COMMENTARY

Bilirubin

Bilirubin, a curse and a boon

J D Ostrow¹, C Tiribelli²

¹ Research Service, VA Puget Sound Health Care System-Seattle Division, and GI/Hepatology Division, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
² Liver Research Center, AREA Science Park and Department of BBCM, University of Trieste, 34012 Trieste, Italy

Correspondence to:
Correspondence to:
Dr J D Ostrow
Research Service (151L), VA Puget Sound Health Care System-Seattle Division, 1660 South Columbian Way, Seattle, WA 98108-1597, USA; jdostrow@medicine.washington.edu

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Unconjugated bilirubin is a curse at high concentrations, producing apoptosis and cell death, but a boon at more physiological levels, protecting cells against oxidant damage

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Keywords: hepatocytes; apoptosis; bile acids; bilirubin; cholestasis; rat

The first 150 words of the full text of this article appear below.

Both hydrophobic bile salts^1,2 and unconjugated bilirubin (UCB)³ induce apoptosis in cultured cells at moderately elevated concentrations and cell necrosis at higher concentrations. Retention of bile salts in cholestasis is believed to cause secondary damage to hepatocytes,⁴ and retention of UCB in severe neonatal jaundice is known to cause bilirubin encephalopathy.⁵ For both agents, the cytotoxicity results from damage to mitochondrial membranes, with collapse of the transmembrane potential and generation of a mitochondrial membrane permeability transition,^1–2,6 and ursodeoxycholic acid or its amidates can prevent apoptosis by inhibiting this process.^1–2,7 It is therefore surprising that, as reported by Granato et al in this issue of Gut,⁸ UCB, at concentrations far above those known to be cytotoxic to neurones and astrocytes,³ is protective against apoptosis induced in cultured rat hepatocytes by the hydrophobic bile salt glycochenodeoxycholate (GCDC) [see page 1774]. This finding raises interesting questions concerning whether UCB . . . [Full text of this article]

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Relevant Article

Bilirubin inhibits bile acid induced apoptosis in rat hepatocytes

A Granato, G Gores, M T Vilei, R Tolando, C Ferraresso, and M Muraca
Gut 2003 52: 1774-1778. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Kirk, J. M (2008). Neonatal jaundice: a critical review of the role and practice of bilirubin analysis. Ann Clin Biochem 45: 452-462 [Abstract] [Full Text]