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Bilirubin, an endogenous metabolite with many significant physiological roles, particularly anti-inflammatory properties, shows great promise as a treatment for inflammatory diseases. However, the binding targets and downstream signaling mechanisms of bilirubin remain unclear. Here, by using quantitative phosphorylation proteomics and several powerful chemical biology techniques such as the Cellular Thermal Shift Assay (CETSA), molecular docking, and MicroScale Thermophoresis (MST), it is identified and confirmed that with-no-lysine (K) kinase 1 (WNK1) is the primary target of bilirubin at physiological concentrations. Bilirubin binds to the kinase domain of WNK1, activating its kinase activity and increasing the intracellular chloride ion concentration via the downstream SPAK/OSR1-KCC2 pathway in neurons. Manipulating endogenous bilirubin levels by deleting Blvra, the bilirubin synthesis enzyme, and Ugt1a1, its metabolic enzyme, significantly promotes and inhibits the activation of the lipopolysaccharide (LPS)-induced NLRP3 inflammasome, respectively, in mouse hippocampus. Similarly, exogenous bilirubin supplementation suppressed LPS-induced NLRP3 inflammasome activation in mouse hippocampus in a WNK1-dependent manner. Quantitative phosphoproteomic analysis of WNK1 downstream signaling elucidated the broad biological roles of WNK1, notably its function in suppressing inflammation. The findings clarify the direct targets and signaling mechanisms underlying the anti-inflammatory effects of bilirubin and pave the way for exploring its novel functions.
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http://dx.doi.org/10.1002/advs.202407349 | DOI Listing |
Rev Med Interne
September 2025
Service d'hématologie biologique, CHU d'Amiens-Picardie, Amiens, France; HEMATIM UR4666, université Picardie Jules-Verne, Amiens, France.
The diagnosis of hemolysis is still based on straightforward biochemical parameters: haptoglobin (the most sensitive), lactate dehydrogenase (LDH), and unconjugated bilirubin. Anemia is not always present. Reticulocyte counts typically exceed 120×10/L, except in cases of associated vitamin deficiency or during the very early phase of acute hemolysis.
View Article and Find Full Text PDFAnn Hepatol
September 2025
Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Introduction And Objectives: Acute kidney injury (AKI) after liver transplantation (LT) impacts patient and graft outcomes. The Albumin-Bilirubin (ALBI) score, an objective and sensitive liver function index, may help predict post-LT outcomes. This study evaluated the association between neohepatic ALBI scores and renal outcomes in living donor LT (LDLT) recipients.
View Article and Find Full Text PDFAnn Surg
September 2025
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Objective: To determine the incidence, clinical outcomes, and anatomical risk factors of portal vein (PV)-related complications after right lobe donor hepatectomy (RLDH).
Summary Background Data: With the increase in living donor liver transplantation, large-scale studies on donor morbidity have been conducted to ensure donor safety. However, reports evaluating PV-related complications following right hepatectomy in living donors are lacking.
Arq Gastroenterol
September 2025
Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Background: Acute upper gastrointestinal bleeding (AUGIB) is a critical medical emergency and is a common cause of illness and death in individuals with liver cirrhosis.
Objective: The point of this study was to check how well the albumin-to-bilirubin ratio (ALBI) and model for end-stage liver disease (MELD) scores could predict how these patients would do in the future.
Methods: The Imam Khomeini Hospital gastroenterology department conducted a retrospective examination.
Eur J Case Rep Intern Med
July 2025
Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.
Background: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening hematologic emergency caused by ADAMTS13 deficiency, leading to microvascular thrombosis, haemolytic anaemia, thrombocytopenia, and end-organ damage. Neurological symptoms occur in up to 90% of cases and are frequently misdiagnosed as stroke. Prompt recognition and treatment reduce the mortality rate from over 90% to 10-20%.
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