Human heme oxygenase-1 (hHO-1) catalyzes the NADPH-cytochrome P450 reductase-dependent oxidation of heme to biliverdin, CO, and free iron. The biliverdin is subsequently reduced to bilirubin by biliverdin reductase. Earlier kinetic studies suggested that biliverdin reductase facilitates the release of biliverdin from hHO-1 (Liu, Y., and Ortiz de Montellano, P. R. (2000 Heme oxygenase oxidizes heme, 1 a pro-oxidant and toxic species, to biliverdin, CO, and free iron (1). Each of the three metabolites formed in the reaction is thought to be physiologically important. Biliverdin is converted by biliverdin reductase to bilirubin, which must then be conjugated with glucuronic acid to be excreted (2). However, bilirubin, albeit toxic at high concentrations, has potent antioxidant properties that may contribute to the anti-inflammatory activity of the heme oxygenases (3, 4). Although still controversial, CO appears to behave as a gaseous signaling molecule akin to nitric oxide (5-7). Finally, the iron released from heme is largely recycled and is critical for iron homeostasis, since less than 3% of the body's daily iron needs are met by absorption from the diet (8). As a result of these activities, heme oxygenase has been shown to have, inter alia, important anti-inflammatory (9) and antiatherosclerotic (10) functions.Human heme oxygenase-1 (hHO-1) is a 33-kDa membranebound protein of 288 amino acid residues that binds heme and uses the bound entity as both the prosthetic group and substrate. A soluble form of hHO-1 (hHO-1 265 ) has been obtained by heterologous expression in E. coli of a truncated version of 265 amino acids that lacks the membrane binding domain (11). The crystal structures of hHO-1 truncated to a length of 233 amino acids (12), a rat homologue truncated to a length of 267 residues (13), and an inherently soluble full-length microbial heme oxygenase (14) have been determined. As recently reviewed, mechanistic studies have established that the transformation of heme to biliverdin is a three-step process that consumes three molecules of oxygen and seven electrons (15, 16). In the first step, ferric heme is oxidized to ␣-meso-hydroxyheme in a reaction that consumes one molecule of oxygen and two electrons. The ferric ␣-meso-hydroxyheme is then converted to ferrous verdoheme in a reaction that consumes a further molecule of oxygen and two electrons and releases CO. In the final stage of the reaction sequence, the verdoheme is converted to ferrous biliverdin with the consumption of a further molecule of oxygen and three electrons. The ferrous iron is then released, followed by dissociation of the biliverdin. Single turnover studies have shown that the rate-limiting step is the release of biliverdin, but in the presence of biliverdin reductase this step is accelerated, and one of the electron transfer steps becomes rate-limiting (17).The electrons required for the catalytic turnover of heme oxygenase are provided by NADPH-cytochrome P450 reductase (1,19,20), a 78-kDa membrane-bound flavoprotein that incorpo...