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Bilirubin: The yellow hormone?

Libor Vítek1, Claudio Tiribelli2

  • 1Faculty General Hospital and 1(st) Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.

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|June 21, 2021
PubMed
Summary

Bilirubin, once viewed as waste, is now recognized for its protective biological functions. Higher levels, seen in Gilbert's syndrome, correlate with reduced incidence of chronic diseases.

Keywords:
BilirubinGilbert syndromebenign hyperbilirubinemiahormone

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Area of Science:

  • Biochemistry
  • Physiology
  • Immunology

Background:

  • Bilirubin is a heme catabolism product.
  • Previously considered a waste product, it's now known to modulate biological functions.
  • Its role extends to cell signaling, metabolism, and immune regulation.

Purpose of the Study:

  • To highlight the multifaceted biological roles of bilirubin.
  • To explore the association between bilirubin levels and chronic diseases.
  • To emphasize the protective effects of unconjugated hyperbilirubinemia.

Main Methods:

  • Literature review of bilirubin's biological functions.
  • Analysis of epidemiological data on chronic diseases and hyperbilirubinemia.
  • Correlation studies between serum bilirubin concentrations and disease incidence.

Main Results:

  • Bilirubin exhibits significant roles in cell signaling, metabolism, and immune responses.
  • Individuals with mild unconjugated hyperbilirubinemia (Gilbert's syndrome) show lower rates of cardiovascular diseases, diabetes, obesity, metabolic syndrome, certain cancers, and neurodegenerative diseases.
  • Higher serum unconjugated bilirubin acts as a protective factor against these conditions.

Conclusions:

  • Bilirubin is a crucial endogenous molecule with significant protective functions.
  • Mild unconjugated hyperbilirubinemia may confer resistance to major chronic diseases.
  • Therapeutic strategies targeting bilirubin levels could be beneficial.