Jirsa M, Sticová E
Centrum experimentální medicíny IKEM Praha.
Vnitr Lek. 2013 Jul;59(7):566-71.
The introductory summarises the classical path of heme degradation and classification of jaundice. Subsequently, a description of neonatal types of jaundice is given, known as Crigler Najjar, Gilberts, DubinJohnson and Rotor syndromes, emphasising the explanation of the molecular mechanisms of these metabolic disorders. Special attention is given to a recently discovered molecular mechanism of the Rotor syndrome. The mechanism is based on the inability of the liver to retrospectively uptake the conjugated bilirubin fraction primarily excreted into the blood, not bile. A reduced ability of the liver to uptake the conjugated bilirubin contributes to the development of hyperbilirubinemia in common disorders of the liver and bile ducts and to the toxicity of xenobiotics and drugs using transport proteins for conjugated bilirubin.
引言部分总结了血红素降解的经典途径和黄疸的分类。随后,介绍了新生儿黄疸的类型,即克里格勒-纳贾尔综合征、吉尔伯特综合征、杜宾-约翰逊综合征和罗特综合征,重点解释了这些代谢紊乱的分子机制。特别关注了最近发现的罗特综合征的分子机制。该机制基于肝脏无法将主要排泄到血液而非胆汁中的结合胆红素部分进行逆向摄取。肝脏摄取结合胆红素的能力降低,会导致肝和胆管常见疾病中高胆红素血症的发生,以及使用结合胆红素转运蛋白的外源性物质和药物的毒性。