Effect of bilirubin on cytochrome c oxidase activity of mitochondria from mouse brain and liver
© Malik et al; licensee BioMed Central Ltd. 2010
Received: 13 April 2010
Accepted: 9 June 2010
Published: 9 June 2010
The unbound, free concentration (Bf) of unconjugated bilirubin (UCB), and not the total UCB level, has been shown to correlate with bilirubin cytotoxicity, but the key molecular mechanisms accounting for the toxic effects of UCB are largely unknown.
Mouse liver mitochondria increase unbound UCB oxidation, consequently increasing the apparent rate constant for unbound UCB oxidation by HRP (Kp), higher than in control and mouse brain mitochondria, emphasizing the importance of determining Kp in complete systems containing the organelles being studied. The in vitro effects of UCB on cytochrome c oxidase activity in mitochondria isolated from mouse brain and liver were studied at Bf ranging from 22 to 150 nM. The results show that UCB at Bf up to 60 nM did not alter mitochondrial cytochrome c oxidase activity, while the higher concentrations significantly inhibited the enzyme activity by 20% in both liver and brain mitochondria.
We conclude that it is essential to include the organelles being studied in the medium used in measuring both Kp and Bf. A moderately elevated, pathophysiologically-relevant Bf impaired the cytochrome c oxidase activity modestly in mitochondria from mouse brain and liver.
Unconjugated bilirubin (UCB) at low concentrations is a potent antioxidant [1, 2] that is neuroprotective , while higher levels of UCB may damage neurons and astrocytes [3–6], resulting in bilirubin-induced neurological dysfunction (BIND) in some neonates with severe unconjugated hyperbilirubinemia. It has been shown that the unbound, free concentration (Bf) of unconjugated bilirubin (UCB), and not the total UCB level, correlates with bilirubin cytotoxicity , but the key molecular mechanisms accounting for the toxic effects of UCB are largely unknown. Although the primary subcellular targets for the toxic effects of UCB are not fully identified, mitochondria are believed to be particularly vulnerable [4, 8–12]. However, with few exceptions [10, 13], most prior research was performed at unbound UCB concentrations (Bf) orders of magnitude higher than its hypothesized upper normal limit of 20 nM (1.2 μg/dL) in plasma of term infants . In addition, most studies used unpurified commercial bilirubin, rendering uncertain whether the observed toxic effects were due to UCB itself, or to contaminants (especially lipids).
Here we demonstrate the need to include the organelles being studied in the medium used in measuring both Kp and Bf. This study further describe the in vitro effect of UCB, at Bf ranging from 22 to 150 nM, on cytochrome c oxidase (E.C. 18.104.22.168) activity in mitochondria isolated from mouse liver and brain. Cytochrome c oxidase is a crucial enzyme in aerobic energy metabolism, serving as the final electron acceptor complex in the mitochondrial electron transport. It catalyzes electron transfer from cytochrome c to molecular oxygen, reducing the latter to water, and yields substantial energy that drives the formation of a proton gradient that is then employed to synthesize cellular ATP . The absence, deficiency or malfunction of this enzyme in human leads to a number of serious disease states . The results obtained in this study are relevant to the in vivo impairment of mitochondrial function by elevated plasma levels of UCB.
Materials and methods
Bilirubin (Sigma Chemical Co.-Aldrich, Milan, Italy) was purified using the method of McDonagh and Assisi . Phenylmethanesulfonyl Fluoride (PMSF), p-Aminobenzamidine dihydrochloride (PAB HCl), ε-Amino-n-Caproic Acid (ε-ACA), n-dodecyl β-D-maltoside, L-ascorbic acid, horseradish peroxidase (Type 1 HRP, EC.22.214.171.124), cytochrome c from horse heart, and Bovine Serum Albumin (BSA) fraction V (Fatty-acid free) were purchased from Sigma Aldrich (St. Louis, MO, USA). Reagent grade hydrogen peroxide (H2O2, 30% wt/vol), hydrochloric acid (HCl, 37%), chloroform, sodium hydroxide and sucrose were purchased from Merck (Darmstadt, Germany). EDTA (disodium salt, dehydrate, crystal) was purchased from BDH (Dorset, England). Tris was purchased from Invitrogen (Carlsbad, CA, USA). HEPES was purchased from Gibco BRL (Grand Island, NY, USA).
