Ostrow J D
J Clin Invest. 1971 Mar;50(3):707-18. doi: 10.1172/JCI106541.
To elucidate the mechanism by which phototherapy reduces serum bilirubin, studies were performed on the catabolism of labeled bilirubin in homozygous jaundiced Gunn rats before, during, and after a period of exposure to 1700 foot candles of daylight fluorescent light. Following equilibration with the body pool of an intravenously administered tracer dose of (3)H- or (14)C-bilirubin, radioactive and diazo reactive compounds were excreted in the bile at a slow, steady rate and plasma specific activity declined semilogarithmically. Subsequent exposure to light caused a marked increase in the biliary excretion of radioactive and diazoreactive compounds. Fecal and urinary radioactivity increased also but remained minor fractions of the total excreted radioactivity. After extinguishing the lights, these variables reverted gradually to control values. Spectral and chromotographic analysis of the excreted pigments and their azopigments demonstrated that the increased biliary radioactivity during phototherapy consisted of two roughly equal fractions: (a) unconjugated bilirubin, excreted at rates comparable to the output of conjugated bilirubin in the bile of normal nonjaundiced rats; and (b) water-soluble bilirubin derivatives, chromatographically identical with those found in Gunn rat bile under control lighting conditions but different from the products of photodecomposition of bilirubin in vitro. In some animals, phototherapy produced little decline in plasma bilirubin despite comparable acceleration of bilirubin catabolism. This was attributed tentatively to increased synthesis of early labeled bilirubin in these animals.
为阐明光疗降低血清胆红素的机制,我们对纯合黄疸Gunn大鼠在暴露于1700英尺烛光的日光荧光灯下之前、期间和之后的标记胆红素分解代谢进行了研究。在静脉注射示踪剂量的(3)H - 或(14)C - 胆红素与体内池平衡后,放射性和重氮反应性化合物以缓慢、稳定的速率排泄到胆汁中,血浆比活性呈半对数下降。随后暴露于光导致放射性和重氮反应性化合物的胆汁排泄显著增加。粪便和尿液中的放射性也增加,但仍占总排泄放射性的一小部分。熄灯后,这些变量逐渐恢复到对照值。对排泄色素及其偶氮色素的光谱和色谱分析表明,光疗期间胆汁放射性增加由两个大致相等的部分组成:(a)未结合胆红素,排泄速率与正常非黄疸大鼠胆汁中结合胆红素的输出速率相当;(b)水溶性胆红素衍生物,在色谱上与对照光照条件下Gunn大鼠胆汁中发现的衍生物相同,但与胆红素体外光分解产物不同。在一些动物中,尽管胆红素分解代谢加速程度相当,但光疗导致血浆胆红素下降很少。这初步归因于这些动物中早期标记胆红素合成增加。