Effect of Bilirubin and Its Photodegradation Products on Adult and Newborn Blood Platelets

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  • SHIRAHATA Akira
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • NOJIRI Toshio
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • SHIIKI Midori
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • NAKAMURA Yuko
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health

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Other Title
  • Bilirubinならびにその光分解産物が成人血小板と新生児血小板に及ぼす影響

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Description

A case of newborn with disseminated intravascular coagulation (DIC) was experienced. The reaction of platelet to bilirubin and its photodegradation products was investigated in order to clarify the possibility that bilirubin and / or its photodegradation products induce DIC. Based on the fundamental study, various concentrations of bilirubin were added to gel filtrated platelet solutions (GFP), including 4.2 mM of CaCl2 and 8.3 mg/dl of bovine fibrinogen at final concentration (f.c.). The most intense aggregation was induced by 5-10 mg / dl of bilirubin (f.c.) in GFP from adult blood, whereas it was induced by 0.5-1.0 mg/dl of bilirubin (f.c.) in GFP from umbilical blood. The less intense aggregation was induced by photodegradation products of bilirubin, and no aggregation was observed after exposure to light for 80 minutes or longer.<BR> Adenosine triphosphate and serotonin were released from GFP of adults by addition of bilirubin, of which concentration ranged from 0.25 to 2.5 mg/dl (f.c.). Albumin (0.8 g/dl), ethanol (0.5%), prostaglandin E1(2×10-1μg/ml), prostaglandin I2(4×10-2μg/dl),aspirin (4×10-2mg/ml) and flurbiprofen (4×10-3mg/dl) of the final concentrations shown above, inhibited partially or perfectly the GFP aggregation of adults induced by f.c. 2.5mg/dI of bilirubin. Heparin enhanced the aggregation at low concentration (≤20 units/ml), but partial inhibition was observed at high concentration(≥40 units/ml). However, dl-α-tocopherol (≤300 mg/dl) had no inhibitory effect on the aggregation. The decreased rate of the aggregation induced by collagen was observed after exposure to light in platelet rich plasma from newborn blood, but not in platelet rich plasma from adult blood. Also, shortening of plasma clotting time was observed after exposure to light in the case of newborn blood but not in the case of adult blood.<BR> These results indicate that phototherapy may induce DIC by activation of platelets, especially in neonates.

Journal

  • Journal of UOEH

    Journal of UOEH 3 (2), 145-154, 1981

    University of Occupational and Environmental Health, Japan

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