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Sources of bilirubin Erythroid Non-erythroid (80%) (20%) • Normal: • Senescent erythrocytes Free heme • Abnormal: • Hemolysis:Extravascular Intravascular • Ineffective erythropoiesis • Cytochromes • Catalase • Peroxidase • Tryptophane pyrrolase • Myoglobin Opening of the heme ring and Enzyme-catalyzed formation of bilirubin OH O CH2 V M M CH2 N N CH2 H H O The linear structure of bilirubin: Two dipyrroles joined by a central methene bridge O OH C C CH2 V M M CH2 N N H O H Bilirubin contains several polar groups (shown in red): Yet, it is insoluble in water
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