175 Years of Bilirubin Testing: Ready for Point‐of‐Care?

Guirguis, Natalie; Bertrand, Antoine-Xavier; Rose, Christopher F.; Matoori, Simon

doi:10.1002/adhm.202203380

Cited by 4 publications

(2 citation statements)

References 67 publications

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“…The reported significant reductions in circulating bilirubin concentrations in patients with RDs when compared to healthy controls, particularly the indirect (unconjugated) fraction which possesses anti-inflammatory and antioxidant effects in vitro and in vivo and the total fraction, which includes the unconjugated fraction, suggest a significant dysregulation in redox balance and inflammatory pathways in these patients. Notably, the results of our systematic review and meta-analysis also suggest that such alterations can be easily captured through the measurement of this endogenous end product of heme metabolism, which has been part of routine hematological and liver assessment in clinical practice for over 60 years ( 18 , 51 ). Sensitivity analyses confirmed the stability of the results of the meta-analysis.…”

Section: Discussionmentioning

confidence: 84%

The role of bilirubin as a biomarker of rheumatic diseases: a systematic review and meta-analysis

Zinellu,

Mangoni

2024

Front. Immunol.

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The identification of novel, yet easily measurable biomarkers of inflammation and oxidative stress might assist in the diagnosis and management of patients with rheumatic diseases (RDs). We conducted a systematic review and meta-analysis of studies investigating the circulating concentrations of bilirubin, the end product of heme metabolism and a potent endogenous antioxidant with anti-inflammatory properties, in patients with RDs and healthy controls. The electronic databases PubMed, Scopus, and Web of Science were searched from inception to 31 December 2023 for relevant articles. We evaluated the risk of bias and the certainty of evidence using the Joanna Briggs Checklist and the Grades of Recommendation, Assessment, Development, and Evaluation Working Group system, respectively. In 17 eligible studies, all with low risk of bias, compared to controls, patients with RDs had significantly lower concentrations of total bilirubin (standard mean difference, SMD=-0.68, 95% CI -0.91 to -0.44, p<0.001; I2 = 92.5%, p<0.001; low certainty of evidence), direct (conjugated) bilirubin (SMD=-0.67, 95% CI -0.92 to -0.41, p<0.001; I2 = 81.7%, p<0.001; very low certainty of evidence), and the active antioxidant and anti-inflammatory indirect (unconjugated) form of bilirubin (SMD=-0.71, 95% CI -1.18 to -0.24, p=0.003; I2 = 95.1%, p<0.001; very low certainty of evidence). The results of the meta-analysis were stable in sensitivity analysis. In meta-regression, there were no significant associations between the SMD of total bilirubin and several clinical and demographic characteristics, including age, male to female ratio, number of participants, liver enzymes and erythrocyte sedimentation rate. In subgroup analysis, the SMD of total bilirubin was significant across a range of RDs, including rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren syndrome, and myositis. Therefore, the results of our systematic review and meta-analysis suggests that the reductions in bilirubin concentrations observed in patients with RDs reflect a state of impaired antioxidant and anti-inflammatory defence due to bilirubin consumption and highlight the promising role of this endogenous product as a biomarker of RDs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023500649.

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Section: Discussionmentioning

confidence: 84%

The role of bilirubin as a biomarker of rheumatic diseases: a systematic review and meta-analysis

Zinellu,

Mangoni

2024

Front. Immunol.

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“…NIRF assays have the potential to reach the point of care. − Thanks to the low interference of hemoglobin with NIRF dyes, there is no need for blood separation which is challenging to perform at the point of care . To detect the fluorescence signal at the point of care, small portable fluorometers are required. , The miniaturization of fluorometers entails technical challenges to achieve trade-offs between dimensions and performance (e.g., limit of detection, accuracy, and precision) .…”

Section: Introductionmentioning

confidence: 99%

Development of a Polymersome Blood Ammonia Assay Coupled with a Portable Near-Infrared Fluorometer

Al-Hawat,

Caron,

Djebbar

et al. 2024

ACS Bio Med Chem Au

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Fluorescent pH‐sensing bandage for point‐of‐care wound diagnostics

Al‐Hawat,

Cherifi,

Tricou

et al. 2023

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Diabetic foot ulcers (DFUs) are a serious and prevalent complication of diabetes. Current diagnostic options are limited to macroscopic wound analysis such as wound size, depth, and infection. Molecular diagnostics promise to improve DFU diagnosis, staging, and assessment of treatment response. Here, we developed a rapid and easy‐to‐use fluorescent pH‐sensing bandage for wound diagnostics. In a fluorescent dye screen, we identified pyranine as the lead compound due to its suitable pH‐sensing properties in the clinically relevant pH range of 6–9. To minimize the release of this dye into the wound bed, we screened a library of ionic microparticles and found a strong adhesion of the anionic dye to a cationic polymeric microparticle. These dye‐loaded microparticles showed a strong fluorescence response in the clinically relevant pH range of 6–9 and a dye release below 1% after 1 day in biological media. The dye‐loaded microparticles were subsequently encapsulated in a calcium alginate hydrogel to minimize the interaction of the microparticles with the wound tissue. This pH‐sensing diagnostic wound dressing was tested on full thickness dorsal wounds of mice, and a linear fluorescence response (R2 = 0.9909) to clinically relevant pH values was observed. These findings encourage further development of this pH‐sensing system for molecular diagnostics in DFUs.

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175 Years of Bilirubin Testing: Ready for Point‐of‐Care?

Cited by 4 publications

References 67 publications

The role of bilirubin as a biomarker of rheumatic diseases: a systematic review and meta-analysis

The role of bilirubin as a biomarker of rheumatic diseases: a systematic review and meta-analysis

Development of a Polymersome Blood Ammonia Assay Coupled with a Portable Near-Infrared Fluorometer

Fluorescent pH‐sensing bandage for point‐of‐care wound diagnostics

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