HMOX1 and hyperinsulinemic hypoglycemia, familial, 4: Furthermore, the effect of QE on mitochondrial biogenesis was found to be abolished upon the introduction of the HO-1 (heme oxygenase-1) inhibitor or Nrf2 deficiency, which provides additional evidence that the modulation of mitochondrial function by QE is mediated through the Nrf2/HO-1 pathway.