Definition

Presentation on
Glucuronidation
The mechanism by which the liver conjugates bilirubin
MEDICAL LABORATORY TECHNOLOGY

BIOLOGICAL CHEMISTRY (BMLS 116)
LEVEL 100
Names Of Group Members
 AMIRIBA ISRAEL AWINBISA

 CHANGA YUSSIF HADI
 MEENA TIBUORATAA EMMANUEL
 NIIBMIAT NYANNUMAAR ELISHA
 NAATULE JOSEPH
 BIYABILIN NIYASAGMA SAMPSON
 AJANG-BISA EDWINA
 MAMPASS ELIJAH
 MOHAMMED ABDUL MALIK NAMZOOYA
 AKAYILA FELICIA LAADI
 AKUMBUWINA BRIGHT
 JAMALDEEN IMBECHE
 WELPUO SILVANUS SANIBE
 BUABENG EVA EFUA ADADZEWA
 ABDUL- SAMED MUNIRA
 DOKURUGU ELIZABETH
 BASIMBO BRIGHT
 BAWA NIMOJER
LEARNING OBJECTIVES
1.Definition of bilirubin
2.Bilirubin formation
3.Bilirubin metabolism
4.Excretion through intestine
Definition of bilirubin
Bilirubin is a yellowish pigment produced
during the breakdown of the red blood cell.
It is processed by the liver and excreted in the
bile, playing a crucial role in the body’s waste
elimination process.
Bilirubin formation
Bilirubin is formed during the breakdown of heme, a component
of hemoglobin found in red blood cells. The process involves
several steps:
 Hemolysis : Aging red blood cells are broken down in the
spleen, releasing heme.
 Heme Breakdown:
Heme is enzymatically converted into biliverdin by the enzyme
heme oxygenase. This step releases carbon monoxide, iron, and
biliverdin.
Bilirubin Formation
 Biliverdin to Bilirubin:
Biliverdin is then converted into bilirubin by the enzyme
biliverdin reductase. This reaction also produces more carbon
monoxide.
 Transport to the Liver:

Unconjugated bilirubin (indirect bilirubin) is transported to the
liver bound to albumin in the bloodstream.
Bilirubin Formation
 Conjugation in the Liver:

In the liver, unconjugated bilirubin is conjugated with
glucuronic acid through the process of glucuronidation, forming
conjugated bilirubin (direct bilirubin).
 Excretion:
Conjugated bilirubin is then excreted into bile, stored in the
gallbladder, and eventually released into the small intestine.
Bilirubin Formation
 Conversion in the Intestine:

In the intestine, bilirubin undergoes further transformations by
bacteria, forming urobilinogen. Some urobilinogen is reabsorbed
and excreted in urine, while the rest is converted into stercobilin
and excreted in feces, giving them their characteristic color.
This entire process helps eliminate waste products from the
breakdown of red blood cells and maintains proper balance in the
body.
Hemoglobin degrading and bilirubin formation
Plasma
Hemoglobin
spleen
Globin
Heme Protein and AA pool
Iron Iron pool

Bilirubin
Bind with
Liver albumin
Conjugation
process
TO
LIVER
Types of bilirubin in serum
 Direct bilirubin: is conjugated (water soluble) bilirubin, it reacts rapidly with
reagent (direct reacting).
 Indirect bilirubin: is unconjugated (water insoluble) bilirubin because it is less
soluble, it reacts more slowly with reagent (reaction carried out in methanol).
 - in this case both conjugated and unconjugated bilirubin are measured given
total bilirubin. Unconjugated will calculated by subtracting direct from total
and so called indirect.
 Total bilirubin = D+ ID
 Knowing the level of each type of bilirubin has diagnostic important.

Normal Range of bilirubin
 1 ～ 16mol/l (0.1 ～ 1mg/dl) 4/5 are
unconjugated bilirubin, others are conjugated
bilirubin.
 <1mg/dl Normal
 1-2mg/dl Occult
 Hyperbilirubinemia
 >2mg/ dl Jaundice
Major differences between unconjugated and
conjugated bilirubin
Features Unconjugated bilirubin (Hemobilirubin) Conjugated bilirubin

Normal serum level The chief form of bilirubin in the blood Present in low conc. in the
blood
Water solubility Absent Present
Affinity to lipids Present Absent
Binding Bind to albumin Bind to glucuronic acid
Reaction to reagents Indirect (Total minus direct) Direct
Renal excretion Absent Present
Affinity to brain tissue Present (kernicterus), toxic Absent, less toxic
Bilirubin Metabolism
Bilirubin is a yellow pigment derived from the breakdown of heme, a

component of the hemoglobin in the red blood cells.
It undergoes several steps in metabolism :
1. Heme breakdown
2. Biliverdin conversion
3. Unconjugated bilirubin
4. Liver uptake
5. Conjugation
6. Excretion
7. Intestinal bacteria
8. Excretion in feces
9. Urobilinogen in urine
 Heme breakdown: Heme is broken down into biliverdin by the

enzyme heme oxygenase.
 Biliverdin conversion: Biliverdin is then converted into

bilirubin by the enzyme biliverdin reductase.
 Unconjugated bilirubin: Bilirubin is initially unconjugated and

insoluble in water. It binds to albumin and is transported to the
liver
 Liver uptake: In the liver, unconjugated bilirubin is taken up by

hepatocytes.
 Conjugation: Inside hepatocytes, bilirubin is conjugated with

glucuronic acid, forming water-soluble conjugated bilirubin
(bilirubin diglucuronide).
 Excretion: Conjugated bilirubin is then excreted into bile and

released into the small intestine.
 Intestinal bacteria: In the intestines, bacteria break down

bilirubin into urobilinogen.
 Excretion in feces: Urobilinogen is partially reabsorbed into

the bloodstream, while the remaining portion is excreted in
feces, giving them their characteristic brown color.
 Urobilinogen in urine: Some urobilinogen is also excreted in

the urine, contributing to the yellow color.
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Presentation on

MEDICAL LABORATORY TECHNOLOGY

 AMIRIBA ISRAEL AWINBISA

 Transport to the Liver:

 Conjugation in the Liver:

 Conversion in the Intestine:

Iron Iron pool

 Knowing the level of each type of bilirubin has diagnostic important.

Features Unconjugated bilirubin (Hemobilirubin) Conjugated bilirubin

Bilirubin is a yellow pigment derived from the breakdown of heme, a

 Heme breakdown: Heme is broken down into biliverdin by the

 Biliverdin conversion: Biliverdin is then converted into

 Unconjugated bilirubin: Bilirubin is initially unconjugated and

 Liver uptake: In the liver, unconjugated bilirubin is taken up by

 Conjugation: Inside hepatocytes, bilirubin is conjugated with

 Excretion: Conjugated bilirubin is then excreted into bile and

 Intestinal bacteria: In the intestines, bacteria break down

 Excretion in feces: Urobilinogen is partially reabsorbed into

 Urobilinogen in urine: Some urobilinogen is also excreted in

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