title: The molecular basis for the immunomodulatory activities of unconjugated bilirubin.
abstract: Nearly a century ago, jaundiced patients were observed to have surprising and spontaneous remissions from incurable immunologic diseases including rheumatoid arthritis, allergy, and asthma. The mystery of why this phenomenon occurred remains unresolved to this day. Bilirubin has traditionally been considered an excretory product resulting from heme metabolism with little benefit to human physiology. In the past few decades, however, the salutary role of this byproduct as a potent antioxidant has been repeatedly noted. Most recently, the molecule has been found to possess immunomodulatory properties that rival its redox capacity, possibly explaining its ability to suppress inflammation. In this review, we specifically examine unconjugated bilirubin (UCB) as an immunomodulator and explore the molecular basis for its immunosuppressive effects.
authors.affiliation: Beth Israel Deaconess Medical Center, United States; Harvard Medical School, United States. Electronic address: sjangi@bidmc.harvard.edu.
authors.forename: Sushrut
authors.initials: S
authors.lastname: Jangi
authors.forename: Leo
authors.initials: L
authors.lastname: Otterbein
authors.forename: Simon
authors.initials: S
authors.lastname: Robson
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000276:immunology*; D001663:Bilirubin / Q000276:immunology* / Q000494:pharmacology*; D006801:Humans; D056747:Immunomodulation; D015398:Signal Transduction
chemical_list: D001663:Bilirubin
keywords: Autoimmune disease; Bilirubin; Immunology; Immunomodulation; Lymphocytes