Heme-Oxygenase and Lipid Mediators in Obesity and Associated Cardiometabolic Diseases: Therapeutic Implications

Authors

John A. McClung, Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America.Follow
Lior Levy, Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America.
Victor Garcia, Department of Pharmacology, New York Medical College, Valhalla, NY 10595, United States of America.Follow
David E. Stec, Department of Physiology and Biophysics, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, MS 39216, United States of America. Electronic address: dstec@umc.edu.
Stephen J. Peterson, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, United States of America; New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11215, United States of America.
Nader G. Abraham, Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America; Department of Pharmacology, New York Medical College, Valhalla, NY 10595, United States of America. Electronic address: nader_abraham@nymc.edu.Follow

Author Type(s)

Faculty

DOI

10.1016/j.pharmthera.2021.107975

Journal Title

Pharmacology & Therapeutics

First Page

107975

Document Type

Article

Publication Date

3-1-2022

Department

Medicine

Second Department

Pharmacology

Abstract

Obesity-mediated metabolic syndrome remains the leading cause of death worldwide. Among many potential targets for pharmacological intervention, a promising strategy involves the heme oxygenase (HO) system, specifically its inducible form, HO-1. This review collects and updates much of the current knowledge relevant to pharmacology and clinical medicine concerning HO-1 in metabolic diseases and its effect on lipid metabolism. HO-1 has pleotropic effects that collectively reduce inflammation, while increasing vasodilation and insulin and leptin sensitivity. Recent reports indicate that HO-1 with its antioxidants via the effect of bilirubin increases formation of biologically active lipid metabolites such as epoxyeicosatrienoic acid (EET), omega-3 and other polyunsaturated fatty acids (PUFAs). Similarly, HO-1and bilirubin are potential therapeutic targets in the treatment of fat-induced liver diseases. HO-1-mediated upregulation of EET is capable not only of reversing endothelial dysfunction and hypertension, but also of reversing cardiac remodeling, a hallmark of the metabolic syndrome. This process involves browning of white fat tissue (i.e. formation of healthy adipocytes) and reduced lipotoxicity, which otherwise will be toxic to the heart. More importantly, this review examines the activity of EET in biological systems and a series of pathways that explain its mechanism of action and discusses how these might be exploited for potential therapeutic use. We also discuss the link between cardiac ectopic fat deposition and cardiac function in humans, which is similar to that described in obese mice and is regulated by HO-1-EET-PGC1α signaling, a potent negative regulator of the inflammatory adipokine NOV.

Recommended Citation

McClung, J. A., Levy, L., Garcia, V., Stec, D. E., Peterson, S. J., & Abraham, N. G. (2022). Heme-Oxygenase and Lipid Mediators in Obesity and Associated Cardiometabolic Diseases: Therapeutic Implications. Pharmacology & Therapeutics, 231, 107975. https://doi.org/10.1016/j.pharmthera.2021.107975