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Bilirubin and MS

Posted: Mon Jan 11, 2010 1:06 pm
by LR1234
Edit: I now believe high bilirubin is a negative rather than a positive MS


Hi all,
I found this article about Bilirubin.
I have always had high bilirubin levels (apparantly I have Gilbert's syndrome)
I now wonder if this could be a factor in why some people have a seemingly milder version of MS than others (I have had MS for 14 years and would be considered a mild case)
Has anyone else had their Bilirubin levels checked?

L

Bilirubin as a potent antioxidant suppresses experimental autoimmune encephalomyelitis: implications for the role of oxidative stress in the development of multiple sclerosis.

Liu Y, Zhu B, Wang X, Luo L, Li P, Paty DW, Cynader MS.

Brain Research Center, University of British Columbia, 2211 Wesbrook Mall, V6T 2B5, Vancouver, BC, Canada. yingru@interchange.ubc.ca

Increasing evidence shows that oxidative stress plays an important role in the pathogenesis of multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). In recent years, bilirubin has been demonstrated to be a potent antioxidant in vitro. In this study, we administered bilirubin to rats with acute and chronic EAE. Bilirubin prevented both acute and chronic EAE effectively. More significantly, bilirubin suppressed ongoing clinical EAE and halted EAE progression when given after disease onset. Subsequent histological examination showed that if administered to rats before the onset of EAE, bilirubin interfered with the invasion of inflammatory cells into the central nervous system (CNS) because it protected the blood-brain barrier (BBB) from free radical-induced permeability changes. However, in some cases, inflammation still occurred even when no clinical illness was observed. In rats with treatment initiated after the onset of EAE, despite the clinical improvements, treatment with bilirubin did not reduce the degree of CNS inflammation, or change cytokine expression in CNS lesions, indicating a lack of immunosuppressive effect of this treatment. By contrast, bilirubin treatment significantly alleviated oxidative damage in the spinal cord, and the clinical signs of EAE correlated well with the degree of oxidative injury in the lesions. Our results suggest that free radicals play an important role in the final effector stages of EAE, and that antioxidant therapies may have potential for the treatment of MS.

Posted: Mon Jan 11, 2010 1:49 pm
by shye
Very Interesting LR,
and could the bilirubin be high BECAUSE you have MS? ie, the body's way of producing an antioxidant when needed?

Posted: Mon Jan 11, 2010 1:59 pm
by LR1234
Not sure...
I got my liver results back and they are all well within normal limit:) except the bilirubin (but maybe that is not a problem)

Posted: Mon Jan 11, 2010 2:22 pm
by shye
I don't know--I would think something is wrong, just might be minor. Are you jaundiced?
If not liver, than maybe a blood problem? What would cause blood cells to break down faster than the norm (I think that is what would be going on if not a liver prob)?
How are your doctor's approaching it?

Posted: Mon Jan 11, 2010 2:42 pm
by LR1234
Apparantly this Gilberts syndrome is not dangerous,
I have been to see a liver specialist in the past, he said that when the bilirubin alone is raised its not problem. (If all the enzymes are raised along with the bilirubin then it is a sign of liver damage). I am very occasionally jaundice.

I might look into it all more though as I don't truly yet understand what bilirubin does.

Posted: Tue Jan 12, 2010 5:04 pm
by freiguy
I was told I had a high level of bilirubin about 20 years back. I was diagnosed with MS almost two years ago.

Posted: Thu Jan 27, 2011 4:23 am
by LR1234
Ok, I have following my blood tests and checking the bilirubin levels and how I am feeling.
When my Bilirubin is high my MS is more active and I have symptoms.
When it is low and in "normal" range my MS is practically non existant.

So maybe the body produces bilirubin in response to something like Shye suggested to help or as a reaction to the immune system.

If anyone is having a relapse I would be interested to see what your bilirubin levels come back as and then when you feel well if it has dropped.

At present my bilirubin is back in normal zone and my MS is behaving itself at the moment.

