Download - Billirubin Metabolism
Bilirubin metabolism
عالء الدين
Warning: Audience discretion is advised,
what you are about to see is a true story
about the miserable life of bilirubin.
Translated into English from an Arabic version from a King Saud University parody
Lecture.
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• Inside the vessels of a human
• In the bottom of heart
• There was a loving family called „‟
Hemoglobin‟‟ living.
• In a simple house called „ RBC „.
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• Consist of a father called „‟ ProtoPorphiren” who has a brownish colour.
• Madame „‟ Globin‟‟ who is from a protein origin
• Four sons are called „‟ Iron „‟.
In 120 daysعالء الدين
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hemolysis
• The villian called „‟ReteculoEndothelial System’’ sweeps off the house because it was over 120 days of age.
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And the life of the happy family
changes
)= And becomes sadعالء الدين
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Haemoglobin is cleaved into haem & Globin which is hydrolysed into free AA
• Globin asks for divorce to get back to her family
house „‟ Amino acid pool‟‟.
طلقنى طلقنى
..طلقنى
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And every iron gets into his automobile
„‟Transferrin‟‟ and travels far away.
Bye Daddy!!…
Iron is carried on transferrin to be reused
)= Dad becomes lonely and sadعالء الدين
عالء الدينHis colour changes to green and people called him
„‟ Biliverden‟‟
Protoporpherin is then reduced into Biliverden
عالء الدينThen his name changes to the infamous yellow
colour called „‟Bilirubin‟‟
Then into Bilirubin
عالء الدينHis friends convince him to tie the knot again.
They propose Mademoiselle „‟ Albumin‟‟ to him.
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Indirect bilirubin is water insoluble
• But Mademoiselle „‟ Albumin „‟ wanted to know
him better before getting married.
I heard that you are
‘’ indirect’’, I
wanna know ya
more before we
marry!.
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so it is carried on albumin and called haemobilirubin or indirect bilirbin
•So some people believe they got married
Darling, people think we are married;
tell them we are just „‟ engaged‟‟.
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Or unconjugated bilirubin
They get called „‟haemobilirubin”
•“indirect bilirubin”
•“unconjugated bilirubin ”
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Indirect bilirubin cannot be filtrated from the kidney even in it‟s exess so not present in urine in
haemolytic jaundice “acholuric”
• But Indirect billuribin cannot enter the kidney even if it was in an ample quantities because it is toolarge.
عالء الدين
و
Whaddaya
think of dat
house dear?
Oh dear, I would never live in
such a house, it‟s a factory
not a house. So big!!
So Bilirubin decides to live in the liver, but Mrs.
Albumin refuses.
عالء الدين• They split up
The sad bilirubin enters the „liver‟
Farewell darling
=(
•عالء الدين In the liver; Bilirubin meets with two hawt blue
ladies.
What are your
names my blue
angels?
Glucuronic
acid
Marry me?
Indirect bilirubin is conjugated in the liver with 2 glucuronic acid molecules
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Glucuronyl transferase
• The enzyme „‟Glucuronyl transferase „‟ wed them*.
• His name changes to Direct or Conjugated or Cholibilirubin
Now it is termed Direct or Conjugated or Cholibilirubin
Enzyme
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Conjuged bilirubin can be filtrated in urine if it is increased as in obstructive & hepatocellular jaundice
The cool thing about you
girls; you are so cute and
small we can enter the „‟
kidney‟‟ easily.
We better go to the
„‟ Small intestine‟‟
whaddaya think?
I don‟t know the
directions, I should
ask one of my buds
to lead me there.
عالء الدين
Ladies, this is
Mr. „Bile Salts‟
Let‟s go fellows, Bile
to go!!
عالء الدينAll of them went to the small intestines through
But something unexpected happenedbile.
Direct bilirubin (Bile pigment) is secreted into bile with bile salts
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Intestinal bacteria remove glucuronides and reduce bilirubin into stercobilirubin
• Bacteria attacks! Bilirubin lost their wives and
became a widow called “stercobilinogen”
عالء الدين• So Stercobilinogen decided to go back to blood and get
absorbed with the nutrients.
Some of it is reabsorbed and go to the liver
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While some remain and become oxidized to stercobilinogen
• Others were pessimist and decided to die by oxidisation, so they went along the ‘’stool’’ and are called ‘’Stercobilin’’
• They give the stool its dark colour.
عالء الدين• But the part that went to the liver divided into two
groups
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A fraction of the absorbed part become excreted again into bile“Entero-hepatic Ciculation”
Some went again through bile in a circulation called ‘’ Entero-hepatic Circulation’’.
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Some go to the kidney and excreted as urobilinogen which is oxidized into urobilin
A group went to the kidney, excreted with urine as Urobilinogen which oxidses into urobilin.
.This was the ending of bilirubin‟s lifeعالء الدين
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stool
Urine
Blood
Sterco
bilinogen
Summary
Entero-
hepatic
circulation
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Urine
stool
Blood
Sterco
bilinogen
Haemolytic
jaundice
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Urine
stool
Blood
Sterco
bilinogen
Hepatocellular
jaundice
indirect
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Urine
stool
Blood
Obstructive
Jaundice