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Rallabandi S, Amin SB. Bilirubinemia and retinopathy of prematurity in infants ≤ 29 weeks' gestational age. Pediatr Res 2024:10.1038/s41390-024-03479-8. [PMID: 39191947 DOI: 10.1038/s41390-024-03479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/16/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Bilirubin is a known antioxidant. We hypothesized that the degree of bilirubinemia is inversely associated with oxidative stress-mediated retinopathy of prematurity (ROP). METHODS A prospective study was performed to determine if bilirubinemia is associated with ROP in infants ≤ 29 wks' gestational age and birth weights ≤ 1000 g. Total serum bilirubin (TSB) levels were measured at least twice daily during the first week and at least daily during the second week to determine peak and mean TSB levels. The outcomes were the incidence and severity of ROP. RESULTS Of 193 infants studied, 110 developed ROP: 53 had mild (stage 1 in zone 2 or 3); 31 had moderate (stage 2 in zone 2 or 3); and 26 had severe ROP ( ≥ stage 3 in any zone or any stage in zone 1). Mean TSB levels were associated with the severity (adjusted odds ratio [AOR] 0.68, 95% confidence interval [CI]:0.47-0.98, p = 0.04), but not with the incidence of ROP (AOR 0.81, 95% CI:0.52-1.27, p = 0.3). Peak TSB levels were also associated with the severity (AOR 0.71, 95% CI:0.52-0.96, p = 0.02), but not with the incidence of ROP (AOR 0.71, 95% CI:0.48-1.01, p = 0.07). CONCLUSIONS Bilirubinemia may be protective against severity of ROP. IMPACT Retinopathy of prematurity (ROP) is a disease mediated by oxidative stress. Increasing antioxidant status may decrease the incidence and severity of ROP. Bilirubin is a known antioxidant; however, findings from observational studies evaluating the role of bilirubinemia against the incidence and/or severity of ROP in premature infants are conflicting. Our findings from this prospective study suggests that bilirubinemia may be protective against the severity of ROP.
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Affiliation(s)
- Srujana Rallabandi
- Division of Neonatology, Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Sanjiv B Amin
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI, USA.
- Department of Pediatrics, Wayne State University, Detroit, MI, USA.
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2
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Paul BD, Pieper AA. Neuroprotective Roles of the Biliverdin Reductase-A/Bilirubin Axis in the Brain. Biomolecules 2024; 14:155. [PMID: 38397392 PMCID: PMC10887292 DOI: 10.3390/biom14020155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
Biliverdin reductase-A (BVRA) is a multi-functional enzyme with a multitude of important roles in physiologic redox homeostasis. Classically, BVRA is well known for converting the heme metabolite biliverdin to bilirubin, which is a potent antioxidant in both the periphery and the brain. However, BVRA additionally participates in many neuroprotective signaling cascades in the brain that preserve cognition. Here, we review the neuroprotective roles of BVRA and bilirubin in the brain, which together constitute a BVRA/bilirubin axis that influences healthy aging and cognitive function.
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Affiliation(s)
- Bindu D. Paul
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Lieber Institute for Brain Development, Baltimore, MD 21205, USA
| | - Andrew A. Pieper
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH 44106, USA
- Brain Health Medicines Center, Harrington Discovery Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
- Geriatric Psychiatry, GRECC, Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Institute for Transformative Molecular Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Neurosciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
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3
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Lee IC, Yu CS, Hu YC, Wang XA. Unconjugated bilirubin is correlated with the severeness and neurodevelopmental outcomes in neonatal hypoxic-ischemic encephalopathy. Sci Rep 2023; 13:23075. [PMID: 38155251 PMCID: PMC10754932 DOI: 10.1038/s41598-023-50399-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Unconjugated bilirubin (UB) levels during the first week after birth are related to outcomes in neonatal hypoxic-ischemic encephalopathy (HIE). Clinical Sarnat staging of HIE, brain magnetic resonance imaging (MRI), hearing outcomes, and neurodevelopmental outcomes ≥ 1 year were used to correlate UB in 82 HIE patients. The initial UB level was significantly correlated with lactic acid levels. The peak UB was higher (p < 0.001) in stage I (10.13 ± 4.03 mg/dL, n = 34) than in stages II and III (6.11 ± 2.88 mg/dL, n = 48). Among the 48 patients receiving hypothermia treatment, a higher peak UB was significantly (p < 0.001) correlated with unremarkable brain MRI scans and unremarkable neurodevelopmental outcomes at age ≥ 1 year. The peak UB were higher (P = 0.015) in patients free of seizures until 1 year of age (6.63 ± 2.91 mg/dL) than in patients with seizures (4.17 ± 1.77 mg/dL). Regarding hearing outcomes, there were no significant differences between patients with and without hearing loss. The UB level in the first week after birth is an important biomarker for clinical staging, MRI findings, seizures after discharge before 1 year of age, and neurodevelopmental outcomes at ≥ 1 year of age.
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Affiliation(s)
- Inn-Chi Lee
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, School of Medicine, Chung Shan Medical University, #110, Section 1, Chien-Kuo North Road, Taichung, 402, Taiwan.
- Division of Neonatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Chin-Sheng Yu
- Department of Information Engineering and Computer Science, Feng Chia University, Taichung, Taiwan
| | - Ya-Chun Hu
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Xing-An Wang
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, School of Medicine, Chung Shan Medical University, #110, Section 1, Chien-Kuo North Road, Taichung, 402, Taiwan
- Division of Neonatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
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A Sex-Specific Comparative Analysis of Oxidative Stress Biomarkers Predicting the Risk of Cardiovascular Events and All-Cause Mortality in the General Population: A Prospective Cohort Study. Antioxidants (Basel) 2023; 12:antiox12030690. [PMID: 36978938 PMCID: PMC10044882 DOI: 10.3390/antiox12030690] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Oxidative stress plays a pivotal role in cardiovascular (CV) disease, but current biomarkers used to predict CV events are still insufficient. In this study, we comparatively assessed the utility of redox-related biomarkers in predicting the risk of CV events and all-cause mortality in male and female subjects from the general population. Subjects (n = 5955) of the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) population-based cohort study were included. Blood homocysteine, gamma-GT, HDL cholesterol, bilirubin and protein-adjusted free thiol (R-SH, sulfhydryl groups) levels were quantified at baseline and were prospectively analyzed in association with the risk of CV events and all-cause mortality. After adjustment for potentially confounding factors, protein-adjusted R-SH and homocysteine levels were significantly associated with the risk of CV events in men (HR 0.63 [0.40–0.99], p = 0.045 and HR 1.58 [1.20–2.08], p = 0.001, respectively). Protein-adjusted R-SH and HDL cholesterol levels were significantly associated with the risk of all-cause mortality in men (HR 0.52 [0.32–0.85], p = 0.009 and HR 0.90 [0.85–0.94], p < 0.001, respectively), while the same was observed for bilirubin and homocysteine levels in women (HR 0.68 [0.48–0.98], p = 0.040 and HR 2.30 [1.14–3.76], p < 0.001, respectively). Lower levels of protein-adjusted R-SH were robustly associated with an increased risk of CV events and all-cause mortality in men. Our results highlight the value of R-SH levels in cardiovascular risk assessment and their potential significance as being amenable to therapeutic intervention, while reaffirming the importance of other oxidative stress-related biomarkers, such as homocysteine, HDL cholesterol and bilirubin.
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Butterfield DA, Boyd-Kimball D, Reed TT. Cellular Stress Response (Hormesis) in Response to Bioactive Nutraceuticals with Relevance to Alzheimer Disease. Antioxid Redox Signal 2023; 38:643-669. [PMID: 36656673 PMCID: PMC10025851 DOI: 10.1089/ars.2022.0214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/08/2023] [Indexed: 01/20/2023]
Abstract
Significance: Alzheimer's disease (AD) is the most common form of dementia associated with aging. As the large Baby Boomer population ages, risk of developing AD increases significantly, and this portion of the population will increase significantly over the next several decades. Recent Advances: Research suggests that a delay in the age of onset by 5 years can dramatically decrease both the incidence and cost of AD. In this review, the role of nuclear factor erythroid 2-related factor 2 (Nrf2) in AD is examined in the context of heme oxygenase-1 (HO-1) and biliverdin reductase-A (BVR-A) and the beneficial potential of selected bioactive nutraceuticals. Critical Issues: Nrf2, a transcription factor that binds to enhancer sequences in antioxidant response elements (ARE) of DNA, is significantly decreased in AD brain. Downstream targets of Nrf2 include, among other proteins, HO-1. BVR-A is activated when biliverdin is produced. Both HO-1 and BVR-A also are oxidatively or nitrosatively modified in AD brain and in its earlier stage, amnestic mild cognitive impairment (MCI), contributing to the oxidative stress, altered insulin signaling, and cellular damage observed in the pathogenesis and progression of AD. Bioactive nutraceuticals exhibit anti-inflammatory, antioxidant, and neuroprotective properties and are potential topics of future clinical research. Specifically, ferulic acid ethyl ester, sulforaphane, epigallocatechin-3-gallate, and resveratrol target Nrf2 and have shown potential to delay the progression of AD in animal models and in some studies involving MCI patients. Future Directions: Understanding the regulation of Nrf2 and its downstream targets can potentially elucidate therapeutic options for delaying the progression of AD. Antioxid. Redox Signal. 38, 643-669.
