É uma doença que afeta a forma como a bilirrubina é processada no corpo, e que é causada por uma alteração genética que a pessoa herdou.
Introdução
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É uma doença que afeta a forma como a bilirrubina é processada no corpo, e que é causada por uma alteração genética que a pessoa herdou.
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 82 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 191 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
19 genes identificados com associação a esta condição.
Deubiquitinase that mediates 'Lys-63'-linked deubiquitination of tight junction proteins, such as MARVELD2 and LSR, and which is involved in the survival of auditory hair cells and hearing (PubMed:32124521, PubMed:39587316). Specifically cleaves 'Lys-63'-linked polyubiquitin chains composed of at least 3 ubiquitin molecules, while it is not able to deubiquitinate substrates with shorter ubiquitin chains: recognizes ubiquitin chain in position S2 and catalyzes en bloc cleavage of polyubiquitin ch
Cell junction, tight junction
Cholestasis, progressive familial intrahepatic, 7, with or without hearing loss
An autosomal recessive form of progressive cholestasis, a disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease. Some PFIC7 patients develop hearing loss in childhood.
Ribosome biogenesis factor. Involved in nucleolar processing of pre-18S ribosomal RNA. Part of the small subunit (SSU) processome, first precursor of the small eukaryotic ribosomal subunit. During the assembly of the SSU processome in the nucleolus, many ribosome biogenesis factors, an RNA chaperone and ribosomal proteins associate with the nascent pre-rRNA and work in concert to generate RNA folding, modifications, rearrangements and cleavage as well as targeted d Involved in SSU pre-rRNA proce
Nucleus, nucleolusChromosome
Involved in the negative regulation of fatty acid biosynthesis, probably acting as an adapter that allows ubiquitination of acetyl-CoA carboxylase 1 (ACACA) by E3 ubiquitin-protein ligase COP1, and promotes ACACA degradation (PubMed:39920308). The adapter function requires the C-terminal proline-rich domain and may be apart from the kinesin motor activity (Probable)
Cytoplasm, cytoskeletonCell projection, cilium
Cholestasis, progressive familial intrahepatic, 8
An autosomal recessive form of progressive cholestasis, a disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease. PFIC8 onset is in early infancy.
Key regulator of abscission step in cytokinesis: part of the cytokinesis checkpoint, a process required to delay abscission to prevent both premature resolution of intercellular chromosome bridges and accumulation of DNA damage. Together with CHMP4C, required to retain abscission-competent VPS4 (VPS4A and/or VPS4B) at the midbody ring until abscission checkpoint signaling is terminated at late cytokinesis. Deactivation of AURKB results in dephosphorylation of CHMP4C followed by its dissociation
Cytoplasm, cytoskeleton, microtubule organizing center, centrosomeCleavage furrowMidbody, Midbody ring
Mediates the Na(+)-independent uptake of organic anions (PubMed:10358072, PubMed:15159445, PubMed:17412826). Shows broad substrate specificity, can transport both organic anions such as bile acid taurocholate (cholyltaurine) and conjugated steroids (dehydroepiandrosterone 3-sulfate, 17-beta-glucuronosyl estradiol, and estrone 3-sulfate), as well as eicosanoids (prostaglandin E2, thromboxane B2, leukotriene C4, and leukotriene E4), and thyroid hormones (T4/L-thyroxine, and T3/3,3',5'-triiodo-L-th
Basolateral cell membraneBasal cell membrane
Hyperbilirubinemia, Rotor type
An autosomal recessive form of primary conjugated hyperbilirubinemia. Affected individuals develop mild jaundice not associated with hemolysis shortly after birth or in childhood. They have delayed plasma clearance of the unconjugated anionic dye bromsulphthalein and prominent urinary excretion of coproporphyrin I. Hepatic pigmentation is normal.
May play a role in vesicle-mediated protein trafficking to lysosomal compartments and in membrane docking/fusion reactions of late endosomes/lysosomes. Required for proper trafficking and targeting of the collagen-modifying enzyme lysyl hydroxylase 3 (LH3) to intracellular collagen (PubMed:28017832). Mediates phagolysosomal fusion in macrophages (PubMed:18474358). Proposed to be involved in endosomal maturation implicating VIPAS39. In epithelial cells, the VPS33B:VIPAS39 complex may play a role
Late endosome membraneLysosome membraneEarly endosomeCytoplasmic vesicle, clathrin-coated vesicleRecycling endosome
Arthrogryposis, renal dysfunction, and cholestasis 1
An autosomal recessive multisystem disorder with characteristics of congenital joint contractures, renal tubular dysfunction, neonatal cholestasis with bile duct hypoplasia and low gamma glutamyl transpeptidase activity, severe failure to thrive, ichthyosis, and a defect in platelet alpha-granule biogenesis. Most patients do not survive past the first year of life.
Energy-dependent phospholipid efflux translocator that acts as a positive regulator of biliary lipid secretion. Functions as a floppase that translocates specifically phosphatidylcholine (PC) from the inner to the outer leaflet of the canalicular membrane bilayer into the canaliculi of hepatocytes. Translocation of PC makes the biliary phospholipids available for extraction into the canaliculi lumen by bile salt mixed micelles and therefore protects the biliary tree from the detergent activity o
Cell membraneApical cell membraneMembrane raftCytoplasmCytoplasmic vesicle, clathrin-coated vesicle
Cholestasis, progressive familial intrahepatic, 3
A disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease before adulthood. PFIC3 inheritance is autosomal recessive.
