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Bilirubin-induced neural impairment: a special focus on myelination, age-related windows of susceptibility and associated co-morbidities.
Semin Fetal Neonatal Med. 2015 Feb; 20(1):14-19.SF

Abstract

Bilirubin-induced neurologic dysfunction (BIND) and classical kernicterus are clinical manifestations of moderate to severe hyperbilirubinemia whenever bilirubin levels exceed the capacity of the brain defensive mechanisms in preventing its entrance and cytotoxicity. In such circumstances and depending on the associated co-morbidities, bilirubin accumulation may lead to short- or long-term neurodevelopmental disabilities, which may include deficits in auditory, cognitive, and motor processing. Neuronal cell death, astrocytic reactivity, and microglia activation are part of the bilirubin-induced pathogenesis. Less understood is how abnormal growth and maturation of oligodendrocytes may impact on brain development, affecting the formation of myelin tracts. Based on in-vitro and in-vivo models, as well as in clinical cases presented here, we propose the existence of impaired myelination by bilirubin with long-term sequelae, mainly in pre-term infants. Sensitive time-windows are highlighted and centered on the different developmental-dependent impairments determined by bilirubin, and the influence of sepsis and hypoxia is reviewed.

Authors+Show Affiliations

Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal; Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal. Electronic address: dbrites@ff.ulisboa.pt.Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal; Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25534357

Citation

Brites, Dora, and Adelaide Fernandes. "Bilirubin-induced Neural Impairment: a Special Focus On Myelination, Age-related Windows of Susceptibility and Associated Co-morbidities." Seminars in Fetal & Neonatal Medicine, vol. 20, no. 1, 2015, pp. 14-19.
Brites D, Fernandes A. Bilirubin-induced neural impairment: a special focus on myelination, age-related windows of susceptibility and associated co-morbidities. Semin Fetal Neonatal Med. 2015;20(1):14-19.
Brites, D., & Fernandes, A. (2015). Bilirubin-induced neural impairment: a special focus on myelination, age-related windows of susceptibility and associated co-morbidities. Seminars in Fetal & Neonatal Medicine, 20(1), 14-19. https://doi.org/10.1016/j.siny.2014.12.002
Brites D, Fernandes A. Bilirubin-induced Neural Impairment: a Special Focus On Myelination, Age-related Windows of Susceptibility and Associated Co-morbidities. Semin Fetal Neonatal Med. 2015;20(1):14-19. PubMed PMID: 25534357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilirubin-induced neural impairment: a special focus on myelination, age-related windows of susceptibility and associated co-morbidities. AU - Brites,Dora, AU - Fernandes,Adelaide, Y1 - 2014/12/19/ PY - 2014/12/24/entrez PY - 2014/12/24/pubmed PY - 2016/1/1/medline KW - Bilirubin-induced neurological dysfunction KW - Hypoxia KW - Kernicterus KW - Sensitive time-window KW - Sepsis KW - White matter damage SP - 14 EP - 19 JF - Seminars in fetal & neonatal medicine JO - Semin Fetal Neonatal Med VL - 20 IS - 1 N2 - Bilirubin-induced neurologic dysfunction (BIND) and classical kernicterus are clinical manifestations of moderate to severe hyperbilirubinemia whenever bilirubin levels exceed the capacity of the brain defensive mechanisms in preventing its entrance and cytotoxicity. In such circumstances and depending on the associated co-morbidities, bilirubin accumulation may lead to short- or long-term neurodevelopmental disabilities, which may include deficits in auditory, cognitive, and motor processing. Neuronal cell death, astrocytic reactivity, and microglia activation are part of the bilirubin-induced pathogenesis. Less understood is how abnormal growth and maturation of oligodendrocytes may impact on brain development, affecting the formation of myelin tracts. Based on in-vitro and in-vivo models, as well as in clinical cases presented here, we propose the existence of impaired myelination by bilirubin with long-term sequelae, mainly in pre-term infants. Sensitive time-windows are highlighted and centered on the different developmental-dependent impairments determined by bilirubin, and the influence of sepsis and hypoxia is reviewed. SN - 1878-0946 UR - https://wwww.unboundmedicine.com/medline/citation/25534357/Bilirubin_induced_neural_impairment:_a_special_focus_on_myelination_age_related_windows_of_susceptibility_and_associated_co_morbidities_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1744-165X(14)00097-3 DB - PRIME DP - Unbound Medicine ER -