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Affiliation(s)
- D. Allan Butterfield
- Department of Chemistry, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Debra Boyd-Kimball
- Department of Biochemistry, Chemistry, and Physics, University of Mount Union, Alliance, Ohio, USA
| | - Tanea T. Reed
- Department of Chemistry, Eastern Kentucky University, Richmond, Kentucky, USA
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Mondal S, Pan N, Ghosh R, Bera A, Mukherjee D, Maji TK, Adhikari A, Ghosh S, Bhattacharya C, Pal SK. Interaction of a Jaundice Marker Molecule with Redox Modulatory Nano Hybrid: A Combined Electrochemical and Spectroscopic Study towards the Development of a Theranostics Tool. ChemMedChem 2022; 17:e202100660. [DOI: 10.1002/cmdc.202100660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Susmita Mondal
- S N Bose National Centre for Basic Sciences CBMS Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Nivedita Pan
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological, Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 kolkata INDIA
| | - Ria Ghosh
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological and Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Arpan Bera
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological and Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Dipanjan Mukherjee
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological and Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Tuhin Kumar Maji
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological and Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Anirudddha Adhikari
- S N Bose National Centre for Basic Sciences Department of Chemical, Biological and Macromolecular Sciences Block JD, Sector III, Salt Lake 700106 Kolkata INDIA
| | - Sangeeta Ghosh
- IIEST Shibpur: Indian Institute of Engineering Science and Technology Department of Chemistry Howrah-711103, West Bengal, INDIA 711103 Howrah INDIA
| | - Chinmoy Bhattacharya
- IISET Department of Chemistry Howrah-711103, West Bengal, INDIA 711103 Howrah INDIA
| | - Samir Kumar Pal
- SNBNCBS CBMS Block JD, Sector IIISalt Lake City 700098 Kolkata INDIA
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Iskander I, Abdelmonem S, El Houchi S, Mandour I, Aly H. Intensive phototherapy and oxidant-antioxidant status in infants with jaundice. Early Hum Dev 2021; 161:105465. [PMID: 34517206 DOI: 10.1016/j.earlhumdev.2021.105465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Conventional phototherapy converts unconjugated bilirubin to its oxidation products and consequently causes oxidative stress with lipid peroxidation products. New devices that deliver intensive phototherapy are efficacious in treating severe hyperbilirubinemia and minimizing the need for exchange transfusions. However, the oxidative stress status when using these devices has not been explored. Therefore, we aimed to study the impact of using intensive phototherapy on the oxidant-antioxidant status in severely jaundiced neonates. STUDY DESIGN This prospective case-control study included term newborns admitted with severe hyperbilirubinemia managed with intensive phototherapy. Baseline oxidant-antioxidant concentrations were compared to healthy controls and re-measured after 8 h of intensive phototherapy exposure. RESULTS The study included 40 cases with severe jaundice and 40 non-jaundiced apparently normal controls. Total serum bilirubin at enrollment was 23.4 ± 4.2 mg/dl that significantly decreased after 8 h of therapy to 15.4 ± 3.4 mg/dl (p < 0.001). The decline of total serum bilirubin was 1 mg/dl/h. Bilirubin: albumin ratio decreased from 3.45 ± 0.28 to 2.7 ± 0.21 (p < 0.001). Total antioxidant capacity (TAC), superoxide dismutase (SOD), malondialdehyde (MDA), and total oxidative stress (TOS) concentrations were lower in cases (p < 0.001, p < 0.001, p = 0.049, and p < 0.001 respectively) compared to controls. Following 8 h of intensive phototherapy, further decline of TAC (p = 0.016) with increased concentrations of TOS (p = 0.005) were noted. SOD and MDA did not change. CONCLUSIONS Although efficacious, intensive phototherapy was associated with increased oxidative stress. The clinical correlates for harms related to such oxidative stress need further studying.
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Affiliation(s)
- Iman Iskander
- Department of Neonatology, Cairo University Children's Hospital, Cairo, Egypt
| | - Samira Abdelmonem
- Department of Neonatology, Cairo University Children's Hospital, Cairo, Egypt
| | - Salma El Houchi
- Department of Neonatology, Cairo University Children's Hospital, Cairo, Egypt
| | - Iman Mandour
- Department of Neonatology, Cairo University Children's Hospital, Cairo, Egypt
| | - Hany Aly
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, OH, United States of America.
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8
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Dani C, Pratesi S, Mannaioni G, Gerace E. Neurotoxicity of Unconjugated Bilirubin in Neonatal Hypoxic-Ischemic Brain Injury in vitro. Front Pediatr 2021; 9:659477. [PMID: 33959576 PMCID: PMC8093500 DOI: 10.3389/fped.2021.659477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The pathophysiology of bilirubin neurotoxicity in course of hypoxic-ischemic encephalopathy (HIE) in term and preterm infants is still poorly understood. We hypothesized that oxidative stress may be a common mechanism that link hyperbilirubinemia and HIE. Objectives: The objective of the present study was to evaluate whether unconjugated bilirubin (UCB) may enhance the HI brain injury by increasing oxidative stress and to test pioglitazone and allopurinol as new antioxidant therapeutic drugs in vitro. Methods: The effects of UCB were tested on organotypic hippocampal slices subjected to 30 min oxygen-glucose deprivation (OGD), used as in vitro model of HIE. The experiments were performed on mature (14 days in culture) and immature (7 days in culture) slices, to mimic the brains of term and preterm infants, respectively. Mature and immature slices were exposed to UCB, human serum albumin (HSA), pioglitazone, and/or allopurinol for 24 h, immediately after 30 min OGD. Neuronal injury was assessed using propidium iodide (PI) fluorescence. ROS formation was quantified by using the 2',7'-dichlorodihydrofluorescein diacetate (DCF-DA) method. Results: In mature slices, we found that the neurotoxicity, as well as oxidative stress, induced by OGD were enhanced by UCB. HSA significantly prevented UCB-increased neurotoxicity, but had a slight reduction on ROS production. Allopurinol, but not pioglitazone, significantly reduced UCB-increased neurotoxicity induced by OGD. In immature slices exposed to OGD, no increase of neuronal death was observed, whereas oxidative stress was detected after UCB exposure. HSA, pioglitazone and allopurinol have no protective effects on both OGD-induced neuronal death and on UCB-induced oxidative stress. For this reason, UCB, pioglitazone and allopurinol was also tested on ischemic preconditioning protocol. We found that UCB abolished the neuroprotection induced by preconditioning and increased oxidative stress. These effects were restored by allopurinol but not pioglitazone. Conclusions: UCB characterized a different path of neuronal damage and oxidative stress in mature and immature hippocampal slice model of HIE. Management of hyperbilirubinemia in a complex pathological condition, such as HIE and hyperbilirubinemia, should be very careful. Allopurinol could deserve attention as a novel pharmacological intervention for hyperbilirubinemia and HIE.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Simone Pratesi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Guido Mannaioni
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Elisabetta Gerace
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Hansen TWR, Wong RJ, Stevenson DK. Molecular Physiology and Pathophysiology of Bilirubin Handling by the Blood, Liver, Intestine, and Brain in the Newborn. Physiol Rev 2020; 100:1291-1346. [PMID: 32401177 DOI: 10.1152/physrev.00004.2019] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Bilirubin is the end product of heme catabolism formed during a process that involves oxidation-reduction reactions and conserves iron body stores. Unconjugated hyperbilirubinemia is common in newborn infants, but rare later in life. The basic physiology of bilirubin metabolism, such as production, transport, and excretion, has been well described. However, in the neonate, numerous variables related to nutrition, ethnicity, and genetic variants at several metabolic steps may be superimposed on the normal physiological hyperbilirubinemia that occurs in the first week of life and results in bilirubin levels that may be toxic to the brain. Bilirubin exists in several isomeric forms that differ in their polarities and is considered a physiologically important antioxidant. Here we review the chemistry of the bilirubin molecule and its metabolism in the body with a particular focus on the processes that impact the newborn infant, and how differences relative to older children and adults contribute to the risk of developing both acute and long-term neurological sequelae in the newborn infant. The final section deals with the interplay between the brain and bilirubin and its entry, clearance, and accumulation. We conclude with a discussion of the current state of knowledge regarding the mechanism(s) of bilirubin neurotoxicity.
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Affiliation(s)
- Thor W R Hansen
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Ronald J Wong
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - David K Stevenson
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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10
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Bulut O, Erek A, Duruyen S. Effects of hyperbilirubinemia on markers of genotoxicity and total oxidant and antioxidant status in newborns. Drug Chem Toxicol 2020; 45:451-455. [DOI: 10.1080/01480545.2019.1710182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ozgul Bulut
- Department of Pediatrics, Division of Neonatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Aybala Erek
- Department of Biochemistry, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Sadettin Duruyen
- Department of Biochemistry, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
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11
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Changes in bilirubin in infants with hypoxic-ischemic encephalopathy. Eur J Pediatr 2018; 177:1795-1801. [PMID: 30232591 DOI: 10.1007/s00431-018-3245-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 01/09/2023]
Abstract
Antioxidant properties of bilirubin have been reported in many studies. We hypothesized that bilirubin might be involved in neuroprotection mechanisms against oxidative stress in infants with hypoxic-ischemic encephalopathy (HIE) and that total serum bilirubin (TSB) might increase in these patients. We retrospectively studied infants with gestational age ≥ 35 weeks and birth weight ≥ 1800 g who were admitted to the neonatal intensive care unit (NICU) with a diagnosis of moderate-to-severe HIE and received or did not receive therapeutic hypothermia. We evaluated peak TSB and changes of mean TSB in these patients in comparison with a control group of infants admitted to the NICU with diagnoses other than HIE. Peak and mean TSB values were lower in the no hypothermia and hypothermia groups in comparison with the control group, while differences were not noted between infants who received hypothermia or did not. Regression analysis showed that HIE and hypothermia significantly reduced the risk of developing TSB values higher than median value (> 8.4 mg/dL) in our population.Conclusion: Peak and mean TSB values were lower in infants with moderate-to-severe HIE than in control infants. HIE and hypothermia independently decreased TSB. These results exclude a TSB increase as a neuroprotective mechanism in infants with HIE. We speculated that low TSB values in infants with HIE could be due to hypoxic repression of HO expression and represent a defensive strategy for limiting brain injuries in these patients. What is Known: • The role of oxidative stress in the pathophysiology of hypoxic-ischemic encephalopathy (HIE) has been elucidated in many studies, and other studies have demonstrated the antioxidant properties of bilirubin. • The potential neuroprotective role of bilirubin as antioxidant agent has never been evaluated in infants with HIE. What is New: • Mean total serum bilirubin (TSB) values are lower in infants with moderate-to-severe HIE than in control infants, since HIE and hypothermia independently decreased TSB. • An increase in bilirubin was not a neuroprotective mechanism in infants with HIE possibly because of hypoxic repression of HO expression as defensive strategy for limiting brain injuries.
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Abstract
Hyperbilirubinemia is the most frequent clinical problem neonatologists must deal with during the newborn period. It has been suggested that bilirubin is involved in the balance between antioxidant and pro-oxidant agents due to its antioxidant properties. However, the relevance of these effects in vivo in term and preterm infants is still debated. We performed a literature review of studies that investigated the association between total serum bilirubin (TSB) and oxidative stress in newborn infants. We found that studies in term infants give contradictory results, while studies in preterm infants suggest that the TSB increase is associated with an oxidative stress increase due to concurrent factors other than bilirubin level, such as heme oxygenase (HO) activity. Moreover, it could be speculated that low physiologic TSB values are associated with antioxidant effects, while high pathologic TSB values are associated with pro-oxidant effects. Literature data do not allow the establishment of whether if the antioxidant properties of bilirubin are important from a clinical point of view and can affect the outcome in ill infants.
