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bilirubin
Physiology: ,Bilirubin is a waste product of heme metabolism, produced largely in the spleen where senescent erythrocytes are phagocytosed. However, it is also produced in the brain where it may serve a constituent role as an antioxidant.
Bilirubin is formed from heme by sequential actions of heme oxygease in association with cyt P450 reductase & bilirubin reductase.
heme oxygenase
cyt P450 reductase
heme[Fe+2] + O2 ------------------> biliverdin + CO + Fe+2
+ NADPH + H+ + NADP+ + H2O
biliverdin reductase
biliverdin --------------------> bilirubin + NADP+
+ NADPH + H+
Biliverdin reductase rapidly reduces biliverdin to bilirubin.
Bilirubin binds non-covalently to albumin (unconjugated bilirubin) for transport to the liver, where it is conjugated with glucuronic acid (conjugated bilirubin), then excreted in the bile. In certain conditions, bilirubin may also bind covalently to albumin to form delta-bilirubin.
Bilirubin has the capacity to reduce 10,000 higher fold concentrations of H2O2 through the biliverdin reductase cycle.
Laboratory:
- bilirubin in specimen
- bilirubin in skin
- bilirubin in stone
- bilirubin in body fluid
- bilirubin in amniotic fluid
- bilirubin in CSF
- bilirubin in pericardial fluid
- bilirubin in peritoneal fluid
- bilirubin in serum
- bilirubin in stool
- bilirubin in synovial fluid
- bilirubin in urine
- bilirubin direct in body fluid
- bilirubin direct in blood
- bilirubin direct in serum/plasma
- bilirubin direct in peritoneal fluid
- bilirubin direct in pleural fluid
- bilirubin indirect in body fluid
- bilirubin indirect in blood
- bilirubin indirect in peritoneal fluid
- bilirubin conjugated in body fluid
- bilirubin conjugated in dialysis fluid
- bilirubin conjugated in peritoneal fluid
- bilirubin conjugated in serum
- bilirubin unconjugated in serum
- bilirubin crystals in urine
Interactions
molecular events
Related
bilirubin conjugated in serum
bilirubin crystals in urine
bilirubin in urine (Ictotest)
bilirubin metabolism, inborn error
bilirubin unconjugated in serum (indirect bilirubin)
heme catabolism
Specific
bilirubin diglucuronide; conjugated bilirubin; direct bilirubin
delta bilirubin
General
heme metabolite
pigment
Database Correlations
PUBCHEM correlations
References
- Clinical Diagnosis & Management by Laboratory Methods,
J.B. Henry (ed), W.B. Saunders Co., Philadelphia,
PA. 1991, pg 233
- Sedlak TW, Snyder SH.
Messenger molecules and cell death: therapeutic implications.
JAMA. 2006 Jan 4;295(1):81-9.
PMID: 16391220
Substructures
pyrrole