Proposed to be involved in endosomal maturation implicating in part VPS33B. In epithelial cells, the VPS33B:VIPAS39 complex may play a role in the apical RAB11A-dependent recycling pathway and in the maintenance of the apical-basolateral polarity (PubMed:20190753). May play a role in lysosomal trafficking, probably via association with the core HOPS complex in a discrete population of endosomes; the functions seems to be independent of VPS33B (PubMed:19109425). May play a role in vesicular traff
CytoplasmCytoplasmic vesicleEarly endosomeRecycling endosomeLate endosome
Arthrogryposis, renal dysfunction and cholestasis syndrome 2
A multisystem disorder, characterized by neurogenic arthrogryposis multiplex congenita, renal tubular dysfunction and neonatal cholestasis with bile duct hypoplasia and low gamma glutamyl transpeptidase activity. Platelet dysfunction is common.
Catalyzes the transport of the major hydrophobic bile salts, such as taurine and glycine-conjugated cholic acid across the canalicular membrane of hepatocytes in an ATP-dependent manner, therefore participates in hepatic bile acid homeostasis and consequently to lipid homeostasis through regulation of biliary lipid secretion in a bile salts dependent manner (PubMed:15791618, PubMed:16332456, PubMed:18985798, PubMed:19228692, PubMed:20010382, PubMed:20398791, PubMed:22262466, PubMed:24711118, Pub
Apical cell membraneRecycling endosome membraneEndosomeCell membrane
Cholestasis, progressive familial intrahepatic, 2
A disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease before adulthood. PFIC2 inheritance is autosomal recessive.
Serine/threonine protein kinase that may be involved in the regulation of pre-mRNA processing. It may phosphorylate components of nuclear splice factor compartments (SFC), such as non-snRNP splicing factors containing a serine/arginine-rich domain (SR proteins). Reversible phosphorylation of SR proteins may cause their release into the nucleoplasm and change their local concentration, thereby influencing alternative splicing
Golgi apparatusCytoplasm, cytoskeleton, microtubule organizing center, centrosomeNucleus speckleEndoplasmic reticulum membraneCell membraneCytoplasm
Cholestasis, progressive familial intrahepatic, 13
A form of progressive cholestasis, a disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease. PFIC13 is an autosomal recessive form characterized by progressive liver dysfunction and chronic renal failure often associated with unilateral renal agenesis and glomerulosclerosis.
May be involved in vesicular trafficking via its association with the CART complex. The CART complex is necessary for efficient transferrin receptor recycling but not for EGFR degradation. Required in a complex with RAB11A and RAB11FIP2 for the transport of NPC1L1 to the plasma membrane. Together with RAB11A participates in CFTR trafficking to the plasma membrane and TF (transferrin) recycling in nonpolarized cells. Together with RAB11A and RAB8A participates in epithelial cell polarization. Tog
Cytoplasm
Diarrhea 2, with microvillus atrophy, with or without cholestasis
A disease characterized by onset of intractable life-threatening watery diarrhea during infancy. Two forms are recognized: early-onset microvillus inclusion disease with diarrhea beginning in the neonatal period, and late-onset, with first symptoms appearing after 3 or 4 months of life.
Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxycholic acid (CDCA), lithocholic acid, deoxycholic acid (DCA) and allocholic acid (ACA). Plays a essential role in BA homeostasis through the regulation of genes involved in BA synthesis, conjugation and enterohepatic circulation. Also regulates lipid and glucose homeostasis and is involved innate immune response (PubMed:10334992, PubMed:10334993, PubMed:21383957, PubMed:22820415). The FXR-RXR heterodimer binds
Nucleus
ATP-dependent transporter of the ATP-binding cassette (ABC) family that binds and hydrolyzes ATP to enable active transport of various substrates including many drugs, toxicants and endogenous compound across cell membranes. Transports a wide variety of conjugated organic anions such as sulfate-, glucuronide- and glutathione (GSH)-conjugates of endo- and xenobiotics substrates (PubMed:10220572, PubMed:10421658, PubMed:11500505, PubMed:16332456). Mediates hepatobiliary excretion of mono- and bis-
Apical cell membrane
Dubin-Johnson syndrome
Autosomal recessive disorder characterized by conjugated hyperbilirubinemia, an increase in the urinary excretion of coproporphyrin isomer I, deposition of melanin-like pigment in hepatocytes, and prolonged retention of sulfobromophthalein, but otherwise normal liver function.
UDP-glucuronosyltransferase (UGT) that catalyzes phase II biotransformation reactions in which lipophilic substrates are conjugated with glucuronic acid to increase the metabolite's water solubility, thereby facilitating excretion into either the urine or bile (PubMed:12181437, PubMed:15472229, PubMed:18004206, PubMed:18004212, PubMed:18719240, PubMed:19830808, PubMed:23288867, PubMed:15231852, PubMed:21422672, PubMed:38211441). Essential for the elimination and detoxification of drugs, xenobiot
Endoplasmic reticulum membraneCytoplasm, perinuclear region
Gilbert syndrome
Occurs as a consequence of reduced bilirubin transferase activity and is often detected in young adults with vague non-specific complaints.