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Affiliation(s)
- Carlo Dani
- a Division of Neonatology , Careggi University Hospital of Florence , Florence , Italy.,b Department of Neurosciences, Psychology , Drug Research and Child Health, Careggi University Hospital of Florence , Florence , Italy
| | - Chiara Poggi
- a Division of Neonatology , Careggi University Hospital of Florence , Florence , Italy
| | - Simone Pratesi
- a Division of Neonatology , Careggi University Hospital of Florence , Florence , Italy
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13
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Morioka I. Hyperbilirubinemia in preterm infants in Japan: New treatment criteria. Pediatr Int 2018; 60:684-690. [PMID: 29906300 DOI: 10.1111/ped.13635] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 05/04/2018] [Accepted: 06/13/2018] [Indexed: 11/28/2022]
Abstract
In 1992, Kobe University proposed treatment criteria for hyperbilirubinemia in newborns using total serum bilirubin and serum unbound bilirubin reference values. In the last decade, chronic bilirubin encephalopathy has been found to develop in preterm infants in Japan because it can now be clinically diagnosed based on an abnormal signal of the globus pallidus on T2-weighted magnetic resonance imaging and abnormal auditory brainstem response with or without apparent hearing loss, along with physical findings of kinetic disorders with athetosis. We therefore revised the Kobe University treatment criteria for preterm hyperbilirubinemic infants in 2017. The three revised points are as follows: (i) newborns are classified under gestational age at birth or corrected gestational age, not birthweight; (ii) three treatment options were created: standard phototherapy, intensive phototherapy, and albumin therapy and/or exchange blood transfusion; and (iii) initiation of standard phototherapy, intensive phototherapy, and albumin therapy and/or exchange blood transfusion is decided based on the total serum bilirubin and serum unbound bilirubin reference values for gestational weeks at birth at <7 days of age, and on the reference values for corrected gestational age at ≥7 days of age. Studies are needed to establish whether chronic bilirubin encephalopathy can be prevented using the 2017 revised Kobe University treatment criteria for preterm infants in Japan.
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Affiliation(s)
- Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.,Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
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Human serum albumin-stabilized gold nanoclusters act as an electron transfer bridge supporting specific electrocatalysis of bilirubin useful for biosensing applications. Bioelectrochemistry 2016; 111:7-14. [PMID: 27126550 DOI: 10.1016/j.bioelechem.2016.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/14/2016] [Indexed: 11/24/2022]
Abstract
Human serum albumin (HSA)-stabilized Au18 nanoclusters (AuNCs) were synthesized and chemically immobilized on an Indium tin oxide (ITO) plate. The assembly process was characterized by advanced electrochemical and spectroscopic techniques. The bare ITO electrode generated three irreversible oxidation peaks, whereas the HSA-AuNC-modified electrode produced a pair of redox peaks for bilirubin at a formal potential of 0.27V (vs. Ag/AgCl). However, the native HSA protein immobilized on the ITO electrode failed to produce any redox peak for bilirubin. The results indicate that the AuNCs present in HSA act as electron transfer bridge between bilirubin and the ITO plate. Docking studies of AuNC with HSA revealed that the best docked structure of the nanocluster is located around the vicinity of the bilirubin binding site, with an orientation that allows specific oxidation. When the HSA-AuNC-modified electrode was employed for the detection of bilirubin using chronoamperometry at 0.3V (vs. Ag/AgCl), a steady-state current response against bilirubin in the range of 0.2μM to 7μM, with a sensitivity of 0.34μAμM(-1) and limit of detection of 86.32nM at S/N 3, was obtained. The bioelectrode was successfully applied to measure the bilirubin content in spiked serum samples. The results indicate the feasibility of using HSA-AuNC as a biorecognition element for the detection of serum bilirubin levels using an electrochemical technique.
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Ahmed FH, Carr PD, Lee BM, Afriat-Jurnou L, Mohamed AE, Hong NS, Flanagan J, Taylor MC, Greening C, Jackson CJ. Sequence-Structure-Function Classification of a Catalytically Diverse Oxidoreductase Superfamily in Mycobacteria. J Mol Biol 2015; 427:3554-3571. [PMID: 26434506 DOI: 10.1016/j.jmb.2015.09.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 12/11/2022]
Abstract
The deazaflavin cofactor F420 enhances the persistence of mycobacteria during hypoxia, oxidative stress, and antibiotic treatment. However, the identities and functions of the mycobacterial enzymes that utilize F420 under these conditions have yet to be resolved. In this work, we used sequence similarity networks to analyze the distribution of the largest F420-dependent protein family in mycobacteria. We show that these enzymes are part of a larger split β-barrel enzyme superfamily (flavin/deazaflavin oxidoreductases, FDORs) that include previously characterized pyridoxamine/pyridoxine-5'-phosphate oxidases and heme oxygenases. We show that these proteins variously utilize F420, flavin mononucleotide, flavin adenine dinucleotide, and heme cofactors. Functional annotation using phylogenetic, structural, and spectroscopic methods revealed their involvement in heme degradation, biliverdin reduction, fatty acid modification, and quinone reduction. Four novel crystal structures show that plasticity in substrate binding pockets and modifications to cofactor binding motifs enabled FDORs to carry out a variety of functions. This systematic classification and analysis provides a framework for further functional analysis of the roles of FDORs in mycobacterial pathogenesis and persistence.
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Affiliation(s)
- F Hafna Ahmed
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - Paul D Carr
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - Brendon M Lee
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - Livnat Afriat-Jurnou
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - A Elaaf Mohamed
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - Nan-Sook Hong
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia
| | - Jack Flanagan
- University of Auckland Faculty of Medical and Health Sciences, 85 Park Road, Grafton, Auckland 2013, New Zealand
| | - Matthew C Taylor
- Commonwealth Scientific and Industrial Research Organisation Land and Water Flagship, Clunies Ross Street, Acton, ACT 2060, Australia
| | - Chris Greening
- Commonwealth Scientific and Industrial Research Organisation Land and Water Flagship, Clunies Ross Street, Acton, ACT 2060, Australia
| | - Colin J Jackson
- Australian National University Research School of Chemistry, Sullivans Creek Road, Acton, ACT 2601, Australia.
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Polley N, Saha S, Adhikari A, Banerjee S, Darbar S, Das S, Pal SK. Safe and symptomatic medicinal use of surface-functionalized Mn3O4 nanoparticles for hyperbilirubinemia treatment in mice. Nanomedicine (Lond) 2015; 10:2349-63. [DOI: 10.2217/nnm.15.83] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim: Testing the potential of citrate-capped Mn3O4 nanoparticles (NPs) as a therapeutic agent for alternative rapid treatment of hyperbilirubinemia through direct removal of bilirubin (BR) from blood in mice. Materials & methods: NPs were synthesized and the mechanism of BR degradation in presence and absence of biological macromolecules were characterized in vitro. To test the in vivo BR degradation ability of NPs, CCl4-intoxicated mice were intraperitoneally injected with NPs. Results: We demonstrated ultrahigh efficacy of the NPs in symptomatic treatment of hyperbilirubinemia for rapid reduction of BR in mice compared with conventional medicine silymarin without any toxicological implications. Conclusion: These findings may pave the way for practical clinical use of the NPs as safe medication of hyperbilirubinemia in human subjects.
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Affiliation(s)
- Nabarun Polley
- Department of Chemical, Biological & Macromolecular Sciences, S N Bose National Centre for Basic Sciences, Block JD, Sector III, Salt Lake, Kolkata 700 098, India
| | - Srimoyee Saha
- Department of Physics, Jadavpur University, 188, Raja Subodh Chandra Mullick Road, Jadavpur, Kolkata 700032, India
| | - Aniruddha Adhikari
- Department of Chemical, Biological & Macromolecular Sciences, S N Bose National Centre for Basic Sciences, Block JD, Sector III, Salt Lake, Kolkata 700 098, India
| | - Somtirtha Banerjee
- Department of Physics, Jadavpur University, 188, Raja Subodh Chandra Mullick Road, Jadavpur, Kolkata 700032, India
| | - Soumendra Darbar
- Research & Development Division, Dey's Medical Stores (Mfg.) Ltd, 62, Bondel Road, Ballygunge, Kolkata 700019, India
| | - Sukhen Das
- Department of Physics, Jadavpur University, 188, Raja Subodh Chandra Mullick Road, Jadavpur, Kolkata 700032, India
| | - Samir Kumar Pal
- Department of Chemical, Biological & Macromolecular Sciences, S N Bose National Centre for Basic Sciences, Block JD, Sector III, Salt Lake, Kolkata 700 098, India
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Sarici D, Gunes T, Yazici C, Akin MA, Korkmaz L, Memur S, Kurtoglu S, Ozturk MA, Sarici SU. Investigation on malondialdehyde, S100B, and advanced oxidation protein product levels in significant hyperbilirubinemia and the effect of intensive phototherapy on these parameters. Pediatr Neonatol 2015; 56:95-100. [PMID: 25261050 DOI: 10.1016/j.pedneo.2014.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 05/25/2014] [Accepted: 06/19/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The parameters of oxidative stress [advanced oxidation protein products (AOPPs), malondialdehyde (MDA), and S100B] and the effect of intensive phototherapy (PT) on these parameters have not been studied extensively in newborns with significant hyperbilirubinemia (SH). We aimed to measure the levels of MDA, S100B, and AOPPs in newborns with SH, and to compare newborns with healthy control newborns without hyperbilirubinemia on the basis of these parameters of oxidative stress. In addition, we investigated the effect of intensive PT on these parameters during the treatment of SH and report our findings for the first time in the literature. METHODS The study was performed in newborns (n = 62) who underwent intensive PT because of SH. Newborns without jaundice constituted the control group (n = 30). Both groups were compared with respect to demographic characteristics and biochemical (laboratory) parameters including MDA, AOPPs, and S100B. MDA, AOPPs, and S100B were also compared before and after intensive PT in the PT group. In the study group, a correlation analysis of demographic characteristics; MDA, AOPP, and S100B values; and changes occurring in MDA, AOPPs, and S100B values due to the effect of intensive PT was performed. RESULTS Serum total bilirubin, S100B, and MDA levels in the PT group before performing PT were significantly higher than those in the control group. In newborns receiving PT serum total bilirubin, MDA and AOPP levels decreased significantly after intensive PT. In correlation analysis, a statistically significant negative correlation was found only between the amount of bilirubin decrease with PT and AOPP levels after PT in the study group. CONCLUSION Whether the significant decrease in MDA levels, which was higher prior to PT, is due to the decrease in serum bilirubin levels or due to the effect of intensive PT itself remains to be determined in further studies. The decrease in AOPP levels after PT implies that intensive PT has protective effects on oxidative stress.
