Bilirubin and Ischemic Stroke: Rendering the Current Paradigm to Better Understand the Protective Effects of Bilirubin

• Published in: Molecular neurobiology Vol. 56; no. 8; pp. 5483 - 5496
• Main Authors: Thakkar, Mrugesh, Edelenbos, Jurian, Doré, Sylvain
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2019; Springer Nature B.V
• Subjects: Animals; Antioxidants; Bilirubin; Bilirubin - chemistry; Bilirubin - therapeutic use; Biomarkers - metabolism; Biomedical and Life Sciences; Biomedicine; Brain Ischemia - complications; Brain Ischemia - drug therapy; Brain Ischemia - pathology; Cell Biology; Diuretics; Humans; Inflammation; Ischemia; Morbidity; Neurobiology; Neurology; Neuroprotection; Neuroprotective Agents - therapeutic use; Neurosciences; Oxidative Stress; Stroke; Stroke - complications; Stroke - drug therapy; Stroke - pathology; Treatment; Ischemia; Antioxidant; Protection; Outcomes
• ISSN: 0893-7648; 1559-1182
• DOI: 10.1007/s12035-018-1440-y

Novel and innovative methods are critical in fostering new treatments and improving clinical outcomes in patients who suffer from ischemic stroke. Bilirubin has long been considered metabolic waste that can be harmful to the body; however, it is now becoming recognized as one of the body’s most potent antioxidant, anti-inflammatory, and neuroprotective molecules. These properties facilitate bilirubin’s anti-atherogenic effects to impede and prevent the formation of thrombi in ischemic stroke. These functions allow for protection from neuronal injury during an ischemic state and suggest that elevated bilirubin levels may be linked to a lower rate of morbidity and mortality. Therefore, here we discuss the pathophysiology of stroke and the molecular properties of bilirubin to better understand their beneficial relationship. We outline clinical studies looking at the relationship between serum bilirubin levels and ischemic stroke prevalence. At this time, few studies have rigorously looked at the relationship between bilirubin and ischemic stroke, whether it is positive or negative. Thus, rigorous research is needed to provide evidence supporting the current studies, expand on these studies, and facilitate their translation to bedside therapy for patients who suffer from ischemic stroke.