Mediates the Na(+)-independent uptake of organic anions (PubMed:10779507, PubMed:15159445, PubMed:17412826). Shows broad substrate specificity, can transport both organic anions such as bile acid taurocholate (cholyltaurine) and conjugated steroids (17-beta-glucuronosyl estradiol, dehydroepiandrosterone sulfate (DHEAS), and estrone 3-sulfate), as well as eicosanoid leukotriene C4, prostaglandin E2 and L-thyroxine (T4) (PubMed:10779507, PubMed:11159893, PubMed:12568656, PubMed:15159445, PubMed:17
Basolateral cell membraneBasal cell membrane
Hyperbilirubinemia, Rotor type
An autosomal recessive form of primary conjugated hyperbilirubinemia. Affected individuals develop mild jaundice not associated with hemolysis shortly after birth or in childhood. They have delayed plasma clearance of the unconjugated anionic dye bromsulphthalein and prominent urinary excretion of coproporphyrin I. Hepatic pigmentation is normal.
Plays a role in tight junctions and adherens junctions (By similarity). Acts as a positive regulator of RANKL-induced osteoclast differentiation, potentially via mediating downstream transcriptional activity (By similarity)
Cell junction, adherens junctionCell membraneCell junction, tight junctionNucleus
Hypercholanemia, familial, 1
A disorder characterized by elevated serum bile acid concentrations, itching, and fat malabsorption.
Plays an important role in integrin-mediated signaling and functions both in regulating cell migration and immune responses. Promotes formation of focal adhesion complexes, activation of the protein kinase PTK2/FAK1 and subsequent phosphorylation of MAPK1 and MAPK3. Promotes production of pro-inflammatory cytokines by monocytes and macrophages. Plays an important role in modulating inflammation and T-cell-mediated immune responses. Promotes axon growth in the embryonic olfactory bulb. Promotes a
Cell membrane
Cholestasis, progressive familial intrahepatic, 11
An autosomal recessive form of progressive cholestasis, a disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease.
Essential component of the Ost-alpha/Ost-beta complex, a heterodimer that acts as the intestinal basolateral transporter responsible for bile acid export from enterocytes into portal blood (PubMed:16317684). Efficiently transports the major species of bile acids (taurocholate) (PubMed:16317684). Taurine conjugates are transported more efficiently across the basolateral membrane than glycine-conjugated bile acids (By similarity). Can also transport steroids such as estrone 3-sulfate and dehydroep
Cell membraneEndoplasmic reticulum membrane
Cholestasis, progressive familial intrahepatic, 6
An autosomal recessive form of progressive cholestasis, a disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease. PFIC6 patients have elevated liver transaminases and congenital diarrhea.
Catalytic component of a P4-ATPase flippase complex which catalyzes the hydrolysis of ATP coupled to the transport of phospholipids, in particular phosphatidylcholines (PC), from the outer to the inner leaflet of the plasma membrane (PubMed:17948906, PubMed:25315773). May participate in the establishment of the canalicular membrane integrity by ensuring asymmetric distribution of phospholipids in the canicular membrane (By similarity). Thus may have a role in the regulation of bile acids transpo
Cell membraneApical cell membraneCell projection, stereociliumEndoplasmic reticulumGolgi apparatus
Cholestasis, progressive familial intrahepatic, 1
A disorder characterized by early onset of cholestasis that progresses to hepatic fibrosis, cirrhosis, and end-stage liver disease before adulthood. PFIC1 inheritance is autosomal recessive.
Medicamentos e terapias
Mecanismo: Ileal bile acid transporter inhibitor
Mecanismo: Ileal bile acid transporter inhibitor
Variantes genéticas (ClinVar)
149 variantes patogênicas registradas no ClinVar.
