Relationship of bilirubin to diseases caused by increased oxidative stress

Authors: L. Vítek 1,2
Authors‘ workplace: IV. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MU Dr. Aleš Žák, DrSc. 1;  Ústav lékařské bio­chemie a laboratorní dia­gnostiky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MU Dr. Tomáš Zima, DrSc., MBA 2
Published in: Vnitř Lék 2013; 59(7): 618-621


Oxidative stress contributes importantly to pathogenesis of numerous civilization diseases, including cardiovascular diseases, cancer, as well as autoimmune and neurodegenerative conditions. Bilirubin is the major product of the heme catabolic pathway in the intravascular compartment. For long time, bilirubin was considered to be only a waste product, however, recent data from the last 2 decades have proved its important antioxidant properties, which contributes to defense against increased oxidative stress. Numerous experimental as well as clinical studies have demonstrated association between low bilirubin concentrations and cardiovascular diseases, diabetes, certain cancers, autoimunne diseases, such as lupus erythematodes, or rheumatoid arthritis or neurological‑ psychiatric disorders, such as schizofrenia. On the other hand, subjects with mildly elevated blood bilirubin levels, typical for Gilbert syndrome, have decreased risk of these diseases.

Key words:
bilirubin –  oxidative stress –  antioxidant –  Gilbert syndrome


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