The oxidation of heme by heme oxygenase (HO-1) results in highly regiospecific extrusion of the ␣-mesocarbon as CO and the formation of biliverdin IX␣. The first step in the accepted mechanism for this process is ␣-meso-hydroxylation of the heme. To define further the reaction mechanism, the oxidations of the four isomers of meso-methylmesoheme by human truncated HO-1 supported by NADPH-cytochrome P450 reductase, H 2 O 2 , or ascorbate have been examined. Surprisingly, the results establish that (a) HO-1 can oxidize an ␣-meso-methyl-substituted heme to biliverdin IX␣ without proceeding via the ␣-meso-hydroxy intermediate; (b) the normal HO-1 ␣-regiospecificity is inverted in favor of the substituted ␥-position by introduction of a ␥-meso methyl group; and (c) the -and ␦-meso-methylmesohemes are oxidized less regiospecifically to mixtures of methylsubstituted and -unsubstituted mesobiliverdins. The results indicate that electronic rather than steric effects primarily control the regiospecificity of heme cleavage by HO-1.Heme oxygenase, which oxidizes heme 1 to biliverdin IX␣ and CO ( Fig. 1), is of particular interest because of the physiological activities of its reaction products. Biliverdin, which functions as an endogenous antioxidant (1), is reduced to bilirubin and is excreted after conjugation with glucuronic acid (2). However, the excretion of bilirubin is often impaired in newborn children and in other individuals with a glucuronyltransferase deficiency (3). The neurotoxic properties of unconjugated bilirubin make its accumulation undesirable, and inhibition of heme oxygenase is one possible approach to the treatment of this problem. More recently, a potentially important but controversial role as a second messenger akin to nitric oxide has been proposed for the CO produced by heme oxygenase (4 -6).Two forms of heme oxygenase are known: HO-1, which is induced by a variety of agents and stress conditions and is found in highest concentration in the spleen and liver, and HO-2, which is not induced by xenobiotics and is found in highest concentration in the brain and testes (7,8). Human HO-1 is a 32-kDa protein with a C-terminal lipophilic domain that anchors it to the endoplastic reticulum (9). We have demonstrated that a fully active truncated version of human HO-1 (hHO-1) lacking the 23 C-terminal amino acids that constitute the membrane anchor can be expressed in Escherichia coli in high yields (10). A protein lacking the 26 N-terminal amino acids in which the last two amino acids have been mutated (S262R, S263L) has been independently expressed and shown to retain partial activity (11).The heme oxygenase reaction proceeds via a multistep mechanism that depends on reduction equivalents provided by NADPH and P450 reductase. The first step of the reaction is thought to be the O 2 -dependent oxidation of heme to ␣-mesohydroxyheme (Fig. 1). The principal experimental evidence for this intermediate is the finding that synthetic ␣-meso-hydroxyheme is converted to biliverdin IX␣ both by HO-1 (12, 13) and by a...