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Neonatal Hyperbilirubinemia and Kernicterus: Experimental Support for Treatment by Exposure to Visible Light

Neonatal Hyperbilirubinemia and Kernicterus: Experimental Support for Treatment by Exposure to... Abstract CREMER et al1 noted that in infants with neonatal icterus exposure to sunlight resulted in a prompt reduction of the serum bilirubin level; this was subsequently confirmed by other investigatiors.2 Broughton et al3 and Lucey et al4 explored the possibility of applying this observation to the treatment of uncomplicated neonatal hyperbilirubinemia. Bilirubin is a lipid-soluble molecule which readily crosses the blood-brain barrier in either direction.5 In the plasma, bilirubin is tightly bound to albumin which greatly limits the access of the pigment to the central nervous system (CNS).5,6 Illumination of bilirubin in vitro leads to progressive decomposition of the pigment, eventually resulting in loss of its yellow color and its characteristic absorption spectrum in the visible range.7-9 Although the exact chemical structure of these decomposition products is unclear, they are known to be more polar and hence, more water-soluble than bilirubin.8-10 References 1. Cremer, R.J.; Perryman, P.W.; and Richards, D.H.: Influence of Light on the Hyperbilirubinemia of Infants , Lancet 1:1094-1097, 1958.Crossref 2. Ferreira, H.C., et al: Superillumination in Hyperbilirubinemia in the Newborn , An Brasil Ginec 49:147-148, 1960. 3. Broughton, P.M.G., et al: Effect of Blue Light on Hyperbilirubinemia , Arch Dis Child 40:666-671, 1965.Crossref 4. Lucey, J.F.; Ferreiro, M.; and Hewitt, H.J.: Prevention of Hyperbilirubinemia of Prematurity by Phototherapy , J Pediat to be published. 5. Diamond, I., and Schmid, R.: Experimental Bilirubin Encephalopathy: I. The Mode of Entry of Bilirubin-14C into the Central Nervous System , J Clin Invest 45:678-689, 1966.Crossref 6. Schmid, R., et al: Interaction of Bilirubin with Albumin , Nature 206:1041-1043, 1965.Crossref 7. Blondheim, S.H.; Lathrop, D.; and Zabriskie, J.: Effect of Light on the Absorption Spectrum of Jaundiced Serum , J Lab Clin Med 60:31-39, 1962. 8. Ostrow, J.D.; Hammaker, L.; and Schmid, R.: The Preparation of Crystalline Bilirubin-C14 , J Clin Invest 40:1442-1452, 1961.Crossref 9. Ostrow, J.D.: " Photo-Oxidative Derivatives of 14C-Bilirubin and Their Excretion by the Gunn Rat ", in Bouchier, I.A.D. and Billing, B.H. (eds.): Bilirubin Metabolism , Oxford: Blackwell Scientific Publications, 1967, pp 117-127. 10. Ostrow, J.D., and Schmid, R.: The Protein-Binding of C14-Bilirubin in Human and Murine Serum , J Clin Invest 42:1286-1299, 1963.Crossref 11. Diamond, I., and Schmid, R.: Oxidative Phosphorylation in Experimental Bilirubin Encephalopathy , Science 155:1288-1289, 1967.Crossref 12. Menken, M., and Weinbach, E.C.: Oxidative Phosphorylation and Respiratory Control of Brain Mitochondria Isolated From Kernicteric Rats , J Neurochem 14:189-193, 1967.Crossref 13. Lester, R., and Schmid, R.: Intestinal Absorption of Bile Pigments: I. The Enterohepatic Circulation of Bilirubin in the Rat , J Clin Invest 42:736-746, 1963.Crossref 14. Barlow, C.F.: Clinical Aspects of the Blood-Brain Barrier , Ann Rev Med 15:187-202, 1964.Crossref 15. Schanker, L.S.: Passage of Drugs Across Body Membranes , Pharmacol Rev 14:501-530, 1962. 16. Schmid, R., and Hammaker, L.: Metabolism and Disposition of C14-Bilirubin in Congenital Non-hemolytic Jaundice , J Clin Invest 42:1720-1734, 1963.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Neonatal Hyperbilirubinemia and Kernicterus: Experimental Support for Treatment by Exposure to Visible Light

