Bilirubin as a Protective Factor for Rheumatoid Arthritis: An NHANES Study of 2003 - 2006 Data

Fischman, Daniel; Valluri, Ashok; Gorrepati, Venkata Subhash; Murphy, Megan E.; Peters, Ian; Cheriyath, Pramil

doi:10.4021/jocmr444w

Cited by 36 publications

(43 citation statements)

References 15 publications

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“…42 Therefore, the idea of a physiologic role for bilirubin in cytoprotection against short-lasting and long-lasting oxidant-mediated cell injury, such as chronic inflammatory rheumatoid arthritis, has been proposed. 43 Elevated TB levels also have been shown to be protective against stroke, atherosclerosis, and vasculitis. Earlier studies have reported negative association with coronary artery disease and possibly favorable coronary collateral growth in patients with coronary total occlusion.…”

Section: Integrity Of Brainstem Function and Structurementioning

confidence: 98%

Hyperbilirubinemia in Preterm Neonates

Bhutani

Wong

Stevenson

2016

Clinics in Perinatology

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Section: Integrity Of Brainstem Function and Structurementioning

confidence: 98%

Hyperbilirubinemia in Preterm Neonates

Bhutani

Wong

Stevenson

2016

Clinics in Perinatology

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“…Numerous reports have found that moderate alcohol intake is associated with selected favorable health outcomes (Di Giuseppe et al, 2012; Doll et al, 2005; Freiberg et al, 2004; Mukamal et al, 2003; Rehm et al, 2003; Ronksley et al, 2011), although the mechanism for these benefits is still not understood (Carnevale and Nocella, 2012). At the same time, another line of research has indicated that higher concentrations (but still well within accepted reference ranges) of serum bilirubin, a powerful antioxidant (Rizzo et al, 2010; Stocker et al, 1987), correlate with better health outcomes or conversely lower bilirubin concentrations with higher morbidities (Cheriyath et al, 2010; Curtin and Fairchild, 2003; Fischman et al, 2010; Horsfall et al, 2011; Novotny and Vitek, 2003; Perlstein et al, 2008; Rigato et al, 2005; Vitek and Schwertner, 2008; Wu et al, 2011). Of note, any drinking has been reported to be associated with higher, but still within the reference range, concentrations of serum bilirubin as compared to abstainers (Tanaka et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Acute alcohol consumption elevates serum bilirubin: An endogenous antioxidant

O’Malley

Gueorguieva²,

et al. 2015

Drug and Alcohol Dependence

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Background Moderate alcohol consumption has been associated with both negative and favorable effects on health. The mechanisms responsible for reported favorable effects remain unclear. Higher (not necessarily elevated) concentrations of serum bilirubin, an antioxidant, have also been associated with reduced risk of cardiovascular disease and all-cause mortality. This study tests the hypothesis that single dose alcohol consumption elevates bilirubin providing a potential link between these observations. Methods 18 healthy individuals (8 cigarette smokers) were administered alcohol, calibrated to achieve blood concentrations of 20, 80 and 120 mg/dL, in random order in 3 laboratory sessions separated by a week. Each session was preceded by and followed by 5–7 days of alcohol abstinence. Serum bilirubin was measured at 7:45 am prior to drinking, at 2 pm, and at 7:45 the next morning. Mixed effects regression models compared baseline and 24 hr. post-drinking bilirubin concentrations. Results Total serum bilirubin (sum of indirect and direct) concentration increased significantly after drinking from baseline to 24 hours in non-smokers (from Mean=0.38, SD=0.24 to Mean=0.51 SD=0.30, F(1, 32.2) =24.24, p<.0001) but not in smokers (from Mean=0.25, SD=0.12 to Mean=0.26, SD=0.15, F(1, 31.1) =0.04, p=0.84). In nonsmokers the indirect bilirubin concentration and the ratio of indirect (unconjugated) to direct (conjugated) bilirubin also increased significantly. Conclusions Alcohol consumption leads to increases in serum bilirubin in nonsmokers. Considering the antioxidant properties of bilirubin, our findings suggest one possible mechanism for the reported association between alcohol consumption and reduced risk of some disorders that could be tested in future longitudinal studies.

