Heme Oxygenase in Cerebral Injury
There is significant research supporting a therapeutic role for the heme oxygenase metabolic pathway in cerebral injury, including traumatic brain injury (which includes concussion) and acute ischemic stroke. The up-regulation of this enzyme and its metabolites have been shown to be neuroprotective, to prevent neuroinflammation and to improve outcomes in preclinical in vivo models of cerebral injury. Also, in vitro studies have shown anti-inflammatory and anti-apoptotic (anti-cell death) properties in neural cells.
The primary mechanism of action are anti-inflammatory and anti-apoptotic. The HO pathway acts in an anti-inflammatory manner by down-regulating genes associated with inflammation (NFκB, VCAM-1, and ICAM-1) and in an anti-apoptotic manner by increasing key anti-oxidant pathways (Nrf-2, HO-1). Please see the Citations for more information.
The targeting of the heme oxygenase pathway in cerebral injury could potentially provide a much-needed therapeutic intervention for these patients.