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Affiliation(s)
- Dilek Sarici
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey.
| | - Tamer Gunes
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Cevat Yazici
- Department of Biochemistry, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Ali Akin
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Seyma Memur
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Selim Kurtoglu
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mehmet Adnan Ozturk
- Division of Neonatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Serdar Umit Sarici
- Division of Neonatology, Department of Pediatrics, Ufuk University Faculty of Medicine, Ankara, Turkey
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Lipid peroxidation, DNA damage and total antioxidant status in neonatal hyperbilirubinemia. J Perinatol 2014; 34:519-23. [PMID: 24674982 DOI: 10.1038/jp.2014.45] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/18/2014] [Accepted: 02/12/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Lipid peroxidation, DNA damage and total antioxidant status (TAS) were assessed in neonates with unconjugated hyperbilirubinemia (UCH). STUDY DESIGN Plasma malondialdehyde (MDA), 8-hydroxy-2-deoxy-guanosine (8-OH-dG) and TAS levels were compared between 64 term newborns with idiopathic UCH and 30 age-matched healthy controls. RESULT Compared with controls, an overall increase in mean plasma MDA and 8-OH-dG levels and a decrease in TAS level were noted in the UCH group. Within the UCH group, mean plasma MDA level was found to be low in infants with lower bilirubin levels, but a progressive increase was documented above the bilirubin level of 20 mg dl(-1). A significant increase in 8-OH-dG level was documented even at lower bilirubin levels, and a decrease i plasma TAS level was found at bilirubin levels above 16 mg dl(-1). MDA and 8-OH-dG levels were significantly higher, whereas TAS level was significantly lower in five neonates who developed features of acute bilirubin encephalopathy compared with those with normal outcome. Alteration of MDA, 8-OH-dG and TAS levels showed high predictive accuracy for poor outcome. CONCLUSION Moderate-to-severe UCH was associated with higher oxidative stress and lower antioxidant defense. Alteration of oxidative stress parameters may be utilized as early predictors for poor outcome. High DNA damage even at lower bilirubin levels suggests possible genotoxic effect of bilirubin in UCH.
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Abstract
SIGNIFICANCE Many reports have underscored the importance of the heme degradation pathway that is regulated by heme oxygenase (HO). This reaction releases bile pigments and carbon monoxide (CO), which are important antioxidant and signaling molecules. Thus, the reaction of HO-1 would have significant cytoprotective effects. Nevertheless, the importance of this protein goes beyond its enzymatic action. New evidence outlines significant effects of inactive forms of the HO-1 protein. RECENT ADVANCES In fact, the role of the HO protein in cellular signaling, including transcription factor activation, binding to proteins, phosphorylation, and modulation of protein function, among others, has started being elucidated. The mechanism by which the inducible form of HO-1, in particular, can migrate to various cellular compartments to mediate important signaling or how and why it binds to key transcription factors and other proteins that are important in DNA repair is also described in several physiologic systems. CRITICAL ISSUES The signaling functions of HO-1 may have particular relevance in clinical circumstances, including cancer, as redistribution of HO-1 into the nuclear compartment is observed with cancer progression and metastasis. In addition, along with oxidative stress, the pleiotropic functions of HO-1 modulate antioxidant defense. In organ transplantation, HO and its byproducts suppress rejection at multiple levels and in sepsis-induced pulmonary dysfunction, inhaled CO or modulation of HO activity can change the course of the disease in animals. FUTURE DIRECTIONS It is hoped that a more detailed understanding of the various signaling functions of HO will guide therapeutic approaches for complex diseases.
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Affiliation(s)
- Phyllis A Dennery
- Department of Pediatrics, University of Pennsylvania , Philadelphia, Pennsylvania
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20
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Massarsky A, Abraham R, Nguyen KC, Rippstein P, Tayabali AF, Trudeau VL, Moon TW. Nanosilver cytotoxicity in rainbow trout (Oncorhynchus mykiss) erythrocytes and hepatocytes. Comp Biochem Physiol C Toxicol Pharmacol 2014; 159:10-21. [PMID: 24096131 DOI: 10.1016/j.cbpc.2013.09.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 12/11/2022]
Abstract
Silver nanoparticles (AgNPs) are present in a multitude of consumer and medical products; however, the toxicity of AgNPs is not fully understood. This research aimed to elucidate the relationship between AgNP cytotoxicity and oxidative stress and damage in rainbow trout (Oncorhynchus mykiss) hepatocytes and erythrocytes in comparison to silver ions (Ag(+)). Generally the cytotoxicity of AgNPs and Ag(+) was similar, such that both silver types generated reactive oxygen species, decreased glutathione levels, and decreased activities of glutathione reductase and glutathione-S-transferase. Nonetheless, the two silver types had different cellular targets; AgNPs increased lipid peroxidation without apparent uptake into the cells whereas Ag(+) increased DNA damage. Furthermore, the toxicity of both silver types was generally decreased in cells treated with cysteine while treatment with buthionine sulfoximine increased the toxicity of both silver types.
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Affiliation(s)
- Andrey Massarsky
- Department of Biology & Centre for Advanced Research in Environmental Genomics, University of Ottawa, Ottawa, Ontario, Canada.
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21
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Lidong Z, Xiaoquan W, Tao C, Weiwei G, Chang L, Shiming Y. Hyperbilirubinemia and Auditory Neuropathy. J Otol 2013. [DOI: 10.1016/s1672-2930(13)50001-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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Abstract
It is common knowledge that thalassemic patients are under significant oxidative stress. Chronic hemolysis, frequent blood transfusion, and increased intestinal absorption of iron are the main factors that result in iron overload with its subsequent pathophysiologic complications. Iron overload frequently associates with the generation of redox-reactive labile iron, which in turn promotes the production of other reactive oxygen species (ROS). If not neutralized, uncontrolled production of ROS often leads to damage of various intra- and extracellular components such as DNA, proteins, lipids, and small antioxidant molecules among others. A number of endogenous and exogenous defense mechanisms can neutralize and counteract the damaging effects of labile iron and the reactive substances associated with it. Endogenous antioxidant enzymes, such as superoxide dismutase, catalase, glutathione peroxidase, and ferroxidase, may directly or sequentially terminate the activities of ROS. Nonenzymatic endogenous defense mechanisms include metal binding proteins (ceruloplasmin, haptoglobin, albumin, and others) and endogenously produced free radical scavengers (glutathione (GSH), ubiquinols, and uric acid). Exogenous agents that are known to function as antioxidants (vitamins C and E, selenium, and zinc) are mostly diet-derived. In this review, we explore recent findings related to various antioxidative mechanisms operative in thalassemic patients with special emphasis on protein antioxidants.
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Affiliation(s)
- Samir Awadallah
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
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23
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Dennery PA. Evaluating the beneficial and detrimental effects of bile pigments in early and later life. Front Pharmacol 2012; 3:115. [PMID: 22737125 PMCID: PMC3381237 DOI: 10.3389/fphar.2012.00115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/29/2012] [Indexed: 12/28/2022] Open
Abstract
The heme degradation pathway has been conserved throughout phylogeny and allows for the removal of a pro-oxidant and the generation of unique molecules including bile pigments with important cellular functions. The impact of bile pigments on health and disease are reviewed, as is the special circumstance of neonatal hyperbilirubinemia. In addition, the importance of promoter polymorphisms in the UDP-glucuronosyl transferase gene (UGTA1), which is key to the elimination of excess bilirubin and to the prevention of its toxicity, are discussed. Overall, the duality of bile pigments as either cytoprotective or toxic molecules is highlighted.
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Affiliation(s)
- Phyllis A Dennery
- Division of Neonatology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine Philadelphia, PA, USA
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Zelenka J, Muchova L, Zelenkova M, Vanova K, Vreman HJ, Wong RJ, Vitek L. Intracellular accumulation of bilirubin as a defense mechanism against increased oxidative stress. Biochimie 2012; 94:1821-7. [PMID: 22580386 DOI: 10.1016/j.biochi.2012.04.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 04/30/2012] [Indexed: 12/22/2022]
Abstract
Antioxidant, anti-inflammatory and anti-atherogenic effects have been associated with elevations of unconjugated bilirubin (UCB) in serum and with the induction of heme oxygenase-1 (HO-1), the rate-limiting enzyme in UCB synthesis. The aim of this study was to investigate the intracellular metabolism and antioxidant properties of UCB in human hepatoblastoma HepG2 cells and tissues of Wistar rats exposed to oxidative stressors and lipopolysaccharide (LPS), respectively. Intracellular UCB concentrations in HepG2 cells correlated with its levels in culture media (p < 0.001) and diminished lipid peroxidation in a dose-dependent manner (p < 0.001). Moreover, induction of HO-1 with sodium arsenite led to 2.4-fold (p = 0.01) accumulation of intracellular UCB over basal level while sodium azide-derived oxidative stress resulted in a 60% drop (p < 0.001). This decrease was ameliorated by UCB elevation in media or by simultaneous induction of HO-1. In addition, hyperbilirubinemia and liver HO-1 induction in LPS-treated rats resulted in a 2-fold accumulation of tissue UCB (p = 0.01) associated with enhanced protection against lipid peroxidation (p = 0.02). In conclusion, hyperbilirubinemia and HO-1 induction associated with inflammation and oxidative stress increase intracellular concentrations of UCB, thus enhancing the protection of cellular lipids against peroxidation. Therefore, the previously reported protective effects of hyperbilirubinemia and HO-1 induction are at least in part due to intracellular accumulation of UCB.
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Affiliation(s)
- Jaroslav Zelenka
- Institute of Physiology, Academy of Sciences, Dept. 75, Videnska 1083, Prague 142 20, Czech Republic.
