Does bilirubin act as a free radical quencher of clinical significance in neonates and children?

Abstract

Pediatricians are generally wary of hyperbilirubinemia because elevated circulating bilirubin is seen both as a sign of disease and a cause of pathology. Normal aerobic metabolism is associated with the chance occurrence of reactive oxygen species (ROS) that can damage cellular macromolecules. Bilirubin as a molecule at the crossroads of the natural protection of the body against ROS has been the subject of experiments in vitro and in animals, as well as observational and epidemiological studies during the past two decades. This review assesses the evidence as to whether bilirubin is a free radical quencher of clinical significance in the newborn and children, and thus may have a beneficial role. The overall conclusion is that pediatricians should remain cautious about bilirubin and follow current guidelines.

Keywords

Bilirubin - reactive oxygen species - neonates - hyperbilirubinemia guidelines