Role in Treatment of Disease
While typically regarded as a mere waste product of heme breakdown, evidence that suggests that biliverdin — and other bile pigments — has a physiological role in humans has been mounting.
Bile pigments such as biliverdin naturally possess significant anti-mutagenic and antioxidant properties and therefore fulfill a useful physiological function. Biliverdin and bilirubin have been shown to be potent scavengers of peroxyl radicals. They have also been shown to inhibit the effects of polycyclic aromatic hydrocarbons, heterocyclic amines, and oxidants — all of which are mutagens. Studies have even found that people with higher concentrations levels of bilirubin and biliverdin in their bodies have a lower frequency of cancer and cardiovascular disease.
A 1996 study by McPhee et al. suggested that biliverdin — as well as many other tetrapyrrolic pigments — may function as an HIV-1 protease inhibitor. Of the fifteen compounds tested, biliverdin was one of the most active. In vitro experiments showed that biliverdin and bilirubin competitively inhibited HIV-1 proteases at low micromolar concentrations, reducing viral infectivity. However, when tested in cell culture with micromolar concentrations, it was found that biliverdin and bilirubin reduced infectivity by blocking viral entry into cells. Results were found to be similar for HIV-2 and SIV. Further research is needed to confirm these results, and to determine whether unconjugated hyperbilirubinemia has any effect on the progression of HIV infection.
Current research has suggested that the anti-oxidant properties of biliverdin and other bile pigments may also have a beneficial effect on asthma. This is because oxidative stress may play a vital role in the pathogenesis of asthma. A 2003 study found that asthma patients suffering from jaundice brought on by acute hepatitis B exhibited temporary relief of asthma symptoms. However, there could also have been confounding factors such as elevated levels of cortisol and epinephrine, so more research into this possibility is required.
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