title: Biology of Bilirubin Photoisomers.
abstract: Phototherapy is the main treatment for neonatal hyperbilirubinemia. In acute treatment of extreme hyperbilirubinemia, intensive phototherapy may have a role in 'detoxifying' the bilirubin molecule to more polar photoisomers, which should be less prone to crossing the blood-brain barrier, providing a 'brain-sparing' effect. This article reviews the biology of bilirubin isomers. Although there is evidence supporting the lower toxicity of bilirubin photoisomers, there are studies showing the opposite. There are methodologic weaknesses in most studies and better-designed experiments are needed. In an infant acutely threatened by bilirubin-induced brain damage, intensified phototherapy should be used expediently and aggressively.
authors.affiliation: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: t.w.r.hansen@medisin.uio.no.
authors.forename: Thor Willy Ruud
authors.initials: TW
authors.lastname: Hansen
mesh_terms: D001663:Bilirubin / Q000378:metabolism*; D001812:Blood-Brain Barrier / Q000378:metabolism*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000378:metabolism / Q000628:therapy*; D066298:In Vitro Techniques; D007231:Infant, Newborn; D007536:Isomerism; D007567:Jaundice, Neonatal / Q000378:metabolism / Q000628:therapy*; D010789:Phototherapy
chemical_list: D001663:Bilirubin
keywords: Bilirubin; Bilirubin photoisomers; Jaundice; Membrane permeability; Neonatal; Phototherapy; Solubility; Toxicity