DEPOSITION OF BILIRUBIN ACID IN THE CENTRAL-NERVOUS-SYSTEM - A HYPOTHESIS FOR THE DEVELOPMENT OF KERNICTERUS

被引:55
作者
BRODERSEN, R [1 ]
STERN, L [1 ]
机构
[1] BROWN UNIV,PROVIDENCE,RI 02912
来源
ACTA PAEDIATRICA SCANDINAVICA | 1990年 / 79卷 / 01期
关键词
amorphous bilirubin; bilirubin acid deposition; bilirubin oxidase; index of plasma bilirubin toxicity; kernicterus;
D O I
10.1111/j.1651-2227.1990.tb11323.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
On the basis of the concentration of unconjugated bilirubin and available albumin for the binding of bilirubin it is possible to calculate the level of unbound bilirubin in a serum sample. The solubility of bilirubin can further be calculated when the pH is known. In cases of threatened kernicterus the free bilirubin concentration in serum samples from newborn infants surpasses the solubility by a factor close to one hundred. It is hypothesized that deposition of bilirubin in tissues takes place as an ongoing event, the deposited pigment being eliminated by bilirubin oxidase in healthy infants. Kernicterus results when the rate of deposition becomes overwhelming as a result of high bilirubin concentration, low albumin reserve, low pH, after administration of a displacing drug, or if the bilirubin oxidase system has been compromised by preceding birth asphyxia or other forms of central nervous system injury.
引用
收藏
页码:12 / 19
页数:8
相关论文
共 16 条
[1]   BILIRUBIN-DISPLACING EFFECT OF AMPICILLIN, INDOMETHACIN, CHLORPROMAZINE, GENTAMICIN, AND PARABENS INVITRO AND IN NEWBORN-INFANTS [J].
BRODERSEN, R ;
EBBESEN, F .
JOURNAL OF PHARMACEUTICAL SCIENCES, 1983, 72 (03) :248-253
[2]   DETERMINATION OF RESERVE ALBUMIN-EQUIVALENT FOR LIGAND-BINDING, PROBING 2 DISTINCT BINDING FUNCTIONS OF THE PROTEIN [J].
BRODERSEN, R ;
ANDERSEN, S ;
JACOBSEN, C ;
SONDERSKOV, O ;
EBBESEN, F ;
CASHORE, WJ ;
LARSEN, S .
ANALYTICAL BIOCHEMISTRY, 1982, 121 (02) :395-408
[3]   ENZYMATIC OXIDATION OF BILIRUBIN [J].
BRODERSEN, R ;
BARTELS, P .
EUROPEAN JOURNAL OF BIOCHEMISTRY, 1969, 10 (03) :468-+
[4]  
BRODERSEN R, 1986, BILE PIGMENTS JAUNDI, V1, P157
[5]   RESERVE ALBUMIN AND BILIRUBIN TOXICITY INDEX IN INFANT SERUM [J].
CASHORE, WJ ;
OH, W ;
BRODERSEN, R .
ACTA PAEDIATRICA SCANDINAVICA, 1983, 72 (03) :415-419
[6]   THE RELATIONSHIP BETWEEN SERUM BILIRUBIN AND RESERVE ALBUMIN FOR BINDING OF BILIRUBIN DURING PHOTOTHERAPY OF PRETERM INFANTS [J].
EBBESEN, F .
ACTA PAEDIATRICA SCANDINAVICA, 1981, 70 (03) :405-407
[7]   ALBUMIN ADMINISTRATION COMBINED WITH PHOTOTHERAPY IN TREATMENT OF HYPERBILIRUBINEMIA IN LOW-BIRTH-WEIGHT INFANTS [J].
EBBESEN, F ;
BRODERSEN, R .
ACTA PAEDIATRICA SCANDINAVICA, 1981, 70 (05) :649-653
[8]   COMPARISON BETWEEN 2 PREPARATIONS OF HUMAN-SERUM ALBUMIN IN TREATMENT OF NEONATAL HYPERBILIRUBINEMIA [J].
EBBESEN, F ;
BRODERSEN, R .
ACTA PAEDIATRICA SCANDINAVICA, 1982, 71 (01) :85-90
[9]   RISK OF BILIRUBIN ACID PRECIPITATION IN PRETERM INFANTS WITH RESPIRATORY-DISTRESS SYNDROME - CONSIDERATIONS OF BLOOD-BRAIN BILIRUBIN TRANSFER EQUILIBRIUM [J].
EBBESEN, F ;
BRODERSEN, R .
EARLY HUMAN DEVELOPMENT, 1982, 6 (04) :341-355
[10]  
ERIKSEN EF, 1981, J BIOL CHEM, V256, P4269