Effects of bilirubin on red cell metabolism

Blirubin causes certain defects in erythrocyte metabolism, mainly in glycolysis. These effects of bilirubin were studied in vitro using a relatively physiological assay medium, which consisted of heparinized whole blood. Bilirubin was added in a small quantity of NaOH solution. In the presence of bilirubin a reduced glucose consumption of red cells and an accelerated depletion in the ATP and glycerate-2,3-bisphosphate concentration was found. Bilirubin levels lower than 50 mumol/l did not influence the glucose consumption. In agreement to other investigations it was established that bilirubin causes haemolysis of red cells. ATP-deficient cells are more sensitive to this effect.