2018/07/24 by Christopher Hopper, Lorenz Meinel, Christoph Steiger +1 · 2 citations
Biochemistry, Genetics and Molecular Biology · Medicine · #Heme Oxygenase-1 and Carbon Monoxide #Hemoglobin structure and function #Autophagy in Disease and Therapy
paper · doi:10.2174/1381612824666180723161811
openalex publication_date 2018/07/24 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/15
Heme oxygenase (HO), the rate-limiting step in the degradation of heme to biliverdin, ferrous ion, and carbon monoxide (CO), is an ancestral protective enzyme conserved across phylogenetic domains. While HO was first described in the late 1960s and progressively characterized in the following decades, there has been a surge of innovation over the past twenty years in efforts to leverage the cytoprotective power of HO in a clinical setting. Despite the plethora of preclinical data indicating extraordinary therapeutic potential, HO has remained elusive from the physician's toolbox. The leading candidate in development, CO, has long been misconstrued as a useless toxic gas. Scientists have crafted an array of CO delivery molecules and devices to harness HO, however, each endeavor was met with limitations preventing translation into clinical practice. In this discussion, we summarize the HO / CO field with a clinical and commercial development perspective. More specifically, given the enormous global efforts and capital investment into the field, we ask: where is the breakthrough therapy?