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25
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Hiljadnikova Bajro M, Josifovski T, Panovski M, Jankulovski N, Kapedanovska Nestorovska A, Matevska N, Petrusevska N, Dimovski AJ. Promoter length polymorphism in UGT1A1 and the risk of sporadic colorectal cancer. Cancer Genet 2012; 205:163-7. [DOI: 10.1016/j.cancergen.2012.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 01/23/2012] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
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Total serum bilirubin levels during the first 2 days of life and subsequent neonatal morbidity in very low birth weight infants: a retrospective review. Eur J Pediatr 2012; 171:669-74. [PMID: 22116270 DOI: 10.1007/s00431-011-1634-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 11/14/2011] [Indexed: 10/15/2022]
Abstract
To determine the relationship between total serum bilirubin (TSB) during the first 2 days of life and subsequent neonatal morbidity in very low birth weight (VLBW, less than 1500 g) infants. We performed a prospective study of 582 VLBW infants born between July 1, 2005 and December 31, 2009. TSB was measured in umbilical cord blood (UCB), at 24 and 48 h after birth. Demographic and clinical characteristics of infants in hospital were recorded. The interaction between TSB variables during the first 48 h of life and subsequent neonatal morbidity were assessed in logistic regression analyses adjusted for multiple risk factors. It was found that TSB in UCB was in a negative correlation with occurrence of respiratory distress syndrome (RDS) [OR 0.626, 95% confidence interval (95% CI): 0.446-0.879, p = 0.007], and there was also a negative correlation between TSB in UCB and occurrence of intraventricular hemorrhage (IVH) [OR 0.695, 95% CI 0.826-0.981, p = 0.020]. However, TSB in UCB positively correlated with hyperbilirubinemia [OR 2.471, 95% CI 1.326-3.551, p = 0.012], and TSB at 24 h after birth was also in a positive correlation with early onset sepsis (EOS) [OR 1.299, 95% CI 1.067-1.582, p = 0.011]. VLBW infants with low TSB levels in UCB were more likely to develop RDS and IVH, and those with low TSB levels in UCB were less likely to develop hyperbilirubinemia. Infants with high TSB levels at 24 h after birth were more likely to develop EOS. The protective effect of raised TSB in UCB with respect to RDS and IVH warrants further investigation.
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Kim SY, Park SC. Physiological antioxidative network of the bilirubin system in aging and age-related diseases. Front Pharmacol 2012; 3:45. [PMID: 22457648 PMCID: PMC3303147 DOI: 10.3389/fphar.2012.00045] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 02/27/2012] [Indexed: 01/11/2023] Open
Abstract
Oxidative stress is detrimental to life process and is particularly responsible for aging and age-related diseases. Thus, most organisms are well equipped with a spectrum of biological defense mechanisms against oxidative stress. The major efficient antioxidative mechanism is the glutathione system, operating a redox cycling mechanism for glutathione utilization, which consists of glutathione and its peroxidase and reductase. However, this system is mainly effective for hydrophilic oxidants, while lipophilic oxidants require another scavenging system. Since many age-related pathological conditions are related to lipid peroxidation, especially in association with the aging process, the physiological role of the scavenging system for lipophilic oxidants should be considered. In this regard, the biliverdin to bilirubin conversion pathway, via biliverdin reductase (BVR), is suggested to be another major protective mechanism that scavenges lipophilic oxidants because of the lipophilic nature of bilirubin. The efficiency of this bilirubin system might be potentiated by operation of the intertwined bicyclic systems of the suggested redox metabolic cycle of biliverdin and bilirubin and the interactive control cycle of BVR and heme oxygenase. In order to combat oxidative stress, both antioxidative systems against hydrophilic and lipophilic oxidants are required to work cooperatively. In this regard, the roles of the bilirubin system in aging and age-related diseases are reassessed in this review, and their interacting networks are evaluated.
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Affiliation(s)
- Sung Young Kim
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University Incheon, South Korea
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28
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Zhu J, Xu Y, Zhang G, Wu M, Du L. Total serum bilirubin level in umbilical cord blood and respiratory distress syndrome in very low birth weight infants. J Perinat Med 2011; 40:91-5. [PMID: 22085151 DOI: 10.1515/jpm.2011.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 08/16/2011] [Indexed: 11/15/2022]
Abstract
AIMS To explore the association between total serum bilirubin (TSB) level in umbilical cord blood (UCB) and the occurrence and/or severity of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants. METHODS We performed a prospective study of 579 VLBW infants. The mean TSB level in UCB (1.8 mg/dL) was used to divide the cohort into two groups: neonates with levels <1.8 mg/dL and those with levels >1.8 mg/dL. Demographic and clinical characteristics of the 2 groups, including diagnosis of RDS, need for ventilation, peak fraction of inspired oxygen (FiO2), oxygenation index (OI), and duration of respiratory support, were compared. RESULTS Three hundred and twenty-four infants were included in the low-TSB group and 255 infants were included in the high-TSB group. RDS was less frequent in the high TSB group than in the low one (46.3% vs. 56.6%, P=0.01). A negative association between TSB level in UCB and the occurrence of RDS [odds ratio (OR)=0.620; 95% confidence interval (CI) 0.440-0.873, P=0.006] was observed. However, lower TSB in UCB was not associated with the maximum FiO2, OI, or duration of mechanical ventilation. CONCLUSIONS VLBW infants with low TSB levels in UCB were more likely to develop RDS. However, in conjunction with surfactant replacement therapy, no correlation was found between TSB levels in UCB and the severity of RDS. The negative association between high TSB in UCB and RDS warrants further investigation.
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Affiliation(s)
- Jiajun Zhu
- Department of Neonatology, Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China
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29
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Khan NM, Poduval TB. Immunomodulatory and immunotoxic effects of bilirubin: molecular mechanisms. J Leukoc Biol 2011; 90:997-1015. [PMID: 21807743 DOI: 10.1189/jlb.0211070] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The immunomodulatory and immunotoxic effects of purified UCB have not been evaluated previously at clinically relevant UCB concentrations and UCB:BSA ratios. To delineate the molecular mechanism of UCB-induced immunomodulation, immune cells were exposed to clinically relevant concentrations of UCB. It inhibited LPS-induced B cell proliferation and cytokine production from splenic macrophages. UCB (≥25 μM) was toxic to unfractionated splenocytes, splenic T cells, B cells, macrophages, LPS-stimulated CD19(+) B cells, human PBMCs, and RBCs. Purified UCB also was found to be toxic to splenocytes and human PBMCs. UCB induced necrosis and apoptosis in splenocytes. UCB activated the extrinsic and intrinsic pathways of apoptosis, as reflected by the markers, such as CD95, caspase-8, Bax, MMP, cytoplasmic Ca(+2), caspase-3, and DNA fragmentation. UCB depleted GSH and activated p38MAPK. NAC, caspase inhibitors, and p38MAPK inhibitor attenuated the UCB-induced apoptosis. In vivo administration of ≥25 mg/kbw UCB induced atrophy of spleen, depletion of bone marrow cells, and leukopenia and decreased lymphocyte count and the T and B cell response to mitogens. UCB administration to mice led to induction of oxidative stress, activation of p38MAPK, and cell death in splenocytes. These parameters were attenuated by the injection of NAC and the p38MAPK inhibitor. Our results demonstrate for the first time that clinically relevant concentrations of UCB induce apoptosis and necrosis in immune cells by depleting cellular GSH. These findings should prove useful in understanding the immunosuppression associated with hyperbilirubinemia.
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Affiliation(s)
- Nazir M Khan
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
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Doğan M, Peker E, Kirimi E, Sal E, Akbayram S, Erel O, Ocak AR, Tuncer O. Evaluation of oxidant and antioxidant status in infants with hyperbilirubinemia and kernicterus. Hum Exp Toxicol 2011; 30:1751-60. [DOI: 10.1177/0960327111401638] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The objective of the present study was to determine oxidant and antioxidant status in infants with hyperbilirubinemia and/or kernicterus and to find whether there is a relationship between bilirubin level and oxidant/antioxidant status. Patients: The study includes 69 full-term newborns (neonates with hyperbilirubinemia needing phototherapy [Group 1, n = 36] and neonates with kernicterus [Group 2, n = 33]) and 25 age-matched healthy newborn. Results: Plasma total antioxidant capacity (TAC) and serum total oxidant status (TOS) were significantly higher in Groups 1 and 2 than the control group. There was a significant difference between Group 1 and control cases for malondialdehyde (MDA; p < 0.001). Total free sulfhydryl group (TTHI) values were significantly elevated in Group 1 compared to Group 2 and control cases. Correlation analysis showed that the correlation between total bilirubin (TB) and TAC, TOS, MDA and oxidative stress index may be expressed by a quadratic curve. After phototherapy, a statistically significant increase in nitrite level was observed. Conclusion: We demonstrated that the relationship between serum TB and antioxidants and oxidative stress could be expressed by a quadratic correlation curve.
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Affiliation(s)
- Murat Doğan
- Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Erdal Peker
- Division of Neonatology, Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ercan Kirimi
- Division of Neonatology, Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ertan Sal
- Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Sinan Akbayram
- Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ozcan Erel
- Department of Biochemistry, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Ali Rıza Ocak
- Department of Biochemistry, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Oguz Tuncer
- Division of Neonatology, Department of Pediatrics, School of Medicine, Yuzuncu Yil University, Van, Turkey
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Abstract
Despite a century of research, several clinically relevant areas of bilirubin biochemistry remain controversial, poorly understood, or unrecognized. These include: (i) The structure and molecularity of bilirubin under physiological environments such as membranes, brain tissue and when bound to proteins. Related to this is the large number of structurally different bilirubin species that may occur in blood under pathological conditions and their potential effects on measurements of bilirubin and free bilirubin. (ii) The mechanism of phototherapy, the neurotoxicity of the photoisomers produced and their influence on measurements of bilirubin and free bilirubin. (iii) The role of membrane transporters in the passage of unconjugated bilirubin across the placenta, intestine, vascular epithelium, blood-brain barrier, and into the liver. (iv) Biochemical mechanisms of bilirubin toxicity, pharmacologic prevention of kernicterus, the contribution of bilirubin to antioxidant defenses, and the practical value of free bilirubin measurements for identifying infants at most risk of kernicterus.