Vias biológicas (Reactome)
35 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Alteração do metabolismo e excreção de bilirrubina
Centros de Referência SUS
21 centros habilitados pelo SUS para Alteração do metabolismo e excreção de bilirrubina
Centros para Alteração do metabolismo e excreção de bilirrubina
Detalhes dos centros
Hospital Universitário Prof. Edgard Santos (HUPES)
R. Dr. Augusto Viana, s/n - Canela, Salvador - BA, 40110-060 · CNES 0003808
Serviço de Referência
Hospital de Apoio de Brasília (HAB)
AENW 3 Lote A Setor Noroeste - Plano Piloto, Brasília - DF, 70684-831 · CNES 0010456
Serviço de Referência
Hospital Estadual Infantil e Maternidade Alzir Bernardino Alves (HIABA)
Av. Min. Salgado Filho, 918 - Soteco, Vila Velha - ES, 29106-010 · CNES 6631207
Serviço de Referência
Hospital das Clínicas da UFG
Rua 235 QD. 68 Lote Área, Nº 285, s/nº - Setor Leste Universitário, Goiânia - GO, 74605-050 · CNES 2338424
Serviço de Referência
Hospital das Clínicas da UFMG
Av. Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte - MG, 30130-100 · CNES 2280167
Serviço de Referência
NUPAD / Faculdade de Medicina UFMG
Av. Prof. Alfredo Balena, 189 - 5 andar - Centro, Belo Horizonte - MG, 30130-100 · CNES 2183226
Serviço de Referência
Hospital Universitário João de Barros Barreto
R. dos Mundurucus, 4487 - Guamá, Belém - PA, 66073-000 · CNES 2337878
Serviço de Referência
Hospital de Clínicas da Universidade Federal de Pernambuco
Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife - PE, 50670-901 · CNES 2561492
Atenção Especializada
Instituto de Medicina Integral Prof. Fernando Figueira (IMIP)
R. dos Coelhos, 300 - Boa Vista, Recife - PE, 50070-902 · CNES 0000647
Serviço de Referência
Hospital de Clínicas da UFPR
R. Gen. Carneiro, 181 - Alto da Glória, Curitiba - PR, 80060-900 · CNES 2364980
Serviço de Referência
Hospital Universitário Pedro Ernesto (HUPE-UERJ)
Blvd. 28 de Setembro, 77 - Vila Isabel, Rio de Janeiro - RJ, 20551-030 · CNES 2280221
Serviço de Referência
Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/Fiocruz)
Av. Rui Barbosa, 716 - Flamengo, Rio de Janeiro - RJ, 22250-020 · CNES 2269988
Serviço de Referência
Hospital Universitário Onofre Lopes (HUOL)
Av. Nilo Peçanha, 620 - Petrópolis, Natal - RN, 59012-300 · CNES 2408570
Atenção Especializada
Hospital São Lucas da PUCRS
Av. Ipiranga, 6690 - Jardim Botânico, Porto Alegre - RS, 90610-000 · CNES 2232928
Serviço de Referência
Hospital de Clínicas de Porto Alegre (HCPA)
Rua Ramiro Barcelos, 2350 Bloco A - Av. Protásio Alves, 211 - Bloco B e C - Santa Cecília, Porto Alegre - RS, 90035-903 · CNES 2237601
Serviço de Referência
Hospital Universitário da UFSC (HU-UFSC)
R. Profa. Maria Flora Pausewang - Trindade, Florianópolis - SC, 88036-800 · CNES 2560356
Serviço de Referência
Hospital das Clínicas da FMUSP
R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo - SP, 05403-010 · CNES 2077485
Serviço de Referência
Hospital de Clínicas da UNICAMP
R. Vital Brasil, 251 - Cidade Universitária, Campinas - SP, 13083-888 · CNES 2748223
Serviço de Referência
Hospital de Clínicas de Ribeirão Preto (HCRP-USP)
R. Ten. Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto - SP, 14015-010 · CNES 2082187
Serviço de Referência
Instituto da Criança e do Adolescente (ICr-HCFMUSP)
Av. Dr. Enéas Carvalho de Aguiar, 647 - Cerqueira César, São Paulo - SP, 05403-000 · CNES 2081695
Serviço de Referência
UNIFESP / Hospital São Paulo
R. Napoleão de Barros, 715 - Vila Clementino, São Paulo - SP, 04024-002 · CNES 2688689
Serviço de Referência
Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Pesquisa e ensaios clínicos
Nenhum ensaio clínico registrado para esta condição.
Publicações mais relevantes
Urinary carbonic anhydrase 1 excretion is a marker of hemolysis-triggering conditions suitable for point-of-care testing.
Intravascular hemolysis accompanies diverse diseases, yet blood-based markers (eg, plasma-free hemoglobin [PFH], haptoglobin, lactate dehydrogenase [LDH], and bilirubin) are variably sensitive, nonspecific, or impractical for point-of-care use. We evaluated urinary carbonic anhydrase 1 (CA1) as a mechanistically grounded, urine-based marker of hemolysis in a multicenter study spanning the United Kingdom, Bangladesh, and Peru. We enrolled 234 participants: healthy adults and adults with inherited anemias (Oxford), newborns in intensive care (London), children and adults with complicated or uncomplicated malaria (Bangladesh), and adults attending rural clinics for various medical reasons (Peru). Urine CA1 and hemoglobin (Hb) were quantified by enzyme-linked immunosorbent assay and immunoblot, with CA1:Hb stoichiometry used to distinguish intravascular hemolysis from urogenital blood contamination. Relationships with PFH, LDH, bilirubin, Hb, C-reactive protein (CRP), and clinical variables were tested using regression, principal component analysis, and decision tree. Reference urine samples were predominantly CA1-negative/Hb-negative. In inherited anemias, urinary CA1 was highest in sickle cell disease and correlated with serum LDH and inversely with blood Hb. In neonates, longitudinal CA1 trajectories stratified infants into physiological, transient, and sustained hemolysis groups; higher CA1 levels were associated with prematurity, elevated CRP and lower white blood cell count. Urinary CA1 was detected in Bangladeshi patients with elevated PFH and in cases of intravascular hemolysis not identified by PFH. Among Peruvian participants, urinary CA1 correlated with raised CRP level, consistent with inflammation being a prohemolytic trigger. To enable rapid and cost-effective testing, a lateral flow device was developed and verified for excellent sensitivity and specificity. Urinary CA1 provides a sensitive and practical readout of intravascular hemolysis suitable for point-of-care testing globally.