Purified UCB was dissolved in chloroform (0.5 mg/mL) and the concentrations (μg/mL) determined spectrophotometrically as A453 nm × 0.974 × dilution factor . UCB was divided into 50 μg and 300 μg aliquots, and the chloroform evaporated under nitrogen at <65°C, and stored at -20°C until used. UCB was dissolved either in 0.01 N NaOH for Kp measurement or 0.5% vol/vol DMSO for Bf measurement and Complex IV Assay. H2O2 (1%) was prepared freshly each day by diluting 33.3 μL of 30% H2O2 with 967 μL of potassium phosphate buffer, pH 7.4. HRP stock solution (1 mg/mL) was prepared by dissolving 1 mg HRP in 1 mL potassium phosphate buffer, pH 7.4, and stored at -20°C. Mitochondria isolation buffers are as described in  for liver mitochondria and in  for brain mitochondria. Cytochrome c was reduced by L-ascorbate according to the method of . Full reduction of cytochrome c was confirmed by measuring the absorbance at 550 and 560 nm.
Isolation of mitochondria from mouse liver (LM) and brain (BM) were obtained by sacrificing six BALB/c mice (8-10 weeks) by decapitation (approved by the Eijkman Institute Research Ethics Commission). LM isolation was as in , and brain mitochondria (BM) isolation was as in . Mitochondrial protein concentration was determined by the modified Lowry Protein Assay . Determination of unbound bilirubin (Bf) was performed using the minimally-diluted peroxidase method  with modification . Unbound bilirubin was oxidized by peroxide (H2O2) in the presence of horseradish peroxidase (HRP) with first-order kinetics, while albumin-bound bilirubin was not . The preliminary standardization of the rate constant (Kp) for oxidation of unbound UCB was done by measuring the decrease in A440 following addition of HRP and H2O2 in a system containing buffer, UCB, and 100 μg of brain or liver mitochondria in the absence of albumin [22–24]. Unbound bilirubin (Bf) was determined in a complete system containing buffer, BSA, UCB, and 100 μg of brain or liver mitochondria, by measuring the decrease in A468 in the presence of HRP and H2O2. Bf was calculated from Kp, the HRP concentration, and the initial change of light absorbance peak at 468 nm over time [23, 24]. Triplicate determinations were performed for each measurement, and Kp or Bf was determined from the average of at least three mitochondrial preparations.
Cytochrome c oxidase activity was measured at 37°C as described previously, using 100 μg of brain or liver mitochondria [20, 25], and expressed as percent activity normalized to control incubations at the same BSA concentration but without UCB. The oxidation of cytochrome c by cytochrome c oxidase was followed spectrophotometrically at 550 nm for 30 s, assuming ε1 cm = 19,600 per mol for horse heart cytochrome c. The effect of purified UCB on the activity of cytochrome c oxidase was studied at low (22-31 nM and 60-61 nM) and high (92-107 nM and 142-150 nM) Bf concentrations.
Results for LM and BM were the average of triplicate determinations performed at each Bf level. All data are expressed as mean ± SD of at least 3 experiments obtained in 3 different preparations of mitochondria. Statistical differences were calculated according to the two-tailed Student's t-test, performed on the basis of equal or unequal variance as appropriate. p values lower than 0.05 were considered statistically significant.