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Oh W, Stevenson DK, Tyson JE, Morris BH, Ahlfors CE, Bender GJ, Wong RJ, Perritt R, Vohr BR, Van Meurs KP, Vreman HJ, Das A, Phelps DL, O'Shea TM, Higgins RD. Influence of clinical status on the association between plasma total and unbound bilirubin and death or adverse neurodevelopmental outcomes in extremely low birth weight infants. Acta Paediatr 2010; 99:673-678. [PMID: 20105142 DOI: 10.1111/j.1651-2227.2010.01688.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the influence of clinical status on the association between total plasma bilirubin and unbound bilirubin on death or adverse neurodevelopmental outcomes at 18-22 months corrected age in extremely low birth weight infants. METHOD Total plasma bilirubin and unbound bilirubin were measured in 1101 extremely low birth weight infants at 5 +/- 1 days of age. Clinical criteria were used to classify infants as clinically stable or unstable. Survivors were examined at 18-22 months corrected age by certified examiners. Outcome variables were death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death prior to follow-up. For all outcomes, the interaction between bilirubin variables and clinical status was assessed in logistic regression analyses adjusted for multiple risk factors. RESULTS Regardless of clinical status, an increasing level of unbound bilirubin was associated with higher rates of death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss and death before follow-up. Total plasma bilirubin values were directly associated with death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death before follow-up in unstable infants, but not in stable infants. An inverse association between total plasma bilirubin and death or cerebral palsy was found in stable infants. CONCLUSIONS In extremely low birth weight infants, clinical status at 5 days of age affects the association between total plasma bilirubin and death or adverse neurodevelopmental outcomes at 18-22 months of corrected age. An increasing level of UB is associated a higher risk of death or adverse neurodevelopmental outcomes regardless of clinical status. Increasing levels of total plasma bilirubin are directly associated with increasing risk of death or adverse neurodevelopmental outcomes in unstable, but not in stable infants.
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Affiliation(s)
- W Oh
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - D K Stevenson
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - J E Tyson
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - B H Morris
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - C E Ahlfors
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - G Jesse Bender
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - R J Wong
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - R Perritt
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - B R Vohr
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - K P Van Meurs
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - H J Vreman
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - A Das
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - D L Phelps
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - T Michael O'Shea
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
| | - R D Higgins
- Warren Alpert Medical School of Brown University, RI, USAStanford University, Palo Alto, CAUniversity of Texas, Houston, TX, USAZF Diagnostics Vashon, WA, USAResearch Triangle International, RTI, NC, USAUniversity of Rochester, Rochester, NY, USAWake Forest University Winston-Salem, NC, USANICHD, Bethesda, MD, USA
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Assessment of DNA damage and plasma catalase activity in healthy term hyperbilirubinemic infants receiving phototherapy. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2009; 680:12-6. [DOI: 10.1016/j.mrgentox.2009.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 06/03/2009] [Accepted: 07/25/2009] [Indexed: 11/19/2022]
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Bulmer AC, Ried K, Blanchfield JT, Wagner KH. The anti-mutagenic properties of bile pigments. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2008; 658:28-41. [PMID: 17602853 DOI: 10.1016/j.mrrev.2007.05.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 04/27/2007] [Accepted: 05/01/2007] [Indexed: 02/04/2023]
Abstract
Bile pigments, including bilirubin and biliverdin, are endogenous compounds belonging to the porphyrin family of molecules. In the past, bile pigments and bilirubin in particular were thought of as useless by-products of heme catabolism that can be toxic if they accumulate. However, in the past 20 years, research probing the physiological relevance of bile pigments has been mounting, with evidence to suggest bile pigments possess significant antioxidant and anti-mutagenic properties. More specifically, bile pigments are potent peroxyl radical scavengers and inhibit the mutagenic effects of a number of classes of mutagens (polycyclic aromatic hydrocarbons, heterocyclic amines, oxidants). Coincidentally, persons with elevated circulating bilirubin concentrations have a reduced prevalence of cancer and cardio-vascular disease. Despite the encouraging in vitro anti-mutagenic effects of bile pigments, relatively little research has been conducted on their inhibitory capacity in bacterial and cultured cell assays of mutation, which might link the existing in vitro and in vivo observations. This is the first review to summarise the published data and it is our hope it will stimulate further research on these potentially preventative compounds.
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Affiliation(s)
- A C Bulmer
- School of Human Movement Studies, University of Queensland, Brisbane, Australia; School of Molecular and Microbial Sciences, University of Queensland, Brisbane, Australia; Biopharma Pty. Ltd., 2/67 Richland Avenue, Coopers Plains, Brisbane, Australia.
| | - K Ried
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - J T Blanchfield
- School of Molecular and Microbial Sciences, University of Queensland, Brisbane, Australia
| | - K-H Wagner
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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Bjelaković G, Stojanović I, Jevtović-Stoimenov T, Kostić G, Sokolović D, Ilić M, Bjelaković L. Polyamine oxidase activity in peripheral blood of newborn infants with neonatal hyperbilirubinemia: is bilirubin an antioxidant? J Basic Clin Physiol Pharmacol 2008; 19:103-18. [PMID: 19024928 DOI: 10.1515/jbcpp.2008.19.2.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neonatal hyperbilirubinemia can be physiological and pathological and most frequently is a consequence of faster erythrocytes (RBC) hemolysis. Free unconjugated bilirubin is a highly toxic compound, especially for the central nervous system. The most abundant polyamines circulating in blood are spermidine (Spd) and spermine (Sp), which are mainly localized in RBC, where they control membrane permeability. Polyamine oxidase (PAO) exerts an important activity in the plasma and erythrocytes of newborn infants with hyperbilirubinemia, catalyzing the oxidative deamination of Sp and Spd, producing potentially toxic agents that induce apoptosis of mammalian cells. The present study investigated polyamine metabolism by measuring PAO activity in the blood of newborn infants with hyperbilirubinemia and explored the possible antioxidant function of bilirubin through monitoring malondialdehyde (MDA) levels. METHODS The study included 43 newborns, 10 in the control and 33 in the diseased group. Blood PAO activity and bilirubin and MDA levels were measured using spectrophotometric methods. RESULTS/DISCUSSION Our results indicate that bilirubin, at physiologic concentrations, protects neonatal erythrocytes against oxidative stress. The positive correlation between PAO activity and MDA levels with high bilirubin concentrations (> 200 micromol/L) in newborn infants indicates that in pathological conditions, bilirubin cannot exert its antioxidant function. CONCLUSION Investigating the function of polyamines in erythrocytes and the importance of PAO related to hemolysis and bilirubin synthesis is necessary to shed light on the functions of PAO and its metabolites on the permeability of the erythrocyte membrane.
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Boutros C, Zegdi R, Lila N, Cambillau M, Fornes P, Carpentier A, Fabini JN. Carbon monoxide can prevent acute lung injury observed after ischemia reperfusion of the lower extremities. J Surg Res 2007; 143:437-42. [PMID: 17825843 DOI: 10.1016/j.jss.2007.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2006] [Revised: 01/31/2007] [Accepted: 02/03/2007] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary expression of heme oxygenase has been observed in multiple studies. This expression has been found beneficial in decreasing the severity of acute lung injury (ALI) post ischemia-reperfusion (I/R). The aim of this study was to assess the role of exogenous administration of the end-products of heme oxygenase reaction, carbon monoxide, and bilirubin, in the severity of ALI. STUDY DESIGN We compared five groups of rats (n = 7/group) including a sham group and four I/R of the lower extremities by clamping the abdominal aorta for 2 h followed by reperfusion for 2 h. The four I/R groups included a control group, one pretreated with bilirubin (50 micromol/kg IV), another with inhaled carbon monoxide (CO) (250 ppm), and the last pretreated with both. The severity of ALI has been evaluated by a histological assay grading neutrophilic infiltration, as well as a study of the microvascular permeability using the Evans blue. RESULTS The administration of CO prevented pulmonary microvascular permeability alteration noted after I/R of the lower limbs (pulmonary content of Evans blue: 141 +/- 23 microg/g of tissue in the isolated I/R group versus 68 +/- 34 microg/g of tissue in CO group; P < 0.001). Histologically CO administration inhibited neutrophilic sequestration observed after I/R. On the other hand, treatment by bilirubin alone (50 micromol/kg IV) did not modify the extent of pulmonary injury. CONCLUSION Exogenous administration of carbon monoxide by inhalation at low doses prevented ALI post-I/R in this model.
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Affiliation(s)
- Cherif Boutros
- Laboratory of the Study of Cardiac Grafts and Protheses, Broussias Hospital, Paris, France.
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Annabi Berrahal A, Nehdi A, Hajjaji N, Gharbi N, El-Fazâa S. Antioxidant enzymes activities and bilirubin level in adult rat treated with lead. C R Biol 2007; 330:581-8. [PMID: 17637439 DOI: 10.1016/j.crvi.2007.05.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 05/24/2007] [Accepted: 05/25/2007] [Indexed: 11/29/2022]
Abstract
Lead toxicity is closely related to its accumulation in several tissues and its interference with bioelements, whose role is critical for several biological processes. Recently, oxidative stress has been proposed as a possible mechanism involved in lead toxicity. This study was carried out to investigate the effect of dose-dependent lead exposure on haematological and oxidative stress parameters. Adult male 'Wistar' rats (150-200 g) were divided into three groups: group [Pb 5] and group [Pb 15] received respectively 5 mg Pb(2+) (n=16) and 15 mg Pb(2+)/kg b.w. (n=16) as lead acetate solution i.p. for a period of seven days. Group [T] (n= 16) served as control and received 15 mg Na(+)/kg b.w. as sodium acetate solution i.p. for the same period. All animals were sacrificed 24 h after the last injection. Blood superoxide dismutase (SOD) and blood glutathione peroxidase (GPx) activities and plasma bilirubin level were measured. Liver was quickly excised for the estimation of alteration in lipid peroxidation indices (MDA). Lead exposure induces, in both treated groups, a marked decline in haematocrit and haemoglobin levels (p<0.01) when compared to control. The results show also a significant decrease (p<0.01) in SOD activity, but only in group [Pb 15]. SOD activity did not decrease in group [Pb 5] in comparison with control (p>0.05). However, lead exposure caused a light increase in GPx activity in group [Pb 15], which remains non-significant (p>0.05) compared to control. Group [Pb 5] did not record significant changes in the activity of GPx. Lead exposure for a period of seven days resulted in a significant (p<0.05) increase in bilirubin level in group [Pb 15] compared to control. The bilirubin level from rats of group [Pb 5] did not reach a statistical significance. Changes in liver MDA content in lead-exposed rats from [Pb 5] and [Pb 15] groups did not reach a statistical (p<0.05) significance. It is concluded that lead induces oxidative stress in a dose-dependent manner. No dose-dependent response was observed in blood GPx activity and liver MDA content. These results could be due to the short duration of the treatment.
