Characteristics of the heme catabolic pathway in mild unconjugated hyperbilirubinemia and their associations with inflammation and disease prevention

Sci Rep. 2017 Apr 7;7(1):755. doi: 10.1038/s41598-017-00933-y.

Abstract

Heme catabolism exerts physiological functions that impact health through depressing inflammation. Upon reactive pathway progression, as in Gilbert's Syndrome (GS; UGT1A1*28 polymorphism), aggravated health effects have been determined. Based on lower inflammation and improved metabolic health reported for GS, inter-group differences in heme catabolism were explored. Therefore, a case-control study including 120 fasted, healthy, age- and gender matched subjects with/without GS, was conducted. Genetic expressions of HMOX-1 and BLVRA were measured. Additionally participants were genotyped for those polymorphisms that are known (UGT1A1*28) or likely (HMOX-1 microsatellites) to impact bilirubinemia. Intracellular interleukins (IL-6, IL-1β, TNFα), circulatory C-reactive protein (CRP), serum amyloid A (SAA) and haptoglobin (Hpt) were analysed as inflammatory markers. To assess intracellular heme oxygenase 1 (HO-1) isolated PBMCs were used. In GS vs. C, inflammation markers were significantly decreased. This was supported by an altered heme catabolism, indirectly reflecting in elevated unconjugated bilirubin (UCB; main phenotypic feature of GS) and iron, decreased hemopexin (Hpx) and Hpt and in up-regulated biliverdin reductase (BLVRA) gene expressions. Moreover, HMOX (GT)n short alleles were non-significantly more prominent in female GS individuals. Herewith, we propose a concept to elucidate why GS individuals encounter lower inflammation, and are thus less prone to oxidative-stress mediated diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alleles
  • Bilirubin / blood*
  • Biomarkers
  • Cytokines / blood
  • Female
  • Gene Expression
  • Genotype
  • Heme / metabolism*
  • Heme Oxygenase-1 / genetics
  • Humans
  • Hyperbilirubinemia / complications*
  • Hyperbilirubinemia / diagnosis
  • Hyperbilirubinemia / metabolism*
  • Hyperbilirubinemia / prevention & control
  • Inflammation / etiology*
  • Inflammation Mediators / metabolism
  • Male
  • Metabolic Networks and Pathways*
  • Microsatellite Repeats
  • Middle Aged
  • Severity of Illness Index
  • Sex Factors
  • Young Adult

Substances

  • Biomarkers
  • Cytokines
  • Inflammation Mediators
  • Heme
  • HMOX1 protein, human
  • Heme Oxygenase-1
  • Bilirubin