Results and Discussion
Liver mitochondria increase the oxidation of unbound UCB
Effect of brain mitochondria (BM) and liver mitochondria (LM) on rate of peroxidation of unbound UCB by HRP (Kp)
vs control ( p )
Control a (n = 22)
0.406 ± 0.01
BM b (n = 15)
0.399 ± 0.02
LM c (n = 16)
0.699 ± 0.03
KCN inhibition of rate of peroxidation of unbound UCB by HRP (Kp)
Relative Kp a
vs LM b or BM c
Control (n = 18)
100 ± 3.1
0.5 mM KCN (n = 12)
84.7 ± 5.8 (p < 0.001)
1.0 mM KCN (n = 11)
73.4 ± 5.8 (p < 0.001)
BM b (n = 11)
99.2 ± 4.4 (p = 0.618)
0.5 mM KCN (n = 6)
88.7 ± 3.3 (p < 0.001)
89.4 ± 3.4 (p < 0.001)
1.0 mM KCN (n = 6)
72.1 ± 6.8 (p < 0.001)
72.1 ± 6.9 (p < 0.001)
LM c (n = 12)
172 ± 6.2 (p < 0.001)
0.5 mM KCN (n = 6)
102 ± 8.1 (p = 0.580)
59.4 ± 4.7 (p < 0.001)
1.0 mM KCN (n = 6)
83.8 ± 9.3 (p < 0.001)
48.8 ± 5.4 (p < 0.001)
The higher Kp values and the decrease of Kp due to KCN addition in the presence of LM indicate that LM contain higher levels of intrinsic peroxidases than BM, confirming previous studies . It has been reported that BM contains bilirubin oxidase, which also has been detected in other organs including liver [28, 29]. Other peroxidases known to be present in mitochondria include phospholipid hydroperoxide glutathione peroxidase (PHGPx) , glutathione peroxidase (GPx), catalase (CAT) [30, 31], and peroxiredoxin (Prx) III , which like other hemoproteins, are inhibitable by KCN [29, 31]. In LM, these intrinsic mitochondrial peroxidases contribute to the UCB oxidation measured in the presence of the added HRP, accounting for the almost 2× higher apparent Kp in the presence of LM compared to BM. These findings emphasize the importance of determining Kp in complete systems containing the organelles being studied.
Effects of B f on mitochondrial cytochrome c oxidase activity
Measured unbound bilirubin (Bf) concentrations at various ratios of [UCB]/[BSA]
UCB/BSA Ratio, [BSA] μM
(BM vs LM)
(control vs LM)
22.3 ± 3.4
22.6 ± 2.2
30.8 ± 2.2
p < 0.005
p < 0.005
61.4 ± 2.3
59.6 ± 2.0
61.5 ± 4.3
p = 0.215, NS
p = 0.788, NS
90.2 ± 2.6
93.4 ± 5.6
104 ± 4.6
p < 0.005
p < 0.005
141 ± 3.9
142 ± 3.4
150 ± 6.3
p < 0.005
p < 0.005
Cytochrome c oxidase activity of mouse liver and brain mitochondria exposed to different free bilirubin (Bf) concentrations
Percent Activity (%) vs control a
Range of Bf (nM)
105 ± 3.1
101 ± 1.8
104 ± 8.9
99.1 ± 3.1
82.0 ± 4.5 e
84.9 ± 3.5 e
82.6 ± 1.0 e
80.7 ± 5.8 e
We showed that, in the application of the peroxidase method, it is important to determine Kp, the first order rate constant for HRP-catalyzed UCB oxidation by peroxide in the absence of albumin; Kp is then used to calculate Bf, in a complete system containing the organelles being studied. As demonstrated in this study, liver mitochondria increase the oxidation of unbound UCB, thus increasing the apparent Kp. As stated at the beginning of this paper, Bf has been shown to correlate with bilirubin cytotoxicity. Bf measurement using the peroxidase method could improve the clinical management of neonatal jaundice by better recognizing babies that need treatment and minimizing unnecessary intervention .
The present study, using purified UCB at pathophysiologically relevant Bf concentrations, demonstrated that at modestly elevated Bf concentrations (about 90 and 150 nM), UCB inhibits cytochrome c oxidase activity by about 20% in both brain and liver mitochondria from mice. Exposure to lower, but still elevated Bf up to about approx. 60 nM did not significantly affect mitochondrial cytochrome c oxidase activity in either BM or LM. The lack of a progressive dose-response effect as Bf increased from approx. 100 to 150 nM, as well as the modest 20% impairment in cytochrome c oxidase activity, suggests that impairment of mitochondrial oxidative activity might not be a major factor in the toxic effects of UCB on these organelles. The results do not negate the reports by others that UCB alters mitochondrial function in other ways [9, 11], for example by altering mitochondrial membrane potential and triggering apoptosis by release of cytochrome c into the cytosol.