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Affiliation(s)
- Alya Annabi Berrahal
- Laboratoire de la physiologie des agressions, effets métaboliques et endocriniens, département de biologie, faculté des sciences de Tunis, université El-Manar, 1060 Tunis, Tunisia.
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Affiliation(s)
- Antony F McDonagh
- Division of Gastroenterology and the Liver Center, Room S-357, Box 0538, University of California, 513 Parnassus Ave, San Francisco, CA 94143-0538, USA.
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Dani C, Bertini G, Cecchi A, Corsini I, Pratesi S, Rubaltelli FF. Association between peak serum bilirubin and severity of respiratory distress syndrome in infants of less than 30 weeks' gestation. J Perinat Med 2007; 35:141-6. [PMID: 17302512 DOI: 10.1515/jpm.2007.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Bilirubin can enter the alveolar space where it could inactivate surfactant and act as an anti-oxidant agent. OBJECTIVE To assess the hypothesis that total serum bilirubin level (TSB) may affect the severity of respiratory distress syndrome (RDS) and the need of respiratory supports in preterm infants. STUDY DESIGN We performed a retrospective study of 184 preterm infants with RDS, whose peak TSB had a median value of 194.8 micromol/L (=11.3 mg/dL). This value was used to stratify patients into two groups: neonates who developed low and high TSB (< or = or >194.8 micromol/L, respectively). For each patient the highest values of inspired oxygen fraction (FiO(2)), arterial to alveolar oxygen tension ratio (a/APO(2)), oxygenation index (O.I.), ventilatory index (V.I.), and the need and duration of respiratory supports were recorded. RESULTS Seventy-five infants were included in the low TSB group and 74 were included in the high TSB group. The RDS severity and the need of respiratory supports were similar in both the groups. The first day of life TSB and peak TSB did not correlate with the highest values of FiO(2) and a/APO(2), and the duration of mechanical ventilation. CONCLUSIONS We did not find any correlation between TSB level and RDS severity. We speculate that this result is because the potential inhibiting effect of bilirubin on surfactant function is neutralized by the exogenous surfactant treatment, while its antioxidant effects do not provide appreciable benefits in the lung tissue.
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Affiliation(s)
- Carlo Dani
- Department of Surgical and Medical Critical Care, Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
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Bulmer AC, Ried K, Coombes JS, Blanchfield JT, Toth I, Wagner KH. The anti-mutagenic and antioxidant effects of bile pigments in the Ames Salmonella test. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2007; 629:122-32. [PMID: 17350329 DOI: 10.1016/j.mrgentox.2007.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 01/22/2007] [Accepted: 01/25/2007] [Indexed: 10/23/2022]
Abstract
The aim of this study was to explore the potential pro- and anti-mutagenic effects of endogenous bile pigments unconjugated bilirubin (BR), biliverdin (BV) and a synthetic, water soluble conjugate, bilirubin ditaurate (BRT) in the Ames Salmonella test. The bile pigments were tested over a wide concentration range (0.01-2 micromol/plate) in the presence of three bacterial strains (TA98, TA100, TA102). A variety of mutagens including benzo[alpha]pyrene (B[alpha]P), 2,4,7 trinitrofluorenone (TNFone), 2-aminofluorene (2-AF), sodium azide (NaN(3)) and tertiary-butyl hydroperoxide (t-BuOOH), were used to promote the formation of mutant revertants. Tests were conducted with (B[alpha]P, 2-AF, t-BuOOH) and without (TNFone, NaN(3), t-BuOOH) metabolic activation incorporating the addition of the microsomal liver preparation, S9. The bile pigments alone did not induce mutagenicity in any of the strains tested (p>0.05). Anti-mutagenic effects of the bile pigments were observed in the presence of all mutagens except for NaN(3) and the anti-mutagenic effects appeared independent of the strain tested. For TNFone induced genotoxicity, the order of effectiveness was BR> or =BRT>BV. However, the order was BV> or =BRT> or =BR for 2-AF. Antioxidant testing in the TA102 strain revealed bile pigments could effectively inhibit the genotoxic effect of t-BuOOH induced oxidative stress. The apparent antioxidant and anti-mutagenic behaviour of bile pigments further suggests their presence in biological systems is of possible physiological importance.
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Affiliation(s)
- A C Bulmer
- School of Human Movement Studies, University of Queensland, Brisbane 4072, Australia.
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Alexandra Brito M, Silva RFM, Brites D. Bilirubin toxicity to human erythrocytes: a review. Clin Chim Acta 2006; 374:46-56. [PMID: 16887110 DOI: 10.1016/j.cca.2006.06.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Revised: 06/05/2006] [Accepted: 06/12/2006] [Indexed: 11/17/2022]
Abstract
Neonatal jaundice, a physiologic condition reflecting the interplay between developmentally modulated changes in bilirubin production and metabolism, affects virtually all newborn infants. Usually, it is an entirely benign process that is resolved at the end of the first week of life without treatment or sequelae. However, in a small percentage of neonates, unconjugated hyperbilirubinemia can pose a neurotoxic risk especially in the presence of aggravating conditions such as a diminished albumin binding capacity and/or affinity, acidosis, displacing drugs and prematurity. Although neuronal cells are considered the main target for unconjugated bilirubin (UCB) toxicity, circulating cells are also affected during neonatal hyperbilirubinemia. Moreover, the UCB ability to cause hemolysis shall further aggravate neonatal jaundice through a vicious circle. In this review, we summarize the most relevant data obtained by our group regarding UCB toxicity and the role of some risk factors for kernicterus. In order to improve the risk assessment of neurotoxicity it is essential to understand the underlying mechanisms of UCB pathophysiology.
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Affiliation(s)
- Maria Alexandra Brito
- Centro de Patogénese Molecular- UBMBE, Faculdade de Farmácia, University of Lisbon, Av. das Forças Armadas, 1600-083 Lisbon, Portugal.
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Silva VM, Thibodeau MS, Chen C, Manautou JE. Transport deficient (TR−) hyperbilirubinemic rats are resistant to acetaminophen hepatotoxicity. Biochem Pharmacol 2005; 70:1832-9. [PMID: 16271353 DOI: 10.1016/j.bcp.2005.09.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2005] [Revised: 09/22/2005] [Accepted: 09/27/2005] [Indexed: 10/25/2022]
Abstract
The biliary excretion of acetaminophen (APAP) is reduced in transport deficient (TR-) hyperbilirubinemic rats lacking the multidrug resistance-associated protein 2 (Mrp2). This mutant strain of Wistar rats has impaired biliary excretion of organic anions and increased hepatic glutathione. The rational for this study was to determine if there is an altered risk for liver damage by APAP in the absence of Mrp2. Therefore, the susceptibility of TR- rats to APAP hepatotoxicity was investigated. Male Wistar and TR- rats were fasted overnight before APAP treatment (1 g/kg). Hepatotoxicity was assessed 24 h later by plasma sorbitol dehydrogenase activity and histopathology. In other studies, TR- rats received buthionine sulfoximine before APAP to reduce hepatic glutathione to values similar to those in Wistar rats. mRNA expression of APAP metabolizing enzymes was also measured in naïve animals. Wistar rats treated with APAP showed significant elevations in plasma sorbitol dehydrogenase activity, while no increases in enzyme activity were observed in TR- rats. Histopathology was in agreement. Hepatic non-protein sulfhydryls were significantly lower in Wistar rats receiving APAP than in TR- rats. TR- rats treated with buthionine sulfoximine and APAP showed dramatic increases in hepatotoxicity. TR- rats had increased mRNA expression of several APAP metabolizing enzymes. Mrp2 expression not only is important in biliary excretion, but also influences the toxic potential of reactive intermediates by controlling intrahepatic GSH and possibly drug metabolism.
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Affiliation(s)
- Vanessa M Silva
- Toxicology Program, Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, 69 North Eagleville Road Unit 3092, Storrs, CT 06269-3092, USA
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Roll EB, Christensen T, Gederaas OA. Effects of bilirubin and phototherapy on osmotic fragility and haematoporphyrin-induced photohaemolysis of normal erythrocytes and spherocytes. Acta Paediatr 2005; 94:1443-7. [PMID: 16263631 DOI: 10.1111/j.1651-2227.2005.tb01818.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To study the effects of phototherapy on erythrocyte haemolysis in vitro and to determine possible differences in sensitivity to phototherapy between normal erythrocytes and spherocytes. METHODS Erythrocytes from four normal healthy donors and two donors with hereditary spherocytosis were treated with bilirubin (160 microM) in the presence of human serum albumin in the molecular ratio bilirubin/albumin 0.8. Treated cells were maintained either in the dark or in blue light (450 nm, 8 mW/cm2, 30 min). The experimental light dose was comparable to 2 h of clinical phototherapy. The osmotic fragility of the treated cells was measured by scoring haemolysis in hypo-osmolar solutions (0.10-0.90% NaCl). The sensitivity to photohaemolysis of cells pre-treated with bilirubin (BR) and/or phototherapy was tested by exposing the cell suspensions to haematoporphyrin and UVA radiation. The delayed (18 h) photohaemolysis was measured by spectrophotometry. RESULTS Osmotic fragility, expressed as percentage haemolysis, of normal erythrocytes was more than doubled in the presence of BR combined with phototherapy (n = 6, p < 0.05). In contrast, osmotic fragility of spherocytes was unaffected by either treatment (n = 8, p < 0.05). Increased photohaemolysis was seen in spherocytes treated with BR (n = 13, p < 0.05), phototherapy (n = 13, p < 0.05) and a combination of the two agents (n = 13, p < 0.05) compared with spherocytes without BR in the dark (n = 6). CONCLUSION Bilirubin may make the plasma membrane of normal erythrocytes more fragile. Newborns with hereditary spherocytosis may be sensitive to phototherapy.
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Effects of bilirubin and phototherapy on osmotic fragility and haematoporphyrin-induced photohaemolysis of normal erythrocytes and spherocytes. Acta Paediatr 2005. [DOI: 10.1080/08035250510032637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Overproduction of reactive oxygen species under pathophysiological conditions, including dyslipidemia, hypertension, diabetes, and smoking, is integral in the development of cardiovascular diseases (CVD). The reactive oxygen species released from all types of vascular cells regulate various signaling pathways that mediate not only vascular inflammation in atherogenesis but also antioxidative and antiinflammatory responses. One such protective and stress-induced protein is heme oxygenase (HO). HO is the first rate-limiting enzyme in heme breakdown to generate equimolar quantities of carbon monoxide, biliverdin, and free ferrous iron. Accumulating evidence has shown that inducible HO (HO-1) and its products function as adaptive molecules against oxidative insults. The proposed mechanisms by which HO-1 exerts its cytoprotective effects include its abilities to degrade the pro-oxidative heme, to release biliverdin and subsequently convert it bilirubin, both of which have antioxidant properties, and to generate carbon monoxide, which has antiproliferative and antiinflammatory as well as vasodilatory properties. Herein, I highlight the relationship of HO and cardiovascular disease, especially atherosclerosis, gene-targeting approaches in animal models, and the potential for and concern about HO-1 as a novel therapeutic target for cardiovascular diseases.