A novel pathogenic variant for dubin-johnson syndrome in a case of hyperbilirubinemia and metabolic associated fatty liver disease.
Dubin-Johnson Syndrome (DJS; OMIM 237500) is a rare autosomal recessive disorder caused by pathogenic variants in the ABCC2 gene, encoding for the multidrug resistance protein 2 (MRP2), resulting in impeded biliary excretion of bilirubin metabolites. It is typically characterized by chronic or intermittent jaundice and conjugated hyperbilirubinemia. We report the case of a 54-year-old male with hyperbilirubinemia (mostly conjugated) and hypertransaminasemia. Hypertransaminasemia was due to presence of Metabolic dysfunction-associated fatty liver disease (MASLD), while whole-genome sequencing revealed a homozygous missense variant affecting ABCC2 (c.3893G > A, p.Gly1298Asp), a previously undescribed variant likely linked to hyperbilirubinemia. It is an extremely rare genetic variant (allele frequency = 6.2 × 10-7). In silico analyses predicted the variant to be highly pathogenic (CADD score 29; AlphaMissense score 0.978; PhyloP 8.87; DynaMut ΔΔG = -0.765 kcal·mol-1 and ΔΔSVib = -0.234 kcal·mol-1·K-1). Structural modeling suggested no gross conformational changes but potential effects local conformation and overall function of the protein. We describe a novel ABCC2 mutation associated with Dubin-Johnson Syndrome. This finding expands the spectrum of ABCC2 variants to evaluate in case of hyperbilirubinemia and highlights the importance of genetic testing in unexplained cases of conjugated hyperbilirubinemia.
Bioactive Metabolites from Lactobacillus acidophilus-Fermented Products Mitigate Carbon Tetrachloride-Induced Liver Injury: Biochemical and In Silico Insights.
Fermented products derived from Lactobacillus have demonstrated therapeutic potential in the management of metabolic disorders, particularly liver diseases. This study aimed to evaluate the hepatoprotective effects of Lactobacillus-fermented products in a carbon tetrachloride (CCl4)-induced murine model of liver damage, with a focus on analyzing the influence of bioactive compounds on key liver function biomarkers. Two Lactobacillus strains (Lactobacillus acidophilus LB-CARS1 and L. acidophilus ST-CARS2) were isolated from commercial yogurts, and milk was fermented using each strain. A total of 40 male Swiss Albino mice were allocated into 5 experimental groups: control, CCl4-only, CCl4 + silymarin, and 2 treatment groups receiving CCl4 plus 1 of the 2 lactic acid bacteria (LAB)-fermented products. After 6 wk, serum concentrations of aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and creatinine were measured. A protein-protein network was constructed using the proteins responsible for hepatoprotection. The cellular pathways of these proteins were also visualized by the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. Molecular docking was performed to assess interactions between identified bioactive compounds and target proteins (superoxide dismutase, catalase, transforming growth factor-β 1, peroxisome proliferator-activated receptor γ, IL-6, and tumor necrosis factor-α). Treatment with LAB-fermented products significantly reduced (P < 0.05) serum AST, ALT, ALP, bilirubin, and creatinine concentrations in the CCl4-treated mice. The 2 products reduced the liver enzymes, though their intensity was different. The interactive pathways of the protein network revealed the most common genes responsible for hepatoprotective activity. Molecular docking revealed strong binding affinities between bioactive compounds and proteins related to inflammation and oxidation. Furthermore, absorption, distribution, metabolism, excretion, and toxicity analysis suggested the potential drug candidates among the docked compounds. The results indicate that LAB-fermented products contain bioactive compounds capable of attenuating liver injury, likely through anti-inflammatory and antioxidant mechanisms, highlighting their potential as functional food interventions in hepatoprotection.
Clinical and Demographic Profile of Wilson Disease in Young Adults: A Retrospective Study at a Tertiary Care Center in Peshawar, Pakistan.
Background Wilson disease (WD) is a rare autosomal recessive disorder of copper metabolism and an important treatable cause of hepatic dysfunction in young adults. Data from South Asian populations remains limited. Hence, the current study aimed to assess the demographic characteristics, clinical features, and diagnostic profile of patients with WD presenting at a tertiary care hospital in Peshawar, Pakistan. Methods This retrospective descriptive study was conducted in the Department of Medicine, Hayatabad Medical Complex, Peshawar, between January 2023 and December 2024. Medical records were systematically reviewed to identify all patients diagnosed with WD during this period. 21 patients with a confirmed WD diagnosis based on the modified Leipzig scoring system (score ≥ 4) and complete diagnostic workup were included. Complete diagnostic data was defined as documented serum ceruloplasmin, 24-hour urinary copper excretion, liver function tests, slit-lamp examination for Kayser-Fleischer (KF) rings, and negative screening for viral and autoimmune hepatitis. Demographic, clinical, and biochemical data were extracted from hospital records and analyzed using SPSS version 25. Post-hoc ethical approval was obtained from the institutional review board. Results The mean age at presentation was 23.2 ± 4.8 years (range 18-35), with a male-to-female ratio of 2:1. 15 patients (71.4%) were between 18 and 25 years of age. Jaundice was the predominant symptom, observed in 21 (100%) patients, while hepatomegaly and KF rings were observed in 18 (85.7%) and 12 (57.1%) of patients, respectively. The mean 24-hour urinary copper excretion was 1,450.3 ± 420.7 µg/day, and the mean serum ceruloplasmin level was 8.4 ± 3.2 mg/dL. Four patients (19%) were from two consanguineous families. A positive correlation between urinary copper and total bilirubin levels was observed (r = 0.74, p < 0.001). Conclusion WD in this internal medicine cohort primarily affected young adults presenting with hepatic manifestations, most commonly jaundice. Elevated urinary copper excretion and reduced serum ceruloplasmin levels were consistent diagnostic findings. Familial clustering, particularly in consanguineous families, was also observed, indicating a pattern consistent with autosomal recessive inheritance within this population.
