Affiliations: Department of Laboratory Medicine, Division of
Clinical Chemistry, Örebro University Hospital, S – 701 85 Örebro,
Sweden. Tel.: +46 19 602 78 17; Fax: +46 19 602 37 85; E-mail:
[email protected]
Abstract: Pediatricians are generally wary of hyperbilirubinemia because
elevated circulating bilirubin is seen both as a sign of disease and a cause of
pathology. Normal aerobic metabolism is associated with the chance occurrence
of reactive oxygen species (ROS) that can damage cellular macromolecules.
Bilirubin as a molecule at the crossroads of the natural protection of the body
against ROS has been the subject of experiments in vitro and in animals,
as well as observational and epidemiological studies during the past two
decades. This review assesses the evidence as to whether bilirubin is a free
radical quencher of clinical significance in the newborn and children, and thus
may have a beneficial role. The overall conclusion is that pediatricians should
remain cautious about bilirubin and follow current guidelines.