Beyond plasma bilirubin: The effects of phototherapy and albumin on brain bilirubin levels in Gunn rats

Frans J. C. Cuperus, Andrea B. Schreuder, Deirdre E. van Imhoff, Libor Vitek, Jana Vanikova, Renata Konickova, Charles E. Ahlfors, Christian V. Hulzebos, Henkjan J. Verkade*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)

Abstract

Background & Aims: Severe unconjugated hyperbilirubinemia, as occurs in Crigler-Najjar disease and neonatal jaundice, carries the risk of neurotoxicity. This neurotoxicity is related to the increased passage of free bilirubin (UCBfree) the fraction of bilirubin that is not bound to plasma proteins, into the brain. We hypothesized that albumin treatment would lower the UCBfree fraction, and thus decrease bilirubin accumulation in the brain.

Methods: We treated chronic (e.g., as a model for Crigler-Najjar disease) and acute hemolytic (e.g., as a model for neonatal jaundice) moderate hyperbilirubinemic Gunn rats with phototherapy, human serum albumin (HSA) or phototherapy + HSA.

Results: In the chronic model, adjunct HSA increased the efficacy of phototherapy; it decreased plasma UCBfree and brain bilirubin by 88% and 67%, respectively (p

Conclusions: We showed that adjunct HSA treatment decreases brain bilirubin levels in phototherapy-treated Gunn rats. We hypothesize that HSA decreases these levels by lowering UCBfree in the plasma. Our results support the feasibility of adjunct albumin treatment in patients with Crigler-Najjar disease or neonatal jaundice. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)134-140
Number of pages7
JournalJournal of Hepatology
Volume58
Issue number1
DOIs
Publication statusPublished - Jan-2013

Keywords

  • Unconjugated hyperbilirubinemia
  • Phototherapy
  • Albumin
  • Brain
  • Gunn rat
  • CRIGLER-NAJJAR SYNDROME
  • UNBOUND BILIRUBIN
  • NEONATAL JAUNDICE
  • UNCONJUGATED HYPERBILIRUBINEMIA
  • INTENSIVE PHOTOTHERAPY
  • EXCHANGE TRANSFUSIONS
  • INFUSION THERAPY
  • KERNICTERUS
  • INFANTS
  • ENCEPHALOPATHY

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