Serum heme oxygenase-1 measurement is useful for evaluating disease activity and outcomes in patients with acute respiratory distress syndrome and acute exacerbation of interstitial lung disease.

BACKGROUND: Oxidative stress plays an important role in acute lung injury, which is associated with the development and progression of acute respiratory failure. Here, we investigated whether the degree of oxidative stress as indicated by serum heme oxygenase-1 (HO-1) is clinically useful for predicting prognosis among the patients with acute respiratory distress syndrome (ARDS) and acute exacerbation of interstitial lung disease (AE-ILD). METHODS: Serum HO-1 levels of newly diagnosed or untreated ARDS and AE-ILD patients were measured at diagnosis. Relationships between serum HO-1 and other clinical parameters and 1 and 3-month mortality were evaluated. RESULTS: Fifty-five patients including 22 of ARDS and 33 of AE-ILD were assessed. Serum HO-1 level at diagnosis was significantly higher in ARDS patients than AE-ILD patients (87.8 ± 60.0 ng/mL vs. 52.5 ± 36.3 ng/mL, P <  0.001). Serum HO-1 correlated with serum total bilirubin (R = 0.454, P <  0.001) and serum LDH (R = 0.500, P <  0.001). In both patients with ARDS and AE-ILDs, serum HO-1 level tended to decrease from diagnosis to 2 weeks after diagnosis, however, did not normalized. Composite parameters including serum HO-1, age, sex, and partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F) ratio for prediction of 3-month mortality showed a higher AUC (ARDS: 0.925, AE-ILDs: 0.892) than did AUCs of a single predictor or combination of two or three predictors. CONCLUSION: Oxidative stress assessed by serum HO-1 is persistently high among enrolled patients for 2 weeks after diagnosis. Also, serum HO-1 levels at the diagnosis combined with age, sex, and P/F ratio could be clinically useful for predicting 3-month mortality in both ARDS and AE-ILD patients.

Spatio-temporal stable isotope variation of a benthic primary consumer in a simple food web in a strongly acidic lake.

Analysis of aquatic food webs is typically undertaken using carbon and nitrogen stable isotope composition of consumer and producer species. However, the trophic consequences of spatio-temporal variation in the isotope composition of consumers have not been well evaluated. Lake Katanuma, Japan, is highly acidic and has only one dominant species of benthic alga and one planktonic microalga, making it a prime system for studying trophic relationships between primary consumers and producers. In this simple lake food web, we conducted a field survey to evaluate spatial and temporal variation in the carbon and nitrogen stable isotope composition of a chironomid larvae in association with a single benthic and planktonic alga. We found a significant correlation between carbon stable isotope ratios of the chironomid larvae and the benthic diatom species in the lake. Thus, chironomid larvae may represent a reliable isotopic baseline for estimating isotope values in benthic diatoms. However, although the correlation held in shallow water, at four m depths, there was no significant relationship between the isotope ratios of chironomids and benthic diatoms, probably because deep-water larvae spend part of their life cycle migrating from the lake shore to deeper water. The differing isotope ratios of deeper chironomid tissues likely reflect the feeding history of individuals during this migration.

Serum heme oxygenase-1 as a marker of lung function decline in patients with chronic silicosis.

OBJECTIVE: To identify predictive factors of excess decline in forced expiratory volume in one second (FEV1) in patients with chronic silicosis. METHODS: Forty-six male patients enrolled in 2004 were screened and received pulmonary function tests. RESULTS: Among the 33 included patients, 12 were categorized as rapid decliners (reduction in FEV1 > 60 mL/yr). The mean level of serum heme oxygenase-1 (HO-1), a marker of oxidative stress, was significantly lower in rapid decliners than in normal decliners (P = 0.002). Logistic regression analysis revealed that serum HO-1 was a factor affecting clinically important decline in FEV1 (odds ratio = 0.52; 95% confidence interval, 0.31 to 0.88) independent of the effects of age, height, weight, smoking, exposure status, and C-reactive protein. CONCLUSIONS: Serum HO-1 may be a predictor of lung function decline in silicosis patients.

Changes in carbon and nitrogen stable isotopes of chironomid larvae during growth, starvation and metamorphosis.

We conducted experiments to determine isotope changes in the deposit-feeding chironomid larvae Chironomus acerbiphilus during feeding, starvation and metamorphosis. Isotope changes in chironomid larvae occurred mainly during growth and rarely afterward. This finding indicates that chironomid isotope turnover mainly occurs in conjunction with growth and suggests that chironomid larvae only break down newly assimilated food for energy during periods of no growth. Chironomid delta(13)C values significantly increased throughout the starvation experiment, indicating that chironomids preferentially break down components with lower delta(13)C content during starvation. We found significant changes in chironomid isotope ratios ((15)N enrichment) during pupation. This evidence suggests that the physiological condition of animals (such as during an active growth phase or pre- or post-molting) is important to their stable isotope ratios.

Heme oxygenase-1, a potential biomarker of chronic silicosis, attenuates silica-induced lung injury.

RATIONALE: Heme oxygenase-1 (HO-1), a rate-limiting enzyme in heme catabolism, has antioxidative, antiapoptotic, and antiinflammatory activities. We examined whether HO-1 might be involved in silicosis. OBJECTIVES: To investigate whether HO-1 can reduce silicosis in mice and humans. METHODS AND MEASUREMENTS: Silicosis was studied using a murine model, and in 46 male patients. Serum HO-1 and 8-hydroxydeoxyguanosine (a marker of oxidative stress) were measured by enzyme-linked immunosorbent assay. Levels of HO-1 were measured by immunohistochemistry and immunoblotting. MAIN RESULTS: Serum HO-1 levels were significantly elevated in patients with silicosis compared with age-matched control subjects or patients with chronic obstructive pulmonary disease. Serum HO-1 levels also correlated inversely with serum 8-hydroxydeoxyguanosine levels and positively with vital capacity and forced expiratory volume in one second in patients with silicosis. HO-1 was present in the lungs of humans and mice with silicosis, especially at sites of silica particle deposition. In mice, silica exposure was associated with acute leukocyte infiltration, leading to development of silicotic lung lesions. The inflammation was suppressed by treatment with hemin, an inducer of HO-1, and enhanced by zinc protoporphyrin, an inhibitor of HO-1. CONCLUSIONS: Pulmonary HO-1 expression is increased in silicosis. HO-1 suppresses reactive oxygen species activity, and subsequent pathologic changes, thereby attenuating disease progression.

[A case of intrapulmonary teratoma presenting with expectoration of white hair and cheese-like material].

A 41-year-old man presented with expectoration of white hair and cheese-like material. The chest radiograph showed a round shadow adjacent to the right hilum. Bronchofiberscopy revealed strands of white hair and an obstruction consisting of sebaceous material in the right B3b bronchus. Right upper lobectomy was performed. Histological examination confirmed the diagnosis of intrapulmonary mature teratoma. This characteristic clinical presentation and the bronchofiberscopic findings may have been specific for the diagnosis of teratoma in this case.