Development of a Physiologically Based Model of Bilirubin Metabolism in Health and Disease and Its Comparison With Real-World Data.
Bilirubin is a breakdown product of erythrocytes and plays a crucial role in elimination of heme-containing proteins. After its synthesis in the reticuloendothelial system, unconjugated bilirubin is released into plasma and taken up into the liver. In hepatocytes, bilirubin is conjugated and excreted into the gastrointestinal tract via bile, where it is further converted to urobilinoids. There are various genetic factors causing abnormal bilirubin levels in plasma, such as Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome. To better understand bilirubin metabolism and its disorders, this study develops a physiologically based computational model incorporating published literature as well as real-world clinical data from the Explorys database. The model simulates bilirubin levels in both healthy individuals and patients with disorders of bilirubin metabolism. Population simulations show that Gilbert syndrome requires a substantial reduction in UDP-glucuronosyltransferase 1A1 activity, while Crigler-Najjar syndrome requires near-complete loss of its function. In contrast, Dubin-Johnson syndrome is characterized by a significant impairment of multidrug resistance-associated protein 2 activity. To also illustrate model behavior under targeted perturbations, we simulated administration of atazanavir in healthy individuals and patients with Gilbert syndrome to investigate its effect on bilirubin levels. Relative to baseline, unconjugated bilirubin maximum concentration (Cmax) increased by 34% in healthy individuals but by 67% in Gilbert syndrome. Overall, this study provides a conceptual and mechanistically informed framework for studying bilirubin homeostasis and the functional consequences of drug administration in health and disease.
Publicações recentes
Ver todas no PubMed📚 EuropePMCmostrando 83
Urinary carbonic anhydrase 1 excretion is a marker of hemolysis-triggering conditions suitable for point-of-care testing.
Blood global hematologyBioactive Metabolites from Lactobacillus acidophilus-Fermented Products Mitigate Carbon Tetrachloride-Induced Liver Injury: Biochemical and In Silico Insights.
Current developments in nutritionClinical and Demographic Profile of Wilson Disease in Young Adults: A Retrospective Study at a Tertiary Care Center in Peshawar, Pakistan.
CureusA novel pathogenic variant for dubin-johnson syndrome in a case of hyperbilirubinemia and metabolic associated fatty liver disease.
Scandinavian journal of gastroenterologyDevelopment of a Physiologically Based Model of Bilirubin Metabolism in Health and Disease and Its Comparison With Real-World Data.
CPT: pharmacometrics & systems pharmacologyStaged approach to overcome hyperbilirubinemia: tailored chemotherapy in liver metastases-a case report.
Journal of gastrointestinal oncologyLC-MS-Based Untargeted Metabolic Profiling in Plasma Following Dapagliflozin Administration in Healthy Volunteers.
MetabolitesOATP1B1/1B3 deficiency exacerbates hyperbilirubinemia in erythropoietic protoporphyria.
Drug metabolism and disposition: the biological fate of chemicalsBilirubin metabolism and its application in disease prevention: mechanisms and research advances.
Inflammation research : official journal of the European Histamine Research Society ... [et al.]Yinchenhao decoction alleviates obstructive jaundice liver injury by modulating epidermal growth factor receptor and constitutive androstane receptor signaling.
World journal of hepatologyChemotherapy-Induced Unconjugated Hyperbilirubinemia Complicated by Other Trigger Factors in a Child with T-Cell Acute Lymphoblastic Leukaemia and UGT1A1 Mutation-Associated Gilbert Syndrome.
Current oncology (Toronto, Ont.)Bilirubin bioconversion to urobilin in the gut-liver-kidney axis: A biomarker for insulin resistance in the Cardiovascular-Kidney-Metabolic (CKM) Syndrome.
Metabolism: clinical and experimentalArachidonic acid enhances hepatocyte bile acid uptake and alleviates cholestatic liver disease by upregulating OATP1 expression.
Food & functionRelapse following withdrawal of D-penicillamine from combination (D-penicillamine + zinc) therapy in hepatic Wilson disease.
Journal of pediatric gastroenterology and nutritionComparison of the efficacy of the gadoxetic acid MRI-derived relative enhancement index (REI) and functional liver imaging score (FLIS) in predicting liver function: validation with Albumin-Bilirubin (ALBI) grade.
Abdominal radiology (New York)Transport mechanism of human bilirubin transporter ABCC2 tuned by the inter-module regulatory domain.
