Neonatal Hyperbilirubinemia: in vivo Characterization of Mechanisms of Bilirubin Neurotoxicity and Pharmacological Treatments
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Developmental, Genetic, Dietary, and Xenobiotic Influences on Neonatal Hyperbilirubinemia.
Hyperbilirubinemia, caused by the accumulation of unconjugated bilirubin, is one of the most common clinical diagnoses in both premature and term newborns. Owing to the fact that bilirubin is metabolized solely through glucuronidation by UDP-glucuronosyltransferase (UGT) 1A1, it is now known that immaturity of UGT1A1, in combination with the overproduction of bilirubin during the developmental ...
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The neurologic manifestations of neonatal hyperbilirubinemia in the central nervous system (CNS) exhibit high variations in the severity and appearance of motor, auditory and cognitive symptoms, which is suggestive of a still unexplained selective topography of bilirubin-induced damage. By applying the organotypic brain culture (OBC: preserving in vitro the cellular complexity, connection and a...
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Therapies to prevent severe neonatal unconjugated hyperbilirubinemia and kernicterus are phototherapy and, in unresponsive cases, exchange transfusion, which has significant morbidity and mortality risks. Neurotoxicity is caused by the fraction of unconjugated bilirubin not bound to albumin (free bilirubin, Bf). Human serum albumin (HSA) administration was suggested to increase plasma bilirubin...
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Background: Clofibrate is a pharmacological agent, which affects the lipid metabolism. This compound could be involved in bilirubin accumulation and excretion process. Therefore, this study aimed to evaluate the effect of oral clofibrate intake on total serum bilirubin (TSB) of neonates hospitalized at Khatam Hospital. Methods: This clinical trial was conducted on 73 neonates with hyperbilirub...
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Background: Considering the increasing rates of early hospital discharge and kernicterus in healthy full term newborns, timely identification of neonates at risk of severe hyperbilirubinemia is of great significance. The aim of this study was to investigate the predictive value of umbilical cord serum (UCS) bilirubin level for subsequent hyperbilirubinemia. Moreover, we compared the predictive ...
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