Bilirubin as a metabolic hormone: the physiological relevance of low levels
| Autor: | Darren M. Gordon, Justin F. Creeden, Terry D. Hinds, David E. Stec |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Physiology Bilirubin Endocrinology Diabetes and Metabolism Heme Review 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Physiology (medical) Internal medicine medicine Animals Humans Clinical significance PPAR alpha Stroke Hyperbilirubinemia Heme catabolism business.industry Jaundice medicine.disease Hormones Heme oxygenase 030104 developmental biology Endocrinology chemistry Nuclear receptor Gene Expression Regulation medicine.symptom Gilbert Disease business Energy Metabolism Metabolic Networks and Pathways Hormone |
| Zdroj: | Am J Physiol Endocrinol Metab |
| ISSN: | 1522-1555 |
| Popis: | Recent research on bilirubin, a historically well-known waste product of heme catabolism, suggests an entirely new function as a metabolic hormone that drives gene transcription by nuclear receptors. Studies are now revealing that low plasma bilirubin levels, defined as “hypobilirubinemia,” are a possible new pathology analogous to the other end of the spectrum of extreme hyperbilirubinemia seen in patients with jaundice and liver dysfunction. Hypobilirubinemia is most commonly seen in patients with metabolic dysfunction, which may lead to cardiovascular complications and possibly stroke. We address the clinical significance of low bilirubin levels. A better understanding of bilirubin’s hormonal function may explain why hypobilirubinemia might be deleterious. We present mechanisms by which bilirubin may be protective at mildly elevated levels and research directions that could generate treatment possibilities for patients with hypobilirubinemia, such as targeting of pathways that regulate its production or turnover or the newly designed bilirubin nanoparticles. Our review here calls for a shift in the perspective of an old molecule that could benefit millions of patients with hypobilirubinemia. |
| Databáze: | OpenAIRE |
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