Nature communicationsIs Environmental Cadmium Exposure Causally Related to Diabetes and Obesity?
CellsThe Effect of Probiotics on Phototherapy for Bilirubin Reduction in Term Neonates: A Randomized Controlled Trial.
Current pediatric reviewsAryl hydrocarbon receptor attenuates cholestatic liver injury by regulating bile acid metabolism.
Biochemical and biophysical research communicationsEvaluating variations in bilirubin glucuronidation activity by protease inhibitors in canine and human primary hepatocytes cultured in a 3D culture system.
Toxicology in vitro : an international journal published in association with BIBRAContinuous exposure to bisphenol S increases the accumulation of endogenous metabolic toxicants by obstructing the glucuronic acid pathway.
Environmental pollution (Barking, Essex : 1987)Gallic acid improves liver cirrhosis by reducing oxidative stress and fibrogenesis in the liver of rats induced by bile duct ligation.
Scandinavian journal of gastroenterologyBiochemical and Hematological Indexes of Liver Dysfunction in Horses.
Journal of equine veterinary scienceBile duct ligation differently regulates protein expressions of organic cation transporters in intestine, liver and kidney of rats through activation of farnesoid X receptor by cholate and bilirubin.
Acta pharmaceutica Sinica. BMechanism of crocin I on ANIT-induced intrahepatic cholestasis by combined metabolomics and transcriptomics.
Frontiers in pharmacologyA Case of Megaspleen With Micrographism.
CureusSystemic ASBT inactivation protects against liver damage in obstructive cholestasis in mice.
JHEP reports : innovation in hepatologyThe mechanism of Yinchenhao decoction in treating obstructive-jaundice-induced liver injury based on Nrf2 signaling pathway.
World journal of gastroenterologyRotor Syndrome Presenting as Dubin-Johnson Syndrome.
Case reports in gastroenterologyBenign inheritable disorders of bilirubin metabolism manifested by conjugated hyperbilirubinemia-A narrative review.
United European gastroenterology journalSexual dimorphism: increased sterol excretion leads to hypocholesterolaemia in female hyperbilirubinaemic Gunn rats.
The Journal of physiology4-Phenylbutyrate protects against rifampin-induced liver injury via regulating MRP2 ubiquitination through inhibiting endoplasmic reticulum stress.
BioengineeredUDP-glucuronosyltransferase 1A4-mediated N2-glucuronidation is the major metabolic pathway of lamotrigine in chimeric NOG-TKm30 mice with humanised-livers.
Xenobiotica; the fate of foreign compounds in biological systemsMechanism of bilirubin elimination in urine: insights and prospects for neonatal jaundice.
Clinical chemistry and laboratory medicineDubin-Johnson Syndrome as Differential Diagnosis for Neonatal Cholestasis.
Journal of pediatric gastroenterology and nutrition[Evaluating the efficacy of diet therapy with protein component modification at Wilson disease].
Voprosy pitaniiaHow Patients With Chronic Liver Diseases Succeed to Deal With COVID-19?
Frontiers in medicineImmune Checkpoint Inhibitor-induced Fanconi Syndrome.
CureusInduction of Steatohepatitis and Liver Tumorigenesis by Enforced Snail Expression in Hepatocytes.
The American journal of pathologyTemporal profile of HEV RNA concentration in blood and stool from patients with acute uncomplicated hepatitis E in a region with genotype 1 predominance.
Journal of viral hepatitisNon-urate transporter 1, non-glucose transporter member 9-related renal hypouricemia and acute renal failure accompanied by hyperbilirubinemia after anaerobic exercise: a case report.
BMC nephrologyYellow fever: profile of cases and factors associated with death in a hospital in the State of Rio de Janeiro, 2017-2018.
Revista de saude publicaCholemic Nephropathy Reloaded.
Seminars in liver diseaseArterial Blood Pressure at Liver Transplant Evaluation Predicts Renal Histology in Candidates With Renal Dysfunction.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation SocietyNineteenth-Century Homeopathic Repertories Predict Increased Urinary Excretion of Bile in Cholestasis but Not in Non-Cholestatic Infant Jaundice.
Homeopathy : the journal of the Faculty of HomeopathyPlants used for the treatment of icterus (jaundice) in Central India: A review.
Annals of hepatologyBody distribution of stable copper isotopes during the progression of cholestatic liver disease induced by common bile duct ligation in mice.
Metallomics : integrated biometal scienceLiver-directed gene therapy results in long-term correction of progressive familial intrahepatic cholestasis type 3 in mice.
Journal of hepatologyUnconjugated bilirubin and schizophrenia: a systematic review.
CNS spectrumsHeme oxygenase-1 induction by hemin prevents oxidative stress-induced acute cholestasis in the rat.
Clinical science (London, England : 1979)Neonatal Cholestasis: A Primer of Selected Etiologies.
Pediatric annalsMeconium microbiome associates with the development of neonatal jaundice.
Clinical and translational gastroenterologyUrinary excretion of homocysteine thiolactone and the risk of acute myocardial infarction in coronary artery disease patients: the WENBIT trial.
Journal of internal medicineAssociation of serum zinc with markers of liver injury in very heavy drinking alcohol-dependent patients.