Posted: Fri Jan 28, 2011 6:44 am
by gymbuff
I have been on Tysabri for more than 3 years. My Bilirubin level is slightly elevated and my neurologist told me that if it goes higher than 30 and remains at that level for a period (didn't specify how long) I may have to go off Tysabri. It is now hovering around 30. Has anyone any suggestions for reducing it. I don't want to give up Tysabri - it works for me.
TIA :D
Gymbuff

Posted: Mon Feb 07, 2011 6:03 pm
by Apuman
LR1234 wrote:Apparantly this Gilberts syndrome is not dangerous,
I have been to see a liver specialist in the past, he said that when the bilirubin alone is raised its not problem. (If all the enzymes are raised along with the bilirubin then it is a sign of liver damage). I am very occasionally jaundice.

I might look into it all more though as I don't truly yet understand what bilirubin does.
I was tested about a year ago and I was found to have high bilirubin levels, and it had been about 4 months since my last relapse. My doctor was concerned about hepatitis, but when I tested negative, he diagnosed me with Gilbert's. He explained that it can actually be beneficial having the extra antioxidants in my system, though he declined to say anything about any connection to MS.

Posted: Mon Feb 07, 2011 6:15 pm
by Perkele
I also have the Gilbert's... coincidence?

Posted: Fri Feb 18, 2011 11:50 am
by numbness23
I also have very high levels, but in 4 short years i am in a wheelchair at 42 yrs of age so thee goes the antioxidant effects!!

I believe Gilberts is very common among mediterranean backgrounds. I am greek orthodox third generation...

Posted: Fri Feb 18, 2011 12:14 pm
by LR1234
I think when the bilirubin is high the MS is more active....when it is lower MS goes quiet.

Sorry to hear of your situation Numbness.

Posted: Fri May 13, 2011 1:20 am
by LR1234
Re-opening the thoughts on bilirubin and Gilberts syndrome.

Would be good to do a test when we are in a relapse and when we are in remission of liver function tests to see what the bilirubin is doing.

Has anyone else been told they have high levels?

Posted: Sat Aug 06, 2011 10:55 am
by LR1234
Taurine protects against bilirubin-induced neurotoxicity in vitro

Purchase
$ 35.95
Benzhong Zhanga, Xi Yangb and Xiaoling Gaoc, ,
a Institute of Toxicology, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
b Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada R3E 0W3
c Center of Clinical Laboratory, The Gansu People's Hospital, Lanzhou 730000, Gansu, China
Accepted 13 January 2010. Available online 21 January 2010.
Abstract
Kernicterus is a bilirubin-induced encephalopathy in newborn. Its spectrum ranges from subtle extrapyramidal to acute encephalopathy and chronic posticteric sequelae. Current treatment of this serious problem is far from optimal. Taurine has been documented to have protective effects on neuronal cells against ischemia in vivo and in vitro. This study used primary neuronal culture to investigate the toxicological effects of unconjugated bilirubin (UCB) and the protection of taurine against UCB-mediated neuron damage. Dose-dependent reduction of cell viability was found. Changes in neurite outgrowth preceded the reduction of cell viability. The bilirubin-mediated neurotoxicity is mainly due to increased rate of cell apoptosis and higher levels of intracellular free calcium ion level. Taurine dramatically improved cell viability in cultured neurons exposed to 12.5 µM UCB. Taurine pretreatment reduced UCB-mediated apoptotic cell death in primary cultured neurons in a concentration-dependent manner, which was associated with reversal of the increased intracellular free calcium ion levels caused by UCB. This study suggests the potential of taurine as a broad-spectrum agent for preventing and/or treating neuronal damage in neonatal jaundice.

http://www.sciencedirect.com/science/ar ... 931000106X

It seems high bilirubin can cause problems......

Posted: Sun Aug 07, 2011 12:27 am
by msmything
In addition to being detected in our blood, higher that normal bilirubin would also spill over in the urine, causing it to be darker, no matter how well hydrated you are.
It's also a part of the standard bedside urine tests done in ERs or Doc offices, giving results in a matter of 5 minutes or so.
One of the first places the early jaundice shows is in the whites of our eyes, pull your bottom lids down and take a look around.