Bilirubin oxidation products, oxidative stress, and intracerebral hemorrhage

J. F. Clark, M. Loftspring, W. L. Wurster, S. Beiler, C. Beiler, K. R. Wagner, G. J. Pyne-Geithman

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

37 Scopus citations


Hematoma and perihematomal regions after intracerebral hemorrhage (ICH) are biochemically active environments known to undergo potent oxidizing reactions. We report facile production of bilirubin oxidation products (BOXes) via hemoglobin=Fenton reaction under conditions approximating putative in vivo conditions seen following ICH. Using a mixture of human hemoglobin, physiological buffers, uncon-jugated solubilized bilirubin, and molecular oxygen and=or hydrogen peroxide, we generated BOXes, confirmed by spectral signature consistent with known BOXes mixtures produced by independent chemical synthesis, as well as HPLC-MS of BOX A and BOX B. Kinetics are straightforward and uncomplicated, having initial rates around 0.002 μM bilirubin per mM hemoglobin per second under normal experimental conditions. In hematomas from porcine ICH model, we observed significant production of BOXes, malondialdehyde, and superoxide dismutase, indicating a potent oxidizing environment. BOX concentrations increased from 0.084 ± 0.01 in fresh blood to 22.24 ± 4.28 in hematoma at 72h, and were 11.22 ±1.90 in adjacent white matter (nmol/g). Similar chemical and analytical results are seen in ICH in vivo, indicating the hematoma is undergoing similar potent oxidations. This is the first report of BOXes production using a well-defined biological reaction and in vivo model of same. Following ICH, amounts of unconjugated bilirubin in hematoma can be substantial, as can levels of iron and hemoglobin. Oxidation of unconjugated bilirubin to yield bioactive molecules, such as BOXes, is an important discovery, expanding the role of bilirubin in pathological processes seen after ICH.

Original languageEnglish
Title of host publicationCerebral Hemorrhage
PublisherSpringer-Verlag Wien
Number of pages6
ISBN (Print)9783211094686
StatePublished - 2008

Publication series

NameActa Neurochirurgica, Supplementum
ISSN (Print)0065-1419


  • Bilirubin oxidation products
  • edema
  • pathology
  • reactive oxygen species
  • stroke


Dive into the research topics of 'Bilirubin oxidation products, oxidative stress, and intracerebral hemorrhage'. Together they form a unique fingerprint.

Cite this