title: Bilirubin-Induced Neurotoxicity in the Preterm Neonate.
abstract: Bilirubin-induced neurotoxicity in preterm neonates remains a clinical concern. Multiple cellular and molecular cascades likely underlie bilirubin-induced neuronal injury, including plasma membrane perturbations, excitotoxicity, neuroinflammation, oxidative stress, and cell cycle arrest. Preterm newborns are particularly vulnerable secondary to central nervous system immaturity and concurrent adverse clinical conditions that may potentiate bilirubin toxicity. Acute bilirubin encephalopathy in preterm neonates may be subtle and manifest primarily as recurrent symptomatic apneic events. Low-bilirubin kernicterus continues to be reported in preterm neonates, and although multifactorial in nature, is often associated with marked hypoalbuminemia.
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Magee-Womens Hospital, Children's Hospital of Pittsburgh, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA. Electronic address: jwatchko@mail.magee.edu.
authors.forename: Jon F
authors.initials: JF
authors.lastname: Watchko
mesh_terms: D001049:Apnea / Q000209:etiology; D017209:Apoptosis; D001663:Bilirubin / Q000378:metabolism*; D001921:Brain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002118:Calcium / Q000378:metabolism; D002453:Cell Cycle; D059447:Cell Cycle Checkpoints; D002462:Cell Membrane / Q000378:metabolism*; D038524:Diffusion Magnetic Resonance Imaging; D059865:Endoplasmic Reticulum Stress; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000150:complications / Q000378:metabolism*; D007231:Infant, Newborn; D007234:Infant, Premature; D007249:Inflammation; D007647:Kernicterus / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008928:Mitochondria / Q000378:metabolism; D009336:Necrosis; D009474:Neurons / Q000378:metabolism* / Q000473:pathology; D018384:Oxidative Stress; D012131:Respiratory Insufficiency / Q000209:etiology
chemical_list: D001663:Bilirubin; D002118:Calcium
keywords: Auditory neuropathy; Cerebellum; Excitotoxicity; Hypoalbuminemia; Kernicterus; Low-bilirubin kernicterus