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0031-6997/05/5704-585-630$7.00
Pharmacol Rev 57:585-630, 2005

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Review Article

Carbon Monoxide: Endogenous Production, Physiological Functions, and Pharmacological Applications

Lingyun Wu and Rui Wang

Department of Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (L.W.); and Department of Biology, Lakehead University, Thunder Bay, Ontario, Canada (R.W.)

Abstract
I. Introduction
II. Milestones for the Biological and Physiological Studies of Carbon Monoxide
    A. Endogenous Production of Carbon Monoxide
    B. Physiological Functions of Carbon Monoxide
III. Heme-Dependent and -Independent Endogenous Production of Carbon Monoxide
    A. Primary Structure of Different Heme Oxygenase Isoforms
    B. Tissue-Specific Distribution of Heme Oxygenases
    C. Subcellular Localization of Heme Oxygenases
    D. Up-Regulation of the Expression and Activity of Heme Oxygenases
    E. Down-Regulation of the Expression and Activity of Heme Oxygenases
    F. Biological Functions of Heme Oxygenases
        1. Production of Carbon Monoxide, Biliverdin/Bilirubin, and Ferrous Iron.
        2. Heme Metabolism.
        3. Heme-Containing Protein and Heme-Binding Protein.
    G. Nonheme Sources of Carbon Monoxide Production
IV. Catabolism of Endogenous Carbon Monoxide
    A. Expiration
    B. Scavenging
    C. Oxidation
V. Physiological Roles of Carbon Monoxide
    A. Carbon Monoxide and Circulatory System
        1. Cardiac Function.
        2. Vascular Contractility.
        3. Platelet Aggregation and Monocyte Activation.
    B. Carbon Monoxide and Nervous System
        1. Hypothalamic-Pituitary-Adrenal Axis.
        2. Glia.
        3. Circadian Rhythm Control.
        4. Odor Response Adaptation.
        5. Nociception and Chemoreception.
        6. Thermal Regulation.
        7. Learning, Memory, and Behavior.
        8. Vision.
        9. Hearing.
        10. Peripheral Autonomic Nervous System.
    C. Carbon Monoxide and Respiratory System
    D. Carbon Monoxide and Reproductive System
    E. Carbon Monoxide and Gastrointestinal System
    F. Carbon Monoxide and Liver
    G. Carbon Monoxide and Kidney
    H. Carbon Monoxide and Pancreas
VI. Pathophysiological Implications of Abnormal Heme Oxygenase/Carbon Monoxide System
    A. Neurodegenerations and Brain Disorders
    B. Hypertension
        1. Hypertension Induced by Heme Oxygenase Inhibitors.
        2. Spontaneously Hypertensive Rats.
        3. Salt-Induced Hypertension.
        4. Angiotensin II-Induced Hypertension.
        5. One Kidney-One Clip Renovascular Hypertension.
        6. Pulmonary Hypertension.
        7. Portal Hypertension.
    C. Carbon Monoxide and Inflammation
    D. Cardiac Hypertrophy and Heart Failure
    E. Transplantation
        1. Allograft Survival.
        2. Xenograft Survival.
    F. Apoptosis and Cellular Proliferation
        1. Vascular Smooth Muscle Cells.
        2. Endothelial Cells.
        3. Other Types of Cells.
    G. Oxidative Stress
VII. Heme Protein-Dependent Cellular and Molecular Mechanisms for Carbon Monoxide Effects
VIII. Interaction of Carbon Monoxide with Different Ion Channels
    A. Carbon Monoxide and KCa Channels
    B. Heme, Heme Oxygenase, 20-Hydroxyeicosatetraenoic Acid, and KCa Channels
    C. Carbon Monoxide and KATP Channels
    D. Carbon Monoxide and Calcium Channels
    E. Carbon Monoxide and Other Ion Channels
        1. Na+ Channels.
        2. Nonselective Cationic Channel.
        3. Cyclic Nucleotide-Gated Ion Channels.
IX. Interaction of Heme Oxygenase/Carbon Monoxide and Nitric-Oxide Synthase/Nitric Oxide Systems
    A. Influence of Carbon Monoxide on Nitric-Oxide Synthase/Nitric Oxide System
        1. Carbon Monoxide Potentiates the Activity of Nitric-Oxide Synthase/Nitric Oxide System.
        2. Carbon Monoxide Reduces the Activity of the Nitric-Oxide Synthase/Nitric Oxide System.
        3. Carbon Monoxide Reduces the Expression of Nitric-Oxide Synthase.
    B. Influence of Nitric Oxide on Heme Oxygenase/Carbon Monoxide System
        1. Nitric Oxide Potentiates the Activity of Heme Oxygenase/Carbon Monoxide System.
        2. Nitric Oxide Reduces the Activity of Heme Oxygenase/Carbon Monoxide System.
X. Therapeutic Applications of Carbon Monoxide
    A. Up-Regulating the Expression of Heme Oxygenase
        1. Genetic Approaches.
        2. Nongenetic Approaches.
    B. The More the Merrier? Down-Regulating the Expression or Activity of Heme Oxygenase
        1. Genetic Approaches.
        2. Nongenetic Approaches.
    C. Inhalation of Carbon Monoxide
    D. Use of Carbon Monoxide-Releasing Compounds
    E. Use of Prodrugs to Generate Carbon Monoxide
XI. Conclusions and Perspectives
Abstract

Over the last decade, studies have unraveled many aspects of endogenous production and physiological functions of carbon monoxide (CO). The majority of endogenous CO is produced in a reaction catalyzed by the enzyme heme oxygenase (HO). Inducible HO (HO-1) and constitutive HO (HO-2) are mostly recognized for their roles in the oxidation of heme and production of CO and biliverdin, whereas the biological function of the third HO isoform, HO-3, is still unclear. The tissue type-specific distribution of these HO isoforms is largely linked to the specific biological actions of CO on different systems. CO functions as a signaling molecule in the neuronal system, involving the regulation of neurotransmitters and neuropeptide release, learning and memory, and odor response adaptation and many other neuronal activities. The vasorelaxant property and cardiac protection effect of CO have been documented. A plethora of studies have also shown the importance of the roles of CO in the immune, respiratory, reproductive, gastrointestinal, kidney, and liver systems. Our understanding of the cellular and molecular mechanisms that regulate the production and mediate the physiological actions of CO has greatly advanced. Many diseases, including neurodegenerations, hypertension, heart failure, and inflammation, have been linked to the abnormality in CO metabolism and function. Enhancement of endogenous CO production and direct delivery of exogenous CO have found their applications in many health research fields and clinical settings. Future studies will further clarify the gasotransmitter role of CO, provide insight into the pathogenic mechanisms of many CO abnormality-related diseases, and pave the way for innovative preventive and therapeutic strategies based on the physiologic effects of CO.


Address correspondence to: Dr. Rui Wang, Department of Biology, Lakehead University, 955 Oliver Rd., Thunder Bay, Ontario, Canada P7B 5E1. E-mail: rwang{at}lakeheadu.ca




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