The Journal of nutritional biochemistryUridine 5'-diphospho-glucronosyltrasferase: Its role in pharmacogenomics and human disease.
Experimental and therapeutic medicineBilirubin in the Liver-Gut Signaling Axis.
Trends in endocrinology and metabolism: TEMToxicity and toxicokinetics of Amanita exitialis in beagle dogs.
Toxicon : official journal of the International Society on Toxinology[The diagnostic value and limits of diagnostic parameters for Wilson's disease].
Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatologyInhibition of UDP-glucose dehydrogenase by 6-thiopurine and its oxidative metabolites: Possible mechanism for its interaction within the bilirubin excretion pathway and 6TP associated liver toxicity.
Journal of pharmaceutical and biomedical analysisThe UGT1A1*28 gene variant predicts long-term mortality in patients undergoing coronary angiography.
Clinical chemistry and laboratory medicineBis-choline tetrathiomolybdate in patients with Wilson's disease: an open-label, multicentre, phase 2 study.
The lancet. Gastroenterology & hepatologyp53-mediated regulation of bile acid disposition attenuates cholic acid-induced cholestasis in mice.
British journal of pharmacologyRole of Hepatobiliary Scintigraphy and Preoperative Liver Biopsy for Exclusion of Biliary Atresia in Neonatal Cholestasis Syndrome.
Indian journal of pediatricsSerum bilirubin levels are negatively associated with diabetic retinopathy in patients with type 1 diabetes and normal renal function.
International ophthalmologyDiagnosis and evaluation of hyperbilirubinemia.
Current opinion in gastroenterologyDrug- and Drug Abuse-Associated Hyperbilirubinemia: Experience With Atazanavir.
Clinical pharmacology in drug developmentThe role of Ntcp, Oatp2, Bsep and Mrp2 in liver injury induced by Dioscorea bulbifera L. and Diosbulbin B in mice.
Environmental toxicology and pharmacologyGunn Rats as a Surrogate Model for Evaluation of Hepatocyte Transplantation-Based Therapies of Crigler-Najjar Syndrome Type 1.
Methods in molecular biology (Clifton, N.J.)Anti-thymocyte globulin-induced hyperbilirubinemia in patients with myelofibrosis undergoing allogeneic hematopoietic cell transplantation.
Annals of hematologyCholic acid therapy in Zellweger spectrum disorders.
Journal of inherited metabolic diseaseCholedochojejunostomy with an innovative magnetic compressive anastomosis: How to determine optimal pressure?
World journal of gastroenterologyInherited disorders of bilirubin clearance.
Pediatric researchCoronary Artery Disease in Patients With Disorders of Bilirubin Excretion.
American journal of therapeuticsBiliverdin Reductase A (BVRA) Mediates Macrophage Expression of Interleukin-10 in Injured Kidney.
International journal of molecular sciencesElevated excretion of biopyrrin as a new marker for idiopathic Parkinson's disease.
Parkinsonism & related disordersGenetic and biochemical study of dual hereditary jaundice: Dubin-Johnson and Gilbert's syndromes. Haplotyping and founder effect of deletion in ABCC2.
European journal of human genetics : EJHGPolarized release of hepatic microRNAs into bile and serum in response to cellular injury and impaired liver function.
Liver international : official journal of the International Association for the Study of the LiverExpression of renal Oat5 and NaDC1 transporters in rats with acute biliary obstruction.
World journal of gastroenterologySerum bilirubin concentration is associated with eGFR and urinary albumin excretion in patients with type 1 diabetes mellitus.
Journal of diabetes and its complicationsBile cast nephropathy due to cholestatic jaundice after using stanozolol in 2 amateur bodybuilders.
Iranian journal of kidney diseasesPharmacological inhibition of apical sodium-dependent bile acid transporter changes bile composition and blocks progression of sclerosing cholangitis in multidrug resistance 2 knockout mice.
Hepatology (Baltimore, Md.)D-Galactosamine Intoxication in Experimental Animals: Is it Only an Experimental Model of Acute Liver Failure?
Medical science monitor : international medical journal of experimental and clinical researchBile duct ligation in mice: induction of inflammatory liver injury and fibrosis by obstructive cholestasis.
Journal of visualized experiments : JoVEAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Urinary carbonic anhydrase 1 excretion is a marker of hemolysis-triggering conditions suitable for point-of-care testing.
- A novel pathogenic variant for dubin-johnson syndrome in a case of hyperbilirubinemia and metabolic associated fatty liver disease.
- Bioactive Metabolites from Lactobacillus acidophilus-Fermented Products Mitigate Carbon Tetrachloride-Induced Liver Injury: Biochemical and In Silico Insights.
- Clinical and Demographic Profile of Wilson Disease in Young Adults: A Retrospective Study at a Tertiary Care Center in Peshawar, Pakistan.
- Development of a Physiologically Based Model of Bilirubin Metabolism in Health and Disease and Its Comparison With Real-World Data.
- Incidental Scleral Icterus in an Adolescent Male With Nausea: Clinical Diagnosis of Gilbert Syndrome in the Pediatric Outpatient Setting.
- Jaundice.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:309816(Orphanet)
- MONDO:0017755(MONDO)
- GARD:21347(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q55787331(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