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Affiliation(s)
- Toshisuke Morita
- Department of Laboratory Medicine, Toho University School of Medicine, Tokyo, 143-8540, Japan.
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Maines MD, Gibbs PEM. 30 some years of heme oxygenase: from a "molecular wrecking ball" to a "mesmerizing" trigger of cellular events. Biochem Biophys Res Commun 2005; 338:568-77. [PMID: 16183036 DOI: 10.1016/j.bbrc.2005.08.121] [Citation(s) in RCA: 176] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Accepted: 08/16/2005] [Indexed: 12/20/2022]
Abstract
In the beginning, the microsomal HO system was presumed to be made of one isozymes, now known as HO-1, which was cytP450-dependent; and, was thought to be of physiological significance solely in the context of catalysis of hemoglobin heme to bile pigments and CO. A succession of discoveries including characterization of the system as an independent mono-oxygenase, identification of a second form, called HO-2, free radical quenching activity of bile pigments, analogous function of CO in cell signaling to NO, and characterization of the system as HSP32 cognates has led to such an impressive expansion in the number of reports dealing with the HO system that surpass anyone's expectation. This review is a compilation of certain older findings and recent events that together ensure placement of the HO system in the mainstream research for decades to come.
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Affiliation(s)
- Mahin D Maines
- University of Rochester Medical Center, Department of Biochemistry and Biophysics, 601 Elmwood Avenue Rochester, NY 14624, USA.
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Dani C, Masini E, Bertini G, di Felice AM, Pezzati M, Ciofini S, Rossetti M, Gallori G, Ciuti R, Buonocore G, Paffetti P, Mannaioni PF, Rubaltelli FF. Role of heme oxygenase and bilirubin in oxidative stress in preterm infants. Pediatr Res 2004; 56:873-7. [PMID: 15470195 DOI: 10.1203/01.pdr.0000145281.12853.9e] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In a previous study, it was found that the decrease in the total plasma bilirubin level (Btot) in preterm infants was associated with the decrease in oxidative stress. We hypothesized that this occurs as a result of a pro-oxidant effect of heme oxygenase (HO), which outcompetes with the antioxidant properties of bilirubin. In this study we studied 12 preterm infants in whom the plasma levels of Btot, total hydroperoxide (TH), protein SH groups, HO activity, non-transferrin-bound iron (NTBI), and erythrocyte CuZn superoxide dismutase (CuZn SOD) activity were concurrently measured when the Btot was >220 microM and after a Btot drop of >34 microM. The Btot decrease was concurrent with the TH decrease, protein SH groups increase, and the HO and CuZn SOD activity increase and was not associated with an NTBI increase. We concluded that 1) Btot does not exert a meaningful antioxidant effect in vivo; 2) HO does not exert a pro-oxidant effect involving an NTBI increase and that, on the contrary, it could exert an antioxidant effect; and 3) the concurrent HO and CuZn SOD activity increase could indicate a synergic antioxidant effect of the two enzymes.
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Affiliation(s)
- Carlo Dani
- Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, 50134 Florence, Italy. cddni@.unifi.it
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Brito MA, Brites D, Butterfield DA. A link between hyperbilirubinemia, oxidative stress and injury to neocortical synaptosomes. Brain Res 2004; 1026:33-43. [PMID: 15476695 DOI: 10.1016/j.brainres.2004.07.063] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2004] [Indexed: 11/28/2022]
Abstract
Cytotoxicity by unconjugated bilirubin involves disturbances of membrane structure, excitotoxicity and cell death. These events were reported to trigger elevated free radicals production and impairment of calcium homeostasis, and to result in loss of cell membrane integrity. Therefore, this study was designed to investigate whether interaction of clinically relevant concentrations of free unconjugated bilirubin with synaptosomal membrane vesicles could be linked to oxidative stress, cytosolic calcium accumulation and perturbation of membrane function. Synaptosomal vesicles were prepared from gerbil cortical brain tissue and incubated with purified bilirubin (<or=1 microM), for 4 h at 37 degrees C. Intracellular concentrations of reactive oxygen species (ROS) and calcium were determined by dichlorofluorescin and BAPTA fluorescent probes, respectively. Membrane protein and lipid oxidation were evaluated by immunocytochemistry and phosphatidylserine exposure by annexin V binding. Levels of reduced and oxidized glutathione (GSH and GSSG, respectively), as well as activities of Mg(2+)-ATPase aminophospholipid translocase (flippase) and Na(+),K(+)-ATPase, were also measured. Our results showed that bilirubin induced oxidative stress, due to a rise in lipid (>or=10%, P<0.05) and protein oxidation (>or=20%, P<0.01), ROS content (approximately 17%, P<0.01), and a decrease in GSH/GSSG ratio (>30%, P<0.01). In addition, synaptosomes exposed to bilirubin exhibited increased externalization of phosphatidylserine (approximately 10%, P<0.05), together with decreased flippase and NA(+),K(+)-ATPase (>or=15%, P<0.05) activities, events that were accompanied by enhanced intracellular calcium levels ( approximately 20%, P<0.01). The data obtained point out that interaction of unconjugated bilirubin with synaptosomal membrane vesicles leads to oxidative injury, loss of membrane asymmetry and functionality, and calcium intrusion, thus potentially contributing to the pathogenesis of encephalopathy by hyperbilirubinemia.
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Affiliation(s)
- Maria Alexandra Brito
- Centro de Patogénese Molecular--UBMBE, Faculdade de Farmácia, University of Lisbon, Av. das Forças Armadas, 1600-083 Lisbon, Portugal.
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Dani C, Martelli E, Tronchin M, Buonocore G, Longini M, Di Filippo A, Giossi M, Rubaltelli FF. Bilirubin influence on oxidative lung damage and surfactant surface tension properties. Pediatr Pulmonol 2004; 38:179-85. [PMID: 15274094 DOI: 10.1002/ppul.20045] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To study the hypothesis that hyperbilirubinemia might reduce in vivo oxidative lung damage while also diminishing lung surfactant surface tension properties during acute lung injury, we performed a randomized study in a rabbit model of acute lung injury. Twenty rabbits were randomized to receive bilirubin or saline intravenously. Acute lung injury was induced by lung lavages with saline. Lung tissue oxidation was evaluated by measuring total hydroperoxide (TH), advanced oxidation protein products (AOPP), and protein carbonyls (PC) in bronchial aspirate (BA) samples. Surface surfactant activity was studied in BA samples using a capillary surfactometer. Bilirubin BA concentration increased in bilirubin-treated rabbits, while it remained undetectable in controls. A similar increase in TH, AOPP, and PC bronchial aspirate concentrations was found in both the study and control groups, while surfactant surface activity was lower in the bilirubin than in the control group. We conclude that during hyperbilirubinemia, bilirubin enters the lung tissue, where it can be detected in BA fluid. Bilirubin is not effective as an antioxidant agent and exerts a detrimental effect on lung surfactant surface tension properties. These findings may have relevance to the management of premature neonates suffering from respiratory distress syndrome and hyperbilirubinemia.
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Affiliation(s)
- Carlo Dani
- Section of Neonatology, Department of Surgical and Medical Critical Care, University of Florence, Florence, Italy.
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Grant DJ, Hall IJ, Eastmond DA, Jones IM, Bell DA. Bilirubin UDP-glucuronosyltransferase 1A1 (UGT1A1) gene promoter polymorphisms and HPRT, glycophorin A, and micronuclei mutant frequencies in human blood. Mutat Res 2004; 560:1-10. [PMID: 15099818 DOI: 10.1016/j.mrgentox.2004.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2003] [Revised: 12/22/2003] [Accepted: 01/29/2004] [Indexed: 11/21/2022]
Abstract
A dinucleotide repeat polymorphism (5-, 6-, 7-, or 8-TA units) has been identified within the promoter region of UDP-glucuronosyltransferase 1A1 (UGT1A1) gene. The 7-TA repeat allele has been associated with elevated serum bilirubin levels that cause a mild hyperbilirubinemia (Gilbert's syndrome). Studies suggest that promoter transcriptional activity of UGT1A1 is inversely related to the number of TA repeats, and that unconjugated bilirubin concentration increases directly with the number of TA repeat elements. Because bilirubin is a known antioxidant, we hypothesized that UGT1A1 repeats associated with higher bilirubin may be protective against oxidative damage. We examined the effect of UGT1A1 genotype on somatic mutant frequency in the hypoxanthine-guanine phosphoribosyl-transferase (HPRT) gene in human lymphocytes and the glycophorin A (GPA) gene of red blood cells (both N0, NN mutants), and the frequency of lymphocyte micronuclei (both kinetochore (K)-positive or micronuclei K-negative) in 101 healthy smoking and nonsmoking individuals. As hypothesized, genotypes containing 7- and 8-TA displayed marginally lower GPA_NN mutant frequency relative to 5/5, 5/6, 6/6 genotypes ( [Formula: see text] ). In contrast, our analysis showed that lower expressing UGT1A1 alleles (7- and 8-TA) were associated with modestly increased HPRT mutation frequency ( [Formula: see text] ), while the same low-expression genotypes were not significantly associated with micronuclei frequencies (K-positive or K-negative) when compared to high-expression genotypes (5- and 6-TA). We found weak evidence that UGT1A1 genotypes containing 7- and 8-TA were associated with increased GPA_NØ mutant frequency relative to 5/5, 5/6, 6/6 genotypes ( [Formula: see text] ). These data suggest that UGT1A1 genotype may modulate somatic mutation of some types, in some cell lineages, by a mechanism not involving bilirubin antioxidant activity. More detailed studies examining UGT1A1 promoter variation, oxidant/antioxidant balance and genetic damage will be needed.
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Affiliation(s)
- Delores J Grant
- Environmental Genomics Section, Laboratory of Computational Biology and Risk Assessment, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA
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