Billirubin Metabolism
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Transcript of Billirubin Metabolism
![Page 1: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/1.jpg)
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Bilirubin metabolism
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عالء الدين
Warning: Audience discretion is advised,
what you are about to see is a true story
about the miserable life of bilirubin.
Translated into English from an Arabic version from a King Saud University parody
Lecture.
![Page 4: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/4.jpg)
عالء الدين
• Inside the vessels of a human
• In the bottom of heart
• There was a loving family called „‟
Hemoglobin‟‟ living.
• In a simple house called „ RBC „.
![Page 5: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/5.jpg)
عالء الدين
• Consist of a father called „‟ ProtoPorphiren” who has a brownish colour.
• Madame „‟ Globin‟‟ who is from a protein origin
• Four sons are called „‟ Iron „‟.
![Page 6: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/6.jpg)
In 120 daysعالء الدين
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عالء الدين
hemolysis
• The villian called „‟ReteculoEndothelial System’’ sweeps off the house because it was over 120 days of age.
![Page 8: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/8.jpg)
عالء الدين
And the life of the happy family
changes
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)= And becomes sadعالء الدين
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عالء الدين
Haemoglobin is cleaved into haem & Globin which is hydrolysed into free AA
• Globin asks for divorce to get back to her family
house „‟ Amino acid pool‟‟.
طلقنى طلقنى
..طلقنى
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عالء الدين
And every iron gets into his automobile
„‟Transferrin‟‟ and travels far away.
Bye Daddy!!…
Iron is carried on transferrin to be reused
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)= Dad becomes lonely and sadعالء الدين
![Page 13: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/13.jpg)
عالء الدينHis colour changes to green and people called him
„‟ Biliverden‟‟
Protoporpherin is then reduced into Biliverden
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عالء الدينThen his name changes to the infamous yellow
colour called „‟Bilirubin‟‟
Then into Bilirubin
![Page 15: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/15.jpg)
عالء الدينHis friends convince him to tie the knot again.
They propose Mademoiselle „‟ Albumin‟‟ to him.
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عالء الدين
Indirect bilirubin is water insoluble
• But Mademoiselle „‟ Albumin „‟ wanted to know
him better before getting married.
I heard that you are
‘’ indirect’’, I
wanna know ya
more before we
marry!.
![Page 17: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/17.jpg)
عالء الدين
so it is carried on albumin and called haemobilirubin or indirect bilirbin
•So some people believe they got married
Darling, people think we are married;
tell them we are just „‟ engaged‟‟.
![Page 18: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/18.jpg)
عالء الدين
Or unconjugated bilirubin
They get called „‟haemobilirubin”
•“indirect bilirubin”
•“unconjugated bilirubin ”
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عالء الدين
Indirect bilirubin cannot be filtrated from the kidney even in it‟s exess so not present in urine in
haemolytic jaundice “acholuric”
• But Indirect billuribin cannot enter the kidney even if it was in an ample quantities because it is toolarge.
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عالء الدين
و
Whaddaya
think of dat
house dear?
Oh dear, I would never live in
such a house, it‟s a factory
not a house. So big!!
So Bilirubin decides to live in the liver, but Mrs.
Albumin refuses.
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عالء الدين• They split up
The sad bilirubin enters the „liver‟
Farewell darling
=(
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•عالء الدين In the liver; Bilirubin meets with two hawt blue
ladies.
What are your
names my blue
angels?
Glucuronic
acid
Marry me?
Indirect bilirubin is conjugated in the liver with 2 glucuronic acid molecules
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عالء الدين
Glucuronyl transferase
• The enzyme „‟Glucuronyl transferase „‟ wed them*.
• His name changes to Direct or Conjugated or Cholibilirubin
Now it is termed Direct or Conjugated or Cholibilirubin
Enzyme
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عالء الدين
Conjuged bilirubin can be filtrated in urine if it is increased as in obstructive & hepatocellular jaundice
The cool thing about you
girls; you are so cute and
small we can enter the „‟
kidney‟‟ easily.
We better go to the
„‟ Small intestine‟‟
whaddaya think?
I don‟t know the
directions, I should
ask one of my buds
to lead me there.
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عالء الدين
Ladies, this is
Mr. „Bile Salts‟
Let‟s go fellows, Bile
to go!!
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عالء الدينAll of them went to the small intestines through
But something unexpected happenedbile.
Direct bilirubin (Bile pigment) is secreted into bile with bile salts
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عالء الدين
Intestinal bacteria remove glucuronides and reduce bilirubin into stercobilirubin
• Bacteria attacks! Bilirubin lost their wives and
became a widow called “stercobilinogen”
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عالء الدين• So Stercobilinogen decided to go back to blood and get
absorbed with the nutrients.
Some of it is reabsorbed and go to the liver
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عالء الدين
While some remain and become oxidized to stercobilinogen
• Others were pessimist and decided to die by oxidisation, so they went along the ‘’stool’’ and are called ‘’Stercobilin’’
• They give the stool its dark colour.
![Page 30: Billirubin Metabolism](https://reader034.fdocuments.in/reader034/viewer/2022042514/558c117cd8b42adf758b45f0/html5/thumbnails/30.jpg)
عالء الدين• But the part that went to the liver divided into two
groups
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عالء الدين
A fraction of the absorbed part become excreted again into bile“Entero-hepatic Ciculation”
Some went again through bile in a circulation called ‘’ Entero-hepatic Circulation’’.
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عالء الدين
Some go to the kidney and excreted as urobilinogen which is oxidized into urobilin
A group went to the kidney, excreted with urine as Urobilinogen which oxidses into urobilin.
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.This was the ending of bilirubin‟s lifeعالء الدين
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عالء الدين
stool
Urine
Blood
Sterco
bilinogen
Summary
Entero-
hepatic
circulation
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عالء الدين
Urine
stool
Blood
Sterco
bilinogen
Haemolytic
jaundice
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عالء الدين
Urine
stool
Blood
Sterco
bilinogen
Hepatocellular
jaundice
indirect
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عالء الدين
Urine
stool
Blood
Obstructive
Jaundice