Archives of Neurology , Volume 18 (6) – Jun 1, 1968

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Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1968.00470360121012
Publisher site
See Article on Publisher Site

Abstract

Abstract CREMER et al1 noted that in infants with neonatal icterus exposure to sunlight resulted in a prompt reduction of the serum bilirubin level; this was subsequently confirmed by other investigatiors.2 Broughton et al3 and Lucey et al4 explored the possibility of applying this observation to the treatment of uncomplicated neonatal hyperbilirubinemia. Bilirubin is a lipid-soluble molecule which readily crosses the blood-brain barrier in either direction.5 In the plasma, bilirubin is tightly bound to albumin which greatly limits the access of the pigment to the central nervous system (CNS).5,6 Illumination of bilirubin in vitro leads to progressive decomposition of the pigment, eventually resulting in loss of its yellow color and its characteristic absorption spectrum in the visible range.7-9 Although the exact chemical structure of these decomposition products is unclear, they are known to be more polar and hence, more water-soluble than bilirubin.8-10 References 1. Cremer, R.J.; Perryman, P.W.; and Richards, D.H.: Influence of Light on the Hyperbilirubinemia of Infants , Lancet 1:1094-1097, 1958.Crossref 2. Ferreira, H.C., et al: Superillumination in Hyperbilirubinemia in the Newborn , An Brasil Ginec 49:147-148, 1960. 3. Broughton, P.M.G., et al: Effect of Blue Light on Hyperbilirubinemia , Arch Dis Child 40:666-671, 1965.Crossref 4. Lucey, J.F.; Ferreiro, M.; and Hewitt, H.J.: Prevention of Hyperbilirubinemia of Prematurity by Phototherapy , J Pediat to be published. 5. Diamond, I., and Schmid, R.: Experimental Bilirubin Encephalopathy: I. The Mode of Entry of Bilirubin-14C into the Central Nervous System , J Clin Invest 45:678-689, 1966.Crossref 6. Schmid, R., et al: Interaction of Bilirubin with Albumin , Nature 206:1041-1043, 1965.Crossref 7. Blondheim, S.H.; Lathrop, D.; and Zabriskie, J.: Effect of Light on the Absorption Spectrum of Jaundiced Serum , J Lab Clin Med 60:31-39, 1962. 8. Ostrow, J.D.; Hammaker, L.; and Schmid, R.: The Preparation of Crystalline Bilirubin-C14 , J Clin Invest 40:1442-1452, 1961.Crossref 9. Ostrow, J.D.: " Photo-Oxidative Derivatives of 14C-Bilirubin and Their Excretion by the Gunn Rat ", in Bouchier, I.A.D. and Billing, B.H. (eds.): Bilirubin Metabolism , Oxford: Blackwell Scientific Publications, 1967, pp 117-127. 10. Ostrow, J.D., and Schmid, R.: The Protein-Binding of C14-Bilirubin in Human and Murine Serum , J Clin Invest 42:1286-1299, 1963.Crossref 11. Diamond, I., and Schmid, R.: Oxidative Phosphorylation in Experimental Bilirubin Encephalopathy , Science 155:1288-1289, 1967.Crossref 12. Menken, M., and Weinbach, E.C.: Oxidative Phosphorylation and Respiratory Control of Brain Mitochondria Isolated From Kernicteric Rats , J Neurochem 14:189-193, 1967.Crossref 13. Lester, R., and Schmid, R.: Intestinal Absorption of Bile Pigments: I. The Enterohepatic Circulation of Bilirubin in the Rat , J Clin Invest 42:736-746, 1963.Crossref 14. Barlow, C.F.: Clinical Aspects of the Blood-Brain Barrier , Ann Rev Med 15:187-202, 1964.Crossref 15. Schanker, L.S.: Passage of Drugs Across Body Membranes , Pharmacol Rev 14:501-530, 1962. 16. Schmid, R., and Hammaker, L.: Metabolism and Disposition of C14-Bilirubin in Congenital Non-hemolytic Jaundice , J Clin Invest 42:1720-1734, 1963.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1968

References