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Bilirubin is a yellow breakdown product of heme catabolism, formed when heme is cleaved by heme oxygenase.1 This reaction produces carbon monoxide and biliverdin, which is rapidly reduced to bilirubin by biliverdin reductase. Bilirubin has key roles as a free radical scavenger with antioxidant and anti-inflammatory actions.1 Free and albumin-bound bilirubin can also scavenge nitric oxide (NO) and NO-related species. Unconjugated bilirubin is highly water-insoluble and must be conjugated with glucuronides to become water soluble and subsequently excreted by the liver and kidney.1
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1. Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease. Clin. Exp. Gastroenterol. 7, 307-328 (2014).