Fig. 2From: Bile pigments in emergency and critical care medicineBile pigments and cardiovascular diseases. CL is bound to cytc in the inner mitochondrial membrane and is released during the early stages of apoptosis in cardiomyocytes. Once oxidized by ROS, cytc leaves the mitochondria through the outer mitochondrial membrane and takes part in apoptosis. It is thought that the antioxidative properties of BR inhibit the release of cytc and in turn, prevent apoptosis in cardiomyocytes. Furthermore, BR administration is known to inhibit inflammation through downregulation of TNF-α, NOX-2, and MCP-1 during cardiac ischemia/reperfusion injury. (CL: cardiolipin, cytc: cytochrome c, ROS: reactive oxygen species, BR: bilirubin, TNF: tumor necrosis factor, NOX: nicotinamide adenine dinucleotide phosphate oxidase, MCP: monocyte chemoattractant protein)Back to article page