Hepatic handling of photoirradiated bilirubin. A study in isolated perfused Wistar rat liver.

Conjugation has been considered the rate-limiting step for bilirubin hepatic transport, and bypass of this metabolic step could explain why photobilirubins can be rapidly cleared by the liver. In this paper we assessed whether photoirradiation may enhance the bilirubin overall hepatic transport in the isolated perfused Wistar rat liver, a model possessing intact transport and conjugating systems. Bilirubin was administered as a bolus so as to reach a perfusate concentration of approximately 10 microM (bilirubin/albumin molar ratio 1:17). Perfusate light exposure (0.56.10(15) quanta s-1 cm-2) yielded 7-10% of configurational photoisomers, which were further identified as (4Z,15E/4E,15Z)-bilirubin IX alpha. Under such conditions, the perfusate removal rate was increased by 39% over that from dark conditions. Likewise, biliary excretion, estimated as total bilirubin recovery at 60 min, was also increased (+48%). This later improvement was mainly produced at the expense of unconjugated bilirubin, which most likely derived from its configurational photoisomers that, once excreted into bile, readily re-isomerized to the parent compound. In addition, this increment was partially due to a delayed improvement of monoglucuronide pigment excretion. The calculated hepatic pigment content was significantly higher under light conditions. A direct assessment of hepatic content of different bilirubin moieties at 20 min after bilirubin administration confirmed that such an increment was fully accounted for by unconjugated pigment. Our finding that hepatic pigment content rose (despite a higher biliary excretion) when the bilirubin was irradiated suggests a higher net uptake of photoisomers than native pigment. This observation, and the finding that bilirubin photoisomers were usually excreted without undergoing conjugation even if the metabolic system is active, contribute to explain the greater appearance of unconjugated bilirubin in Wistar rat bile under light exposure.