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KSHV infection of endothelial cells (EC) in vitro is associated with robust induction of the host gene heme oxygenase-1 (HO-1), a stress-inducible cellular enzyme responsible for heme catabolism.HO-1 is also strongly expressed in spindle cells in KS biopsies.Heme degradation releases iron and produces carbon monoxide (CO) and biliverdin, which is subsequently converted into bilirubin (BR) via biliverdin reductase.