Our studies, done at Bf levels compatible with those in the plasma of jaundiced neonates, did not confirm the suggested greater sensitivity of BM than LM to toxic effects of UCB, derived from studies at vastly higher UCB concentrations , although it is important to bear in mind that the source of the brain mitochondria used in this study are a mixture of various type of cells, not only the ones that are sensitive to bilirubin toxicity, such as neuronal cells, but also the less sensitive ones, such as glial cells . These less sensitive cells might be masking the effect of bilirubin toxicity to the level similar to that of liver mitochondria.
The present work thus demonstrates the importance of comparing effects of UCB at comparable Bf levels, measured using the peroxidase method. It also demonstrates the need to include the organelles in the medium used in measuring both Kp and Bf.
We thank Drs. Sebastián D. Calligaris, Pablo Giraudi and Leslye Roca for bilirubin purification. This work was supported by TWAS Research Grants program in Basic Sciences (Research Grant Agreement (RGA) No. 05-064 RG/BIO/AS).
- Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN: Bilirubin is an antioxidant of possible physiological importance. Science. 1987, 235: 1043-1046. 10.1126/science.3029864.PubMedView ArticleGoogle Scholar
- Sedlak TW, Snyder SH: Bilirubin benefits: cellular protection by a biliverdin reductase antioxidant cycle. Pediatrics. 2004, 113: 1776-1782. 10.1542/peds.113.6.1776.PubMedView ArticleGoogle Scholar
- Dore S, Snyder SH: Neuroprotective action of bilirubin against oxidative stress in primary hippocampal cultures. Ann NY Acad Sci. 1999, 890: 167-172. 10.1111/j.1749-6632.1999.tb07991.x.PubMedView ArticleGoogle Scholar
- Cowger ML, Igo RP, Labbe RF: The mechanism of bilirubin toxicity studied with purified respiratory enzyme and tissue culture systems. Biochem. 1965, 4: 2763-2770. 10.1021/bi00888a029.View ArticleGoogle Scholar
- Ahlfors CE: Bilirubin-albumin binding and free bilirubin. J Perinatol Supl. 2001, 21: 40-42. 10.1038/sj.jp.7210631.View ArticleGoogle Scholar
- Ostrow JD, Pascolo L, Brites D, Tiribelli C: Molecular basis of bilirubin-induced neurotoxicity. Trends Mol Med. 2004, 10: 65-70. 10.1016/j.molmed.2003.12.003.PubMedView ArticleGoogle Scholar
- Calligaris S, Bellarosa C, Giraudi P, Wennberg RP, Ostrow JD, Tiribelli C: Cytotoxicity is predicted by unbound and not total bilirubin concentration. Pediatr Res. 2007, 62: 576-580. 10.1203/PDR.0b013e3181568c94.PubMedView ArticleGoogle Scholar
- Mustafa MG, Cowger ML, King TE: Effects of bilirubin on mitochondrial reactions. J Biol Chem. 1969, 244: 6403-6414.PubMedGoogle Scholar
- Noir BA, Boveris A, Garaza Pereira AM, Stoppani AO: Bilirubin: a multi-site inhibitor of mitochondrial respiration. FEBS Lett. 1972, 27: 270-274. 10.1016/0014-5793(72)80638-0.PubMedView ArticleGoogle Scholar
- Rodrigues CMP, Solá S, Silva R, Brites D: Bilirubin and amlyloid-β peptide induce cytochrome c release through mitochondrial membrane permeabilization. Mol Med. 2000, 6: 936-946.PubMed CentralPubMedGoogle Scholar
- Rodrigues CMP, Solá S, Brites D: Bilirubin induces apoptosis via the mitochondrial pathway in developing rat brain neurons. Hepatol. 2002, 35: 1186-1195. 10.1053/jhep.2002.32967.View ArticleGoogle Scholar
- Rodrigues CMP, Solá S, Brito MA, Brites D, Moura JJG: Bilirubin directly disrupts membrane lipid polarity and fluidity, protein order, and redox status in rat mitochondria. J Hepatol. 2002, 36: 335-341. 10.1016/S0168-8278(01)00279-3.PubMedView ArticleGoogle Scholar
- Silva RFM, Mata LR, Gulbenkian S, Brito A, Tiribelli C, Brites D: Inhibition of glutamate uptake by unconjugated bilirubin in cultured rat astrocytes: role of concentration and pH. Biochem Biophys Res Commun. 1999, 265: 67-72. 10.1006/bbrc.1999.1646.PubMedView ArticleGoogle Scholar
- Wennberg RP, Ahlfors CE, Bhutani VK, Johnson LH, Shapiro SM: Toward understanding kernicterus: a challenge to improve management of jaundiced newborns. Pediatrics. 2006, 117: 474-485. 10.1542/peds.2005-0395.PubMedView ArticleGoogle Scholar
- Capaldi RA: Structure and assembly of cytochrome c oxidase. Arch Biochem Biophys. 1990, 280: 252-262. 10.1016/0003-9861(90)90327-U.PubMedView ArticleGoogle Scholar
- Sarnat HB, Marín-García J: Pathology of mitochondrial encephalomyopathies. Can J Neurol Sci. 2005, 32: 152-166.PubMedView ArticleGoogle Scholar
- McDonagh AF, Assisi F: The ready isomerization of bilirubin-IXα in aqueous solution. Biochem J. 1972, 129: 797-800.PubMed CentralPubMedView ArticleGoogle Scholar
- Towers NR, Dixon H, Kellerman GM, Linnane AW: Biogenesis of mitochondria. 22. The sensitivity of rat liver mitochondria to antibiotics; a phylogenetic difference between a mammalian system and yeast. Arch Biochem Biophys. 1972, 151: 361-369. 10.1016/0003-9861(72)90510-3.PubMedView ArticleGoogle Scholar
- Sims NR: Mitochondrial isolation from brain: strategy, techniques, and criteria for purity. Method Toxicol. 1993, 2: 29-40.Google Scholar
- Trounce IA, Kim YL, Jun AS, Wallace DC: Assessment of mitochondrial oxidative phosphorylation in patient muscle biopsies, lymphoblasts and transmitochondrial cell lines. Method Enzymol. 1996, 264: 484-509. full_text.View ArticleGoogle Scholar
- Lowry OH, Rosebrough NJ, Farr AL, Randall RJ: Protein measurement with the Folin phenol reagent. J Biol Chem. 1951, 193: 265-275.PubMedGoogle Scholar
- Ahlfors CE: Measurement of Plasma Unbound Unconjugated Bilirubin. Anal Biochem. 2000, 279: 130-135. 10.1006/abio.2000.4485.PubMedView ArticleGoogle Scholar
- Roca L, Calligaris S, Wennberg RP, Ahlfors CE, Malik SG, Ostrow JD, Tiribelli C: Factors affecting the binding of bilirubin to serum albumins: validation and application of the peroxidase method. Pediatr Res. 2006, 60: 724-728. 10.1203/01.pdr.0000245992.89965.94.PubMedView ArticleGoogle Scholar
- Jacobsen J, Wennberg RP: Determination of unbound bilirubin in the serum of newborns. Clin Chem. 1974, 20: 783-789.PubMedGoogle Scholar
- Yonetani T: Studies on cytochrome c peroxidase. II.Stoichiometry between enzyme, H2O2, and ferrocytochrome c and enzymic determination of extinction coefficients of cytochrome c. J Biol Chem. 1965, 240: 4509-4514.PubMedGoogle Scholar
- Capaldi RA, Marusich MF, Taanman JW: Mammalian cytochrome-c oxidase: characterization of enzyme and immunological detection of subunits in tissue extracts and whole cells. Method Enzymol. 1995, 260: 117-132. full_text.View ArticleGoogle Scholar
- Patel SP, Katyare SS: A comparative study of reactive oxygen species (ROS) related parameters in rat tissues. Ind J Clin Biochem. 2006, 21: 48-53. 10.1007/BF02913066.View ArticleGoogle Scholar
- Brodersen R, Bartels P: Enzymatic oxidation of bilirubin. Eur J Biochem. 1969, 10: 468-473. 10.1111/j.1432-1033.1969.tb00712.x.PubMedView ArticleGoogle Scholar
- Hansen TW, Allen JW: Oxidation of bilirubin by brain mitochondrial membranes--dependence on cell type and postnatal age. Biochem Mol Med. 1997, 60: 155-160. 10.1006/bmme.1996.2565.PubMedView ArticleGoogle Scholar
- Panfili E, Sandri G, Ernster L: Distribution of glutathione peroxidases and glutathione reductase in rat brain mitochondria. FEBS Lett. 1991, 290: 35-37. 10.1016/0014-5793(91)81219-X.PubMedView ArticleGoogle Scholar
- Salvi M, Battaglia V, Brunati AM, La Rocca N, Tibaldi E, Pietrangeli P, Marcocci L, Mondovi B, Rossi AC, Toninello A: Catalase takes part in rat liver mitochondria oxidative stress defense. J Biol Chem. 2007, 282: 24407-24415. 10.1074/jbc.M701589200.PubMedView ArticleGoogle Scholar
- Chang TS, Cho CS, Park S, Yu S, Kang SW, Rhee SG: Peroxiredoxin III, a mitochondrion-specific peroxidase, regulates apoptotic signaling by mitochondria. J Biol Chem. 2004, 279: 41975-41984. 10.1074/jbc.M407707200.PubMedView ArticleGoogle Scholar
- Zelenka J, Lenícek M, Muchová L, Jirsa M, Kudla M, Balaz P, Zadinová M, Ostrow JD, Wong RJ, Vítek L: Highly sensitive method for quantitative determination of bilirubin in biological fluids and tissues. J Chromatogr B Analyt Technol Biomed Life Sci. 2008, 867: 37-42. 10.1016/j.jchromb.2008.03.005.PubMedView ArticleGoogle Scholar
- Vaz AR, Delgado-Esteban M, Brito MA, Bolaños JP, Brites D, Almeida A: Bilirubin selectively inhibits cytochrome c oxidase activity and induces apoptosis in immature cortical neurons: assessment of the protective effects of glycoursodeoxycholic acid. J Neurochem. 2010, 112: 56-65. 10.1111/j.1471-4159.2009.06429.x.PubMedView ArticleGoogle Scholar
- Weisiger RA, Ostrow JD, Koehler RK, Webster CC, Mukerjee P, Pascolo L, Tiribelli C: Affinity of human serum albumin for bilirubin varies with albumin concentration and buffer composition: results of a novel ultrafiltration method. J Biol Chem. 2001, 276: 29953-29960. 10.1074/jbc.M104628200.PubMedView ArticleGoogle Scholar
- Notter MF, Kendig JW: Differential sensitivity of neural cells to bilirubin toxicity. Exp Neurol. 1986, 92: 670-682. 10.1016/0014-4886(86)90246-3.View ArticleGoogle Scholar
- Silva RF, Rodrigues CM, Brites D: Rat cultured neuronal and glial cells respond differently to toxicity of unconjugated bilirubin. Pediatr Res. 2002, 51: 535-541. 10.1203/00006450-200204000-00022.PubMedView ArticleGoogle Scholar
- Ahlfors CE, Wennberg RP, Ostrow JD, Tiribelli C: Unbound (free) bilirubin (Bf): Improving the paradigm for evaluating neonatal jaundice. Clin Chem. 2009, 55: 1288-1299. 10.1373/clinchem.2008.121269.PubMedView ArticleGoogle Scholar