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. 2019 Sep 13;10:1018. doi: 10.3389/fphar.2019.01018

Figure 1.

Figure 1

Trigger factors’ effect on the regulation of heme biosynthesis. If (I) Induction of HO-1 can catabolize heme and then ALAS1 is de-repressed through the negative regulation network. If (II) Alcohol can induce attacks through the inhibition of uroporphyrinogen decarboxylase and subsequently lead to the accumulation of porphyrin precursors. If (III) Fasting can upregulate the transcription of ALAS1 through the increased production of PGC-1α. If (IV) The hormones estrogen, progesterone and testosterone can increase the enzyme activity of ALA synthase. If (V) The drug metabolism can stimulate heme production, particularly those which need metabolism throughout the cytochrome P450 system, resulting in the excess production of heme precursors. If (VI) The elements of cigarette smoke may stimulate the P450 system and the steroid hormones balance in smokers may be altered.