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“…trasversal striae, pitting, and subungueal hyperkeratosis) 7 very frequently associated with psoriatic arthopathy were not found in the patient here reported. Worth of note, low levels of bilirrubin were related to the severity of rheumatoid arthritis 8 . This inverse relation is based on the antioxidant and anti-inflammatory properties of bilirubin (binding to serum albumin, clearing peroxyl radicals, decreasing oxidative stresses), and reduction of the levels of IL-2 and promotion of cytoprotection by biliverdin 8 .…”

Section: Discussionmentioning

confidence: 99%

“…Worth of note, low levels of bilirrubin were related to the severity of rheumatoid arthritis 8 . This inverse relation is based on the antioxidant and anti-inflammatory properties of bilirubin (binding to serum albumin, clearing peroxyl radicals, decreasing oxidative stresses), and reduction of the levels of IL-2 and promotion of cytoprotection by biliverdin 8 . Hypothetically, similar phenomena might have a role in this severe tophaceous osteoarthopathy.…”

Section: Discussionmentioning

confidence: 99%

A 53-year-old Man With Disabling Arthropathy And Acute Renal Failure

Santos¹,

Vieira²,

Jénior³

et al. 2012

MMJ

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A 53-year-old Brazilian man came to our hospital because of intense oliguria beginning three days before admission. He was a chronic alcohol abuser, with previous diagnosis of type 2 diabetes, dyslipidemia, arterial hypertension, and deforming arthropathy. For one week, he had taken high dosages of indomethacin for bilateral arthralgia on the ankles, wrists, and metacarpophalangeal, metatarsophalangeal and interphalangeal joints. On admission, his BMI was 22.8 Kg/m 2 , and he presented with signs of bilateral acute arthritis in association with numerous asymmetric hard nodules on the periarticular soft tissues. Except for scars on the elbows and right knee, no change was found by examination of cutaneous or mucous surfaces, and nails. There were conspicuous deforming osteoarticular and subcutaneous changes (Figure). Laboratory data: urea 97.6 mg/dL, creatinine 2.4 mg/dL, uric acid 12.2 mg/dL, ionized calcium 1.06 mmol/L, sodium 135 mEq/L, potassium 3.5 mEq/L, magnesium 1.4 mg/dL, glucose 136 mg/dL, ALT 184.8 U/L, AST 291 U/L, albumin 3.66 g/dL, globulins 3.1 g/dL, total bilirubin 0.34 mg/dL, prothrombin activity 89%, INR 1.07; red cells 3.17x10 12 /L, hemoglobin 8.6 g/dL, hematocrit 26.5%, MCV 84 fL, white cells 4.2x10 9 /L, platelets 490 x 10 9 /L. Laboratory data after hydration and nutritional support: urea 42.5 mg/dL, creatinine 0.9 mg/dL, uric acid 8.1 mg/dL, ALT 85.2 U/L, AST 40.1 U/L; red cells 3.37x10 12 /L, hemoglobin 9.3 g/dl, hematocrit 29%, MCV 86 fL, white cells 5.8x10 3 /L, platelets 717 x10 9 /L; cholesterol 159 mg/dL, LDL 93 mg/dL, HDL 18 mg/dL. The images of the echographic study of the kidneys were unremarkable. With clinical improvement, the patient was referred to the Rheumatology outpatient surveillance.

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Bilirubin as a Protective Factor for Rheumatoid Arthritis: An NHANES Study of 2003 - 2006 Data

Cited by 36 publications

References 15 publications

Hyperbilirubinemia in Preterm Neonates

Hyperbilirubinemia in Preterm Neonates

Acute alcohol consumption elevates serum bilirubin: An endogenous antioxidant

A 53-year-old Man With Disabling Arthropathy And Acute Renal Failure

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