Intensive Care Medicine

, Volume 36, Issue 1, pp 42–48 | Cite as

Beneficial effects of the heme oxygenase-1/carbon monoxide system in patients with severe sepsis/septic shock

  • Shoji TakakiEmail author
  • Naoshi Takeyama
  • Yuka Kajita
  • Teru Yabuki
  • Hiroki Noguchi
  • Yasuo Miki
  • Yasusuke Inoue
  • Takashi Nakagawa
  • Hiroshi Noguchi



We evaluated the relations among the arterial carbon monoxide (CO) concentration, heme oxygenase (HO)-1 expression by monocytes, oxidative stress, plasma levels of cytokines and bilirubin, and the outcome of patients with severe sepsis or septic shock.


Thirty-six patients who fulfilled the criteria for severe sepsis or septic shock and 21 other patients without sepsis during their stay in the intensive care unit were studied. HO-1 protein expression by monocytes, arterial CO, oxidative stress, bilirubin, and cytokines were measured.


Arterial blood CO, cytokine, and bilirubin levels, and monocyte HO-1 protein expression were higher in patients with severe sepsis/septic shock than in non-septic patients. Increased HO-1 expression was related to the arterial CO concentration and oxidative stress. There was a positive correlation between survival and increased HO-1 protein expression or a higher CO level.


Arterial CO and monocyte HO-1 protein expression were increased in critically ill patients, particularly those with severe sepsis or septic shock, suggesting that oxidative stress is closely related to HO-1 expression. The HO-1/CO system may play an important role in sepsis.


Carbon monoxide Heme oxygenase I Sepsis 8-Hydroxy 2′-deoxyguanosine Critical care 



This study was supported by the Japan Society for the Promotion of Science [Grant-in-Aid for Scientific Research (C) no. 18591991].


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Shoji Takaki
    • 1
    Email author
  • Naoshi Takeyama
    • 1
  • Yuka Kajita
    • 1
  • Teru Yabuki
    • 1
  • Hiroki Noguchi
    • 1
  • Yasuo Miki
    • 1
  • Yasusuke Inoue
    • 1
  • Takashi Nakagawa
    • 1
  • Hiroshi Noguchi
    • 1
  1. 1.Department of Emergency and Critical Care MedicineAichi Medical UniversityNagakute-choJapan

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