Heme oxygenase-1 messenger RNA expression is induced in peripheral blood mononuclear cells of pediatric cancer patients with systemic inflammatory response syndrome

Jeffrey E. Schmidt, Jim I. Morgan, Carlos Rodriguez-Galindo, David L. Webb, Hua Liang, Robert F. Tamburro

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Objective: To determine whether heme oxygenase-1 messenger RNA expression in peripheral blood mononuclear cells is induced in pediatric cancer patients with the systemic inflammatory response syndrome (SIRS) and whether this expression correlates with the heme oxygenase-1 products, bilirubin and carboxyhemoglobin. Design: Prospective, controlled study. Setting: A tertiary care pediatric oncology hospital. Patients: Fourteen patients admitted to the intensive care unit with a diagnosis of SIRS by American College of Chest Physicians/ Society for Critical Care Medicine consensus criteria and 17 control patients (off therapy, no acute illness). Interventions: Blood for bilirubin, carboxyhemoglobin, and heme oxygenase-1 messenger RNA expression was collected at study entry. SIRS patients continued to have samples collected every 12 hrs for 1 wk or until intensive care unit discharge. Heme oxygenase-1, bilirubin, and carboxyhemoglobin levels of SIRS patients were compared with controls, and correlation between heme oxygenase-1 and products was assessed. Measurements and Main Results: Within 48 hrs of study entry, maximum heme oxygenase-1 expression for all SIRS patients compared with controls was 5.5+ 1.0 vs. 1.1+ 0.1 (p < .0006). Maximum expression was >2.3-fold in 13 of 14 SIRS patients. Maximum heme oxygenase-1 expression also differed from minimum (5.5+ 1.0 vs. 1.6+ 0.3, p < .003). Maximum bilirubin and carboxyhemoglobin levels within 48 hrs of study entry differed between SIRS patients and controls (3.0+ 0.8 vs. 0.3+ 0.1, p= .006; and 1.2+ 0.2 vs. 0.6+ 0.1, p= .001, respectively). Bilirubin, but not carboxyhemoglobin, correlated with heme oxygenase- 1 expression (p= .0013). Conclusions: Heme oxygenase-1 messenger RNA, bilirubin, and carboxyhemoglobin levels were increased within 48 hrs of admission in pediatric cancer patients with SIRS. Heme oxygenase- 1 expression correlated with serum bilirubin levels. The increase in heme oxygenase-1 expression may add to the understanding of the increase in serum bilirubin observed in patients with SIRS/sepsis. These findings support a role for heme oxygenase- 1 in the physiologic response to inflammatory stress. (Pediatr Crit Care Med 2004; 5:554 -560)

Original languageEnglish (US)
Pages (from-to)554-560
Number of pages7
JournalPediatric Critical Care Medicine
Volume5
Issue number6
DOIs
StatePublished - 2004

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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