as exposure to endotoxin.21 Such previous results raise an important question as to whether pretreatment with these non-heme stimuli could also render microvessels less adhesive to circulating leukocytes. Further investigation is obviously required to examine whether the tissue HO-1 induction and subsequent downregulation of leukocyte adhesion are involved in the mechanisms for tolerance against endotoxin or shock conditions.33


*    Acknowledgments
 
We thank Prof Masayuki Miyasaka for his generous gifts of MoAbs and Prof Makoto Murakami for instruction of mast cell isolation. This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan; by grants from Keio University School of Medicine; by Advanced Medical Technology in Health Science Research Grants from the Ministry of Health and Welfare in Japan; and in part by Takeda Science Foundation.


*    Footnotes
 
A portion of this work was presented at the Experimental Biology 98 meeting, April 1998, San Francisco, Calif.

Received February 11, 1999; accepted August 10, 1999.


*    References
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
up arrowDiscussion
*References
 
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