18 Scopus citations


Bilirubin has several physiological functions, both beneficial and harmful. In addition to reactive oxygen species-scavenging activities, bilirubin has potent immunosuppressive effects associated with long-term pathophysiological sequelae. It has been recently recognized as a hormone with endocrine actions and interconnected effects on various cellular signaling pathways. Current studies show that bilirubin also decreases adiposity and prevents metabolic and cardiovascular diseases. All in all, the physiological importance of bilirubin is only now coming to light, and strategies for increasing plasma bilirubin levels to combat chronic diseases are starting to be considered. This review discusses the beneficial effects of increasing plasma bilirubin, incorporates emerging areas of bilirubin biology, and provides key concepts to advance the field.

Original languageEnglish
Pages (from-to)315-328
Number of pages14
JournalTrends in Molecular Medicine
Issue number4
StatePublished - Apr 2023

Bibliographical note

Funding Information:
This work was supported by National Institutes of Health grants R01DK121797 (to T.D.H.) and R01DK126884 (D.E.S.), National Heart, Lung and Blood Institute P01 HL05197-11 (D.E.S.) and K01HL125445 (T.D.H.), and National Institute of General Medical Sciences P20GM104357-02 (D.E.S.). This study was supported by grants MH CZ-DRO-VFN64165 (to L.V.) from the Czech Ministry of Health , Cooperation Program, research area DIAG provided by Charles University , and the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES LX22NPO5104 ) funded by the EU – 'Next Generation EU' .

Publisher Copyright:
© 2023 Elsevier Ltd


  • BVRA
  • Blvra
  • HO-1
  • Hmox1
  • bilirubin
  • cardiovascular disease
  • cell signaling
  • heme oxygenase
  • metabolism
  • nuclear receptors

ASJC Scopus subject areas

  • Molecular Medicine
  • Molecular Biology


Dive into the research topics of 'The physiology of bilirubin: health and disease equilibrium'. Together they form a unique fingerprint.

Cite this