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- Title
Mechanism of bilirubin elimination in urine: insights and prospects for neonatal jaundice.
- Authors
Thomas, Mercy; Hardikar, Winita; Greaves, Ronda F.; Tingay, David G.; Loh, Tze Ping; Ignjatovic, Vera; Newall, Fiona; Rajapaksa, Anushi E.
- Abstract
Despite a century of research, bilirubin metabolism and the transport mechanisms responsible for homeostasis of bilirubin in serum remain controversial. Emerging evidence on the hepatic membrane transporters and inherited disorders of bilirubin metabolism have contributed to a greater understanding of the various steps involved in bilirubin homeostasis and its associated excretory pathways. We discuss these recent research findings on hepatic membrane transporters and evaluate their significance on the newborn bilirubin metabolism and excretion. New insights gained speculate that a proportion of conjugated bilirubin is excreted via the renal system, as an alternative to the intestinal excretion, even in normal physiological jaundice with no associated pathological concerns. Finally, this paper discusses the clinical relevance of targeting the altered renal excretory pathway, as bilirubin in urine may hold diagnostic importance in screening for neonatal jaundice.
- Subjects
NEONATAL jaundice; BILIRUBIN; MEMBRANE transport proteins; HOMEOSTASIS; METABOLIC disorders
- Publication
Clinical Chemistry & Laboratory Medicine, 2021, Vol 59, Issue 6, p1025
- ISSN
1434-6621
- Publication type
Article
- DOI
10.1515/cclm-2020-1759