Vítek Libor, Muchová Lucie, Zelenka Jaroslav, Zadinová Marie, Malina Jirí
Institute of Clinical Biochemistry and Laboratory Diagnostics and 4th Department of Internal Medicine, 1st Medical Faculty, Charles University of Prague, U Nemocnice 2, Praha 2, 128 08, Czech Republic.
J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):135-40. doi: 10.1097/00005176-200502000-00010.
Intestinal metabolism of bilirubin is implicated in the pathogenesis of neonatal jaundice and Crigler-Najjar syndrome. In the present study the authors investigated the effect of oral administration of zinc salts on serum bilirubin levels in hyperbilirubinemic rats.
Bilirubin-binding activities of zinc sulfate and water-insoluble zinc methacrylate were determined in vitro. Congenitally hyperbilirubinemic Gunn rats and artificially hyperbilirubinemic Wistar rats were used in in vivo studies. Animals were fed a normal diet for 1 week and then a treatment diet of either zinc sulfate or zinc methacrylate for additional 2 weeks. Serum and fecal bile pigments were determined at the end of each phase. Biliary bilirubin secretion rates were determined in hyperbilirubinemic Wistar rats fed zinc methacrylate.
Substantial bilirubin-binding activities of zinc salts were demonstrated in in vitro experiments. Treatment with oral zinc salts significantly decreased serum bilirubin levels in Gunn rats (166 +/- 53 versus 123 +/- 38 and 206 +/- 34 versus 131 +/- 31 micromol/L, P < 0.05 for zinc methacrylate and zinc sulfate, respectively). A similar effect of zinc methacrylate was also observed in hyperbilirubinemic Wistar rats (102 +/- 10 versus 14 +/- 4 micromol/L, P < 0.0001). In accord, biliary bilirubin secretion decreased significantly in these animals (45 +/- 11 versus 28 +/- 4 nmol/h 100g body weight, P < 0.02). In contrast to zinc sulfate, treatment with zinc methacrylate did not lead to the elevation of serum zinc levels.
Oral administration of zinc salts efficiently decreased serum bilirubin levels in hyperbilirubinemic rats, presumably as a result of inhibition of enterohepatic circulation of bilirubin. This approach might be useful in the treatment of severe unconjugated hyperbilirubinemias.
胆红素的肠道代谢与新生儿黄疸和克里格勒 - 纳贾尔综合征的发病机制有关。在本研究中,作者调查了口服锌盐对高胆红素血症大鼠血清胆红素水平的影响。
在体外测定硫酸锌和水不溶性甲基丙烯酸锌的胆红素结合活性。先天性高胆红素血症的冈恩大鼠和人工诱导高胆红素血症的Wistar大鼠用于体内研究。动物先喂正常饮食1周,然后再喂硫酸锌或甲基丙烯酸锌治疗饮食2周。在每个阶段结束时测定血清和粪便胆汁色素。在喂甲基丙烯酸锌的高胆红素血症Wistar大鼠中测定胆汁胆红素分泌率。
体外实验证明锌盐具有显著的胆红素结合活性。口服锌盐治疗可显著降低冈恩大鼠的血清胆红素水平(甲基丙烯酸锌组:166±53对123±38,硫酸锌组:206±34对131±31 μmol/L,甲基丙烯酸锌和硫酸锌组P均<0.05)。在高胆红素血症的Wistar大鼠中也观察到甲基丙烯酸锌有类似作用(102±10对14±4 μmol/L,P<0.0001)。与此一致,这些动物的胆汁胆红素分泌显著减少(45±11对28±4 nmol/h 100g体重,P<0.02)。与硫酸锌不同,甲基丙烯酸锌治疗不会导致血清锌水平升高。
口服锌盐可有效降低高胆红素血症大鼠的血清胆红素水平,推测是由于抑制了胆红素的肠肝循环。这种方法可能对治疗严重的非结